Analise eletromiografica dos M. sternohyoideus e M. digastricus : venter anterior

Tese (livre-docencia) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O M. esterno-hióldeo e ventre anterior do M. digastrico esquerdo foram estudados eletromiograficamente em voluntários de 19 a 24 anos. Foi empregado um par de eletrodos, sendo um monopolar de superfície e outro monopolar de agulha. Implantado na massa do músculo. No movimento de abaixamento da mandíbula foram verificados grandes potenciais de ação nos dois músculos, que foram ativos também na propulsão, retrusão e lateralidade à esquerda e á direita da mandíbula. Agiram nos seguintes movimentos da língua: propulsão, lateralidade a esquerda e á direita e colocação da ponta da língua no palato duro, palato mole e assoalho da boca. O M. esterno-hióldeo e o ventre anterior do M. digastrico apresentam durante o movimento de abaixamento da mandíbula e movimentos da língua uma contração isotônica. Os dois músculos estuda dos não participam da cinesiologia da cabeçaAbstract: The sternohyod and anterior belly of the left digastric muscle were studied electromyographically In 20 normal adult volunteers ranging; In age from 19 to 24 years. A pair of electrods were Inserted In the mass of each muscle, being one of monopolar surface and the other of monopolar needle. High action potentials were obeserved In both muscles In the movement of lowering the mandible. The muscles were also active in the propulsion, retraction, lpsilateral and contralateral movements of the mandible. They presented activity in the protraction, ipsilateral and contralateral movements, of the tongue when putlng the tip of the organ on the hard and soft palate and on the floor of the month. The sternohyod and anterior belly of digastric muscles presented an isotonic contraction during the lowering of the mandible and movements of the tongue. Both muscles did not participate of the head kinesiologyLivre DocênciaLivre-Docente em Anatomi

Características da dor em portadores de disfunção temporomandibular: estudo piloto em pacientes com disfunção da coluna cervical

OBJECTIVE: The purpose of the present pilot study was to describe pain complaints of TMD patients and cervical spine dysfunction. METHODS: Fourteen women with myogenous TMD, cervical motion limitation and rotation of at least one of the three first cervical vertebrae evidenced by radiographic examination participated in this study. The multidimensional pain evaluation was accomplished by a Brazilian version of the McGill Pain Questionnaire. RESULTS: The results showed that the most painful body site mentioned was cervical spine, followed by scapular region and temporomandibular joint. More than half of the volunteers reported temporal pain pattern as rhythmic, periodic and, or still, intermittent. The majority of the patients classified the pain intensity assessed at the moment of the evaluation as mild to discomforting. Absolute agreement was not observed among volunteers regarding word dimensions used to describe their pain, although a great number of patients chose the descriptor related to tension as the better expression to describe their painful complaint. CONCLUSION: Pain characteristics of TMD patients with cervical spine dysfunction showed cervical spine as a common painful region reported and words related to affective and emotional dimensions of pain perception can be used by these patients to qualify their pain complain.OBJETIVO: O objetivo deste trabalho foi descrever as queixas de dor em portadores de Disfunção Temporomandibular (DTM) com disfunção da coluna cervical. MÉTODOS: Participaram desta pesquisa 14 portadores de DTM miogênica, do sexo feminino, com limitação do movimento cervical e rotação de pelo menos uma das três primeiras vértebras cervicais, diagnosticada através de exame radiográfico. A avaliação multidimensional da dor foi realizada usando uma versão brasileira do questionário McGill de dor (Br-MPQ). RESULTADOS: Foi observado que a região mais indicada como dolorosa foi a região cervical, seguida pela região da cintura escapular e articulação temporomandibular. Com relação ao padrão temporal da dor, mais da metade dos voluntários anotaram que suas queixas tinham uma característica ritmada, periódica ou intermitente. A intensidade da dor presente registrada no momento da avaliação foi classificada como de leve a forte para a maior parte dos participantes da pesquisa. Nenhuma das dimensões de palavras que descrevem a dor obteve concordância absoluta entre os voluntários, porém a maioria dos voluntários escolheu o descritor relacionado à tensão como a expressão que melhor descreve sua queixa dolorosa. CONCLUSÃO: A característica da queixa de dor, dos portadores de DTM e disfunção da coluna cervical, mostrou que a região cervical é a área mais freqüentemente indicada e que palavras relacionadas as dimensões afetiva e emocional, da percepção de dor, podem ser usadas por estes pacientes para qualificar sua queixa de dor

Cephalometric assessment of the hyoid bone position in Oral Breathing Children

SummaryMaterial and Methods: because of its anatomical and functional relationship with the craniofacial complex, we assessed the cephalometry of the hyoid bone position in relation to the respiratory pattern of these 53 female children, with average age of 10 years; 28 of them are nasal breathers and 25 are oral breathers. Horizontal, vertical and angular cephalometric measures were used in order to determine the hyoid bone location. The Student “t” and the Pearson correlation tests were used in order to compare the groups and the variables.ResultsWe did not see statistically significant differences in mandible and hyoid bone positions and the respiratory pattern. In the hyoid triangle, the 0.40 correlation coeficient was significant between AA-ENP (distance between the Atlas vertebrae and the posterior nasal spine) and C3-H (distance between the third cervical vertebrae and the hyoid bone) showing a positive relation between the bony limits of the upper and lower air spaces. For cranial measures we have suggested a relationship between the hyoid bone position and the mandible morphology.ConclusionThe results led us o conclude that the hyoid bone keeps a stable position, probably in order to secure correct ratios in the airways, and it does not depend on the respiratory pattern

CORRELATION BETWEEN ELECTROMYOGRAPHIC ACTIVITY AND STRENGTH OF THE FLEXOR MUSCLES OF THE WRIST

INTRODUCTION: In analysing the electromyographic (EMG) signal, researchers are often led to interpret variations of the signal as variation in strength of muscle contraction. However, the relationship between the force exerted and the electrical activity of a muscle are not well established. This is due to the considerable variation of data acquisition and processing techniques, the detection site of the muscles analysed, as well as the alterations in their length and the type of contraction. The object of this paper was to evaluate the correlation between electrical activity and muscular strength. METHODS AND PROCEDURES: The flexor muscles of the wrist of the non dominant member of 21 female volunteers (mean age = 21 years, sd = ± 1.5) with no history of skeletal muscle dysfuntion, were analysed. The EMG signal was captured by active surface electrode (DELSYS), over the belly of the muscle in the longitudinal sense of the fibres, having a gain of 10 Hz. The electrode was coupled to a 16 channel 12/36 electromyograph (AqDados - LYNX TECNOLOGIA ELETRÔNICA LTDA), which permitted a gain of 50 Hz. The system bandwidth was 10 to 500 Hz, with an overall gain of 1,000. The data acquisition rate was 1,000 Hz. In order to eliminate possible interferences, a ground electrode was coupled to the distal segment of the forearm. Muscular strength was measured by means of a load cell (model MM/50 kg, KRATOS), placed perpendicularly in the center of the palm surface of the hand. The electrode and the load cell were connected to a 16 channel signal acquisition system (AQDADOS 4.0, LYNIX). The temperature of the room was kept at 23ºC, ± 1. The EMG registers and the strength were collected simultaneously. Result were obtained from the average of three repetitions, shown in RMS and Kgf respectively. The data was collected with the hand fixed to a device which limited the wrist to 45º of flexion and 45º of extension, providing an isometric contraction. RESULTS AND DISCUSSION: The results demonstrated a positive correlation between electromyographic activity and strength of contraction (r = 0.76) in the 45º flexion position, whereas, for the 45º extension position, the correlation was not significant (r = 0.23), considering the sample analysed. The data suggest that there is a positive correlation between EMG and strength, depending on the position of the muscle analysed

Efficacy Of Electroacupuncture For Myofascial Pain In The Upper Trapezius Muscle: A Case Series.

Electroacupunture (EA) includes the passage of an electrical current through the acupuncture needle and is commonly used for pain relief. To evaluate the EA treatment effects for myofascial pain in the upper trapezius muscle. Twenty women aged ranging from 18 to 40 years (mean=24.95; SD=5.88 years), with a body mass index ranging from 19 to 25 kg/m2 (mean=22.33; SD=0.56 kg/m2), with regular menstrual cycles controlled by oral contraceptive, local or referred pain for more than six months and at least one myofascial trigger point in the upper trapezius participated in this study. The participants received a total of nine EA sessions over five weeks. The needles were inserted at the accupoints GB20, GB21, LV3, LI4, and at ashi points. A mixed current of 2 Hz and 100 Hz was applied alternatively every 5 seconds for 30 minutes. The outcomes were pain intensity measured by the visual analogue scale (VAS), pressure pain threshold (PPT) measured by an algometer, electromyography (EMG) and quality of life measured by the SF-36 questionnaire. Inter-occurrences between sessions were monitored. Paired t-test, Wilcoxon test, and repeated measure analysis of variance (ANOVA) having Tukey-Kramer as post-hoc tests were used. Significant improvement in pain intensity and in PPT occurred after treatment (P<0.0001). EMG of the right trapezius during contraction increased significantly, suggesting muscle function enhancement; the quality of life improved, related to physical components of the SF-36 (P<0.05). The EA showed to be a reliable method for myofascial pain relief. Large randomized blinded controlled trials might be carried out to confirm these results. Article registered in the Registro Brasileiro de Ensaios Clínicos under number RBR-4hb6f6.15371-

The effect of hip abduction on the EMG activity of vastus medialis obliquus, vastus lateralis longus and vastus lateralis obliquus in healthy subjects

STUDY DESIGN: Controlled laboratory study. OBJECTIVES: The purposes of this paper were to investigate (d) whether vastus medialis obliquus (VMO), vastus lateralis longus (VLL) and vastus lateralis obliquus (VLO) EMG activity can be influenced by hip abduction performed by healthy subjects. BACKGROUND: Some clinicians contraindicate hip abduction for patellofemoral patients (with) based on the premise that hip abduction could facilitate the VLL muscle activation leading to a VLL and VMO imbalance METHODS AND MEASURES: Twenty-one clinically healthy subjects were involved in the study, 10 women and 11 men (aged X = 23.3 ± 2.9). The EMG signals were collected using a computerized EMG VIKING II, with 8 channels and three pairs of surface electrodes. EMG activity was obtained from MVIC knee extension at 90° of flexion in a seated position and MVIC hip abduction at 0° and 30° with patients in side-lying position with the knee in full extension. The data were normalized in the MVIC knee extension at 50° of flexion in a seated position, and were submitted to ANOVA test with subsequent application of the Bonferroni multiple comparisons analysis test. The level of significance was defined as p ≤ 0.05. RESULTS: The VLO muscle demonstrated a similar pattern to the VMO muscle showing higher EMG activity in MVIC knee extension at 90° of flexion compared with MVIC hip abduction at 0° and 30° of abduction for male (p < 0.0007) and MVIC hip abduction at 0° of abduction for female subjects (p < 0.02196). There were no statistically significant differences in the VLL EMG activity among the three sets of exercises tested. CONCLUSION: The results showed that no selective EMG activation was observed when comparison was made between the VMO, VLL and VLO muscles while performing MVIC hip abduction at 0° and 30° of abduction and MVIC knee extension at 90° of flexion in both male and female subjects. Our findings demonstrate that hip abduction do not facilitated VLL and VLO activity in relation to the VMO, however, this study included only healthy subjects performing maximum voluntary isometric contraction contractions, therefore much remains to be discovered by future researc

Cephalometric assessment of the hyoid bone position in oral breathing children

MATERIAL AND METHODS: because of its anatomical and functional relationship with the craniofacial complex, we assessed the cephalometry of the hyoid bone position in relation to the respiratory pattern of these 53 female children, with average age of 10 years; 28 of them are nasal breathers and 25 are oral breathers. Horizontal, vertical and angular cephalometric measures were used in order to determine the hyoid bone location. The Student t and the Pearson correlation tests were used in order to compare the groups and the variables. RESULTS: We did not see statistically significant differences in mandible and hyoid bone positions and the respiratory pattern. In the hyoid triangle, the 0.40 correlation coeficient was significant between AA-ENP (distance between the Atlas vertebrae and the posterior nasal spine) and C3-H (distance between the third cervical vertebrae and the hyoid bone) showing a positive relation between the bony limits of the upper and lower air spaces. For cranial measures we have suggested a relationship between the hyoid bone position and the mandible morphology. CONCLUSION: The results led us o conclude that the hyoid bone keeps a stable position, probably in order to secure correct ratios in the airways, and it does not depend on the respiratory pattern.MATERIAL E MÉTODOS: em função das relações anatomofuncionais do osso hióide com o complexo craniofacial, realizou-se avaliação cefalométrica da posição do osso hióide em relação ao padrão respiratório. A amostra consistiu de 53 crianças, gênero feminino, com idades médias de 10 anos, sendo 28 respiradoras nasais e 25, bucais. As medidas cefalométricas horizontais, verticais e angulares foram utilizadas com a finalidade de determinar a posição do osso hióide. Estabeleceu-se uma comparação entre os grupos por meio do teste t de student, bem como correlação de Pearson entre as variáveis. RESULTADOS: Observou-se que não ocorreram diferenças estatísticas significativas para a posição mandibular e posição do osso hióide e o tipo do padrão respiratório. No Triângulo Hióideo, o coeficiente de correlação de 0,40 foi significativo entre AA-ENP (distância entre vértebra atlas e espinha nasal posterior) e C3-H (distância entre a terceira vértebra cervical e osso hióide) demonstrando uma relação positiva entre os limites ósseos do espaço aéreo superior e inferior. Para as medidas cranianas sugeriu-se uma relação entre a posição do osso hióide com a morfologia mandibular. CONCLUSÃO: Os resultados permitiram concluir que o osso hióide mantém uma posição estável, provavelmente, para garantir as proporções corretas das vias aéreas e não depende do padrão respiratório predominante.475

Eficácia da eletroacupuntura para dor miofascial do músculo trapézio: uma série de casos

BACKGROUND: Electroacupunture (EA) includes the passage of an electrical current through the acupuncture needle and is commonly used for pain relief. OBJECTIVE: To evaluate the EA treatment effects for myofascial pain in the upper trapezius muscle. METHODS: Twenty women aged ranging from 18 to 40 years (mean=24.95; SD=5.88 years), with a body mass index ranging from 19 to 25 kg/m2 (mean=22.33; SD=0.56 kg/m2), with regular menstrual cycles controlled by oral contraceptive, local or referred pain for more than six months and at least one myofascial trigger point in the upper trapezius participated in this study. The participants received a total of nine EA sessions over five weeks. The needles were inserted at the accupoints GB20, GB21, LV3, LI4, and at ashi points. A mixed current of 2 Hz and 100 Hz was applied alternatively every 5 seconds for 30 minutes. The outcomes were pain intensity measured by the visual analogue scale (VAS), pressure pain threshold (PPT) measured by an algometer, electromyography (EMG) and quality of life measured by the SF-36 questionnaire. Inter-occurrences between sessions were monitored. Paired t-test, Wilcoxon test, and repeated measure analysis of variance (ANOVA) having Tukey-Kramer as post-hoc tests were used. RESULTS: Significant improvement in pain intensity and in PPT occurred after treatment (P<0.0001). EMG of the right trapezius during contraction increased significantly, suggesting muscle function enhancement; the quality of life improved, related to physical components of the SF-36 (P<0.05). CONCLUSION: The EA showed to be a reliable method for myofascial pain relief. Large randomized blinded controlled trials might be carried out to confirm these results. Article registered in the Registro Brasileiro de Ensaios Clínicos under number RBR-4hb6f6.CONTEXTUALIZAÇÃO: A eletroacupuntura (EA) inclui a passagem de uma corrente elétrica pela agulha de acupuntura e é comumente utilizada para aliviar a dor. OBJETIVO: Avaliar o efeito da EA no tratamento da dor miofascial do músculo trapézio superior. MÉTODOS: Participaram 20 voluntárias com idade entre 18 e 40 anos (24,95±5,88 anos), índice de massa corpórea entre 19 e 25 kg/m2 (22,33±0,56 kg/m2), ciclo menstrual regulado por anticoncepcionais, dor por mais de seis meses no trapézio superior, com pelo menos um ponto gatilho miofascial. Nove sessões de EA foram agendadas, sendo duas por semana. As agulhas foram inseridas nos pontos VB20, VB21, F3, IG4 e em pontos ashi. Aplicou-se uma corrente alternada de 2 Hz e 100 Hz a cada 5 segundos durante 30 minutos. Avaliou-se a eficácia do tratamento quantificando a intensidade da dor com a Escala Visual Analógica (EVA); o limiar de dor à pressão (LDP), com algômetro digital, eletromiografia (EMG) e com o questionário de qualidade de vida SF-36. Possíveis fatores influenciadores entre as sessões foram monitorados. Aplicaram-se os testes t pareado, Wilcoxon e análise de variância com medidas repetidas (ANOVA) e, como post-hoc, o teste de Tukey-Kramer. RESULTADO: Após o tratamento, houve melhora na intensidade da dor e no LDP (P<0,0001). A EMG no trapézio direito, durante a contração, aumentou significativamente, sugerindo melhora da função muscular. A qualidade de vida melhorou considerando os componentes físicos do SF-36 (P<0,05). CONCLUSÃO: A EA mostrou-se confiável no alívio da dor miofascial. Estudos randomizados, cegos e controlados devem ser realizados para confirmar esses resultados. Artigo registrado no Registro Brasileiro de Ensaios Clínicos sob o número RBR-4hb6f6.37137

Behavior of cervical muscles in individuals with esophageal speech and artificial larynx

PURPOSE: to evaluate by the surface electromyography the behavior of the sternocleidomastoid and cervical paraspinalis muscles, bilaterally in patients who use esofagic and artificial larynx as alternative to talk and to determine if these conditions modify the cervical muscles behavior. METHODS: ten volunteers were evaluated (two women, eight men), with average age: 49. 7 years, with total laryngectomy, average time of postoperative: 2.6 years, with neck movements limitation, divided in two groups: group 1 with five volunteers (artificial larynx); group 2 with five volunteers (esofagic voice); and group 3 control (seven volunteers). RESULTS: there was no significant difference in the muscular activation pattern during phonation in individuals with esofagic voice and the artificial larynx compared to the control group, however, in the rest condition, there was a significant difference comparing the average values of Root Mean Square (RMS) of groups 1 and 2 with group 3, for the right sternocleidomastoid muscle and the right cervical paraspinalis muscles. CONCLUSION: the vocal option did not interfere on the muscular activation pattern during the phonation, as well as there was no difference in the muscular activation pattern comparing the experimental groups with the control group.OBJETIVO: avaliar através da eletromiografia de superfície o comportamento dos músculos esternocleidomastóideo e paraespinhais cervicais bilateralmente em pacientes que se comunicam por meio da fala esofágica e laringe artificial, para determinar se o tipo de voz utilizada altera o comportamento dos músculos cervicais. MÉTODOS: foram avaliados dez voluntários (duas mulheres e oito homens), idade média de 49,7 anos, com laringectomia total, tempo de pós-operatório médio de 2,6 anos, com limitação dos movimentos do pescoço, divididos em dois grupos: grupo 1: cinco voluntários (laringe artificial); grupo 2: cinco voluntários (voz esofágica); grupo 3 controle (sete voluntários). RESULTADOS: na fonação não houve alteração no padrão de ativação muscular dos indivíduos que utilizam a voz esofágica e a laringe artificial, com relação ao grupo controle. No entanto, na condição de repouso houve diferença significativa, comparando-se os valores médios de Root Mean Square dos grupos 1 e 2 com o grupo 3, para o músculo esternocleidomastóideo direito e para os músculos paraespinhais cervicais direito. CONCLUSÃO: o tipo de opção vocal não interferiu no padrão de ativação muscular durante a fonação, bem como não existiu diferença no padrão de ativação muscular na fonação dos voluntários quando comparados a indivíduos sem intercorrências no aparelho fonador.8290Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

ELECTROMYOGRAPHIC ACTIVITY OF THE VASTUS MEDIALIS OBLIQUE AND VASTUS LATERALIS LONGUS MM. DURING OPEN AND CLOSED KINETIC CHAIN EXERCISES

OBJECTIVES: The purpose of this study was to analyze the electromyographic activity of the Vastus Medialis Oblique (VMO) and Vastus Lateralis Longus (VLL) muscles during knee extension in Open Kinetic Chain Exercise, using a ‘knee extension table’, and in Closed Kinetic Chain Exercise, using a Horizontal Leg-Press (VITALLY). METHODS: The electromyographic activity of the VMO and VLL muscles was measured in 12 subjects between 18 and 23 years old (x=21.9 e SD=1.16), without prior hip, knee, and ankle pathologies, during Maximal Isometric Contraction (MCI) at 90º flexion of hip and knee. A 16-Channel EMG System (CAD 12/36 - 60 K - LINX) and differential surface electrodes (DELSYS) were used to obtain the data. The signal was recorded in Root Mean Square (RMS) and expressed in microvolts. The data analysis was performed through Student’s t-test at a 5% level of significance. RESULTS: The results showed that the electromyographic activity of the VMO muscle was significantly greater than that of the VLL muscle during Open and Closed Kinetic Chain Exercises. CONCLUSIONS: The data of this study, within the experimental conditions used, suggest that the VMO muscle can recover functionally by MCI at 90º flexion of hip and knee during Open Kinetic Chain Exercise, using an ‘extension table’, and also in Closed Kinetic Chain Exercise, using a Horizontal Leg-Press. This research was conducted in accordance with the National Council of Health (Resolution 196/96)