Comparison of the Electromyographic Activity of the Trunk and Rectus Femoris Muscles During Traditional Crunch and Exercise Using the 5-Minute Shaper Device.

Silva, FHO, Arantes, FJ, Gregorio, FC, Santos, FRA, Fidale, TM, Bérzin, F, Bigaton, DR, and Lizardo, FB. Comparison of the electromyographic activity of the trunk and rectus femoris muscles during traditional crunch and exercise using the 5-minute Shaper device. J Strength Cond Res 34(1): 1-10, 2020-Different training devices are available to trigger greater activation of the abdominal muscles compared with that achieved during traditional abdominal exercises. This study aimed to compare the electromyographic (EMG) activity of the upper and lower rectus abdominis, external oblique abdominis, erector spinae, and rectus femoris (RF) muscles during traditional crunch and exercise using the 5-minute Shaper device. A convenience sample of 15 healthy men (mean ± SD; age: 23.65 ± 4.49 years, body fat percentage: 14.26 ± 3.56%) was selected. All men regularly participated in physical activity. Electromyographic data were collected for 5 repetitions of each abdominal exercise (traditional crunch and exercise using the 5-minute Shaper device at beginner, intermediate, advanced, and extreme levels) in a randomized and counterbalanced manner. Data were collected using simple differential surface electrodes and analyzed using repeated-measures analysis of variance (p < 0.05). Electromyographic signals were quantified using a root-mean-square analysis and normalized using the maximum voluntary isometric contraction. Traditional crunch produced greater or similar EMG activity in the abdominal muscles and minimized RF activity compared to the 5-minute Shaper device, hence, traditional crunch is preferred for training, especially for individuals with weak abdominal musculature and lower back problems. Therefore, the use of the 5-minute Shaper device may be questioned when it is intended to intensify the activity of the abdominal muscles; however, this apparatus may be used if greater variations in training are desired, depending on individual preferences.

Correlation of stress and muscle activity of patients with different degrees of temporomandibular disorder.

[Purpose] Temporomandibular disorder is one of the many different adverse health conditions that can be triggered by stress. Therefore, a biopsychosocial model has been proposed to characterize the multifactorial nature of temporomandibular disorder. The aim of the present study was investigate the correlation of salivary cortisol levels with the activities of the masseter and anterior temporal muscles of patients with different degrees of temporomandibular disorder. [Subjects and Methods] Forty-nine women between 18 and 40 years of age with a diagnosis of myogenous temporomandibular disorder based on the Research Diagnostic Criteria for temporomandibular disorders were evaluated using the Fonseca Index to determine the degree of the disorder. Salivary cortisol levels were determined and surface electromyography was used to evaluate electrical activity in the masticatory muscles. [Results] Positive correlations were found among the degree of temporomandibular disorder, electromyographic activity and salivary cortisol: as women with more severe temporomandibular disorder had greater electrical activity in the muscles analyzed, especially the anterior temporal muscle, and higher levels of cortisol. [Conclusion] Muscle activity was greater among individuals with severe temporomandibular disorder and positive correlations were found among electromyographic activity, salivary cortisol and the degree of temporomandibular disorder severity.

Combined Therapy for Associated Orofacial Disorders-A Challenging Case Report.

Health promotion and disease prevention link intricately with lifestyle habits such as a healthy diet, physical activity, and good sleep quality. Temporomandibular joint (TMJ) dysfunction and associated disorders can take away sleep and well-being depending on the form and intensity that affect the individual. A multidisciplinary effort has contributed to significant health advances, improving clinical outcomes concerning TMJ dysfunction. This report presents the case of a 37-year-old Caucasian female physical educator with a good healthy diet with complaints of tooth tightening, constant TMJ and neck pain, and tinnitus. The patient was treated with inferior occlusal splint placement and selective occlusal adjustments based on neuro-occlusal rehabilitation. The patient reported relief of pain symptoms with occlusal and body balance, discontinued analgesic medication, and maintained the occlusal splint to practice sports and sleep due to the perception of improved physical performance and sleep, and quality of life. Based on this report, it is necessary to analyze the causes and define the effects of different disorders to establish their diagnosis and treatment and changing patterns to reestablish functional balance.

Effectiveness of a Uniquely Designed Oral Appliance on Obstructive Sleep Apnea Control: A Pilot Study.

OBJECTIVES: Obstructive sleep apnea is an inflammatory, chronic, and evolutive disease often needing adequate treatment and follow-up. The oral appliance (OA) is an accepted alternative therapy for obstructive sleep apnea (OSA) control. Due to greater adherence, OA with mandibular advancement (OAm) is being recommended treatment for patients who refuse or do not tolerate continuous positive airway pressure. The mode of action of OAm is to promote the advancement of the mandible or tongue with a subsequent increase in the tone of the pharyngeal muscles and the permeability of the upper airway, but most OAm use conventional models as reference, analogic, or digital, dissociating dental arches of the skull structures. MATERIALS AND METHODS: A retrospective longitudinal study of 33 OSA patient treated with a different OAm, that use Camper plane as reference with skull structures for dental arches disocclusion, where polysomnographic, cephalometric measures, and subjective data from questionnaires pre- and post-treatment were assessed and correlated. Descriptive analysis, correlated Chi-square tests, and basic statistics were used. Generalized linear mixed model for repeated measure and post hoc Tukey-Kramer test compares the variables pre- and post-treatment. Shapiro-Wilk test and Pearson's correlation coefficients were used. All statistical tests were set in 5% level of significance. RESULTS: Regarding polysomnography data, there was a significant association between apnea hypopnea index (AHI) with oxygen saturation, arousal index (AI) and the maximum heartbeats, and sleep improvement and health risk reduction. Additionally, from cephalometric data, it was found a significant association between the tongue posture with the soft palate, hioyd-C3 and, lower and posterior airway. When both parameters are correlated, there are a significant dependent association with hyoid bone position with AHI and AI. The limitation of this study was the two-dimensional image used without provide volumetric measurements, but this limitation was reduced with the follow-up polysomnography parameters. CONCLUSION: In this pilot study, DIORS OAm as an uniquely designed device using Camper plane as a reference for disocclusion was effective in the control of OSA.

Immediate effects on electromyographic activity and pressure pain thresholds after a cervical manipulation in mechanical neck pain: a randomized controlled trial.

OBJECTIVE: The purpose of this study was to identify the immediate effects of a manipulation of C5/C6 level on electromyography (EMG) of the deltoid muscle and in pressure pain thresholds (PPTs) in patients with mechanical neck pain. METHODS: Thirty-seven subjects with mechanical neck pain were randomly divided into 2 groups: manipulative group, which received a cervical spine manipulation targeted to C5/C6 segment, and a control group, which did not receive any procedure. Outcomes were EMG data of the deltoid muscle (rest, isometric contraction for 5 or 30 seconds, and isotonic contraction) and PPT over upper trapezius and deltoid muscles and C5 spinous process. They were assessed before and 5 minutes after treatment by a blinded assessor. A 3-way repeated-measures analysis of variance was used to examine the effects of the manipulation. RESULTS: A significant group time interaction for MF at the beginning of isometric contraction for 30 seconds (F = 7.957, P = .006) was also found: the manipulative group experienced a greater increase in MF at the beginning of the isometric contraction than did the control group. A significant group time interaction was also found for root mean square during isometric contraction for 30 seconds (P = .003); however, changes were small. Patients within the manipulative group experienced an increase on PPT over the deltoid (P = .010) and C5 spinous process (P = .025), but not over upper trapezius (P = .776). CONCLUSIONS: Manipulation at C5/C6 level in the study participants seemed to increase EMG amplitude signal and fatigue resistance in a nonspinal (deltoid) muscle innervated by the same segment in patients with mechanical neck pain. However, these changes were relative small. An increase on PPT over those tissues innervated by the manipulated segment was also found after the manipulative procedure.

Core muscle activation during Pilates exercises on the Wunda chair.

OBJETIVES: The Pilates method, developed by Joseph Pilates (1886-1967), has been widely used to improve trunk stability, muscle flexibility and strength, physical fitness, and body awareness. To measure the electromyography of four trunk muscles during three Pilates exercises carried out of the wunda chair. DESING: cross-section study. METHODS: Sixteen women participated in this study with a height and body weight of 1.64 ± 0.04 m and 58.7 ± 7.4 kg, respectively, and a mean age of 27.6 ± 3.7 years. Rectus abdominis (RA), internal oblique (IO), longissimus (LO), and multifidus (MU) muscles was evaluated by electromyographic (EMG) tests activity during three Pilates exercises: going up front (GF), mountain climb (MC), and swan (SW). EMG was normalized and expressed in the time domain, by the RMS. RESULTS: The highest EMG values concerning the four muscles were observed for the MC exercise, followed by GF and SW (ANOVA: p = 0.0001, p = 0.04, p = 0.0002, and p = 0.0013, respectively). Our results show that the three Pilates exercises could recruit all the muscles, with a moderate activity intensity. The ANOVA; p < 0.05 showed significant difference between the muscles, concerning SW (p = 0.0002). CONCLUSION: Our results show that the three Pilates exercises could recruit all the muscles, with a moderate activity intensity.

Electromyographic and cephalometric correlation with the predominant masticatory movement.

OBJECTIVE: This study aimed to evaluate the chewing muscular dynamics and correlate the side of the masticatory movement that is more vertical and/or more horizontal established by the photomeasurement Masticatory Functional Angle (MFA) to the muscular activity behavior, showed in the surface electromyography and in the radiographic images. MATERIAL AND METHOD: Seventeen people were selected of both genders, with the average age of 25 years, without signs or apparent symptoms of masticatory muscular disorders. The teleradiographies were done in lateral norm and surface electromyography of the masseter muscles, anterior portion of temporal and supra-hyoids in rest position and maximal bite. The bite force measured with a metallic transducer that was connected to a force sensor (Strain Gauge) to measure the deformation of the material model SF4 (EMG SYSTEM DO BRASIL). A mandibular goniometer of the EMG System of Brazil was used to measure the opening size. RESULTS: The comparison and correlation were established between the groups with MFA>5 degrees and MFA<5 degrees by the test "t" of Student or test of Mann-Whitney conform the distribution was normal or not, respectively. The results showed significant differences between groups, although without sexual dimorphism, to masseter muscle in maximal bite. CONCLUSION: In conclusion, the anatomic-physiological aspects of temporomandibular disorders are related to the asymmetrical mandible function.

Co-contraction of the core muscles during Pilates exercise on the Wunda Chair.

BACKGROUND: The co-contraction of the core muscles has been reported as the key mechanism towards spinal stability. Classic Pilates exercises aimed at these muscles are known to improve the stability and strength of the trunk without damaging the deep structures of the spine. OBJECTIVE: To evaluate the co-contraction of the mobilizing (rectus abdominis; longissimus) and stabilizing (multifidus; internal oblique) trunk muscles during Pilates exercises - going up front, mountain climber, and swan. METHODS: Sixteen women, all Pilates practitioners, participated in the study. The stabilizing and mobilizing muscles of the trunk (right side) were submitted to electromyography to calculate the percentage of co-contraction during the exercises. One-way repeated measures analysis of variance (ANOVA) was used to verify the difference in %COCON between stabilizers and mobilizers among the three exercises. The post-hoc Bonferroni test (P< 0.01) was applied when necessary. The paired t-test (P< 0.01) was used to verify the difference in %COCON between stabilizers and mobilizers separately for each exercise. RESULTS: The co-contraction values of the stabilizers were higher than those of the mobilizers for all exercises. The going up front (stabilizers) and the swan (mobilizers) exercises showed the highest %COCON values. CONCLUSIONS: The Pilates method is effective for either rehabilitating pathologies or training the trunk muscles in healthy individuals and athletes.

A singular oral appliance to treat obstructive sleep apnea in CPAP non-adherent patients.

INTRODUCTION: The most prescribed treatment option for Obstructive Sleep Apnea (OSA) is CPAP; however, its adherence is limited. Oral Appliance therapy (OAT) is frequently an option or even an adjuvant, being the mandibular advancement Oral Appliance (OAm) the most used prescription. It modifies the upper airway, improving the airway patency. OAm construction is based on the occlusal plane to disocclusion. In this study, the DIORS® appliance was used, a singular OAm, based on Neuro-Occlusal Rehabilitation concepts, that uses Camper's plane as a disocclusion reference, in order to achieve neuromuscular balance and functional stability. OBJECTIVE: This study primarily aimed to assess the DIORS® effectiveness in relation to clinical and polysomnographic outcomes. It was also evaluated if the use of DIORS® is as effective as titrated CPAP to treat CPAP non-adherent patients. METHODS: Twenty patients were included in this study. Objective and subjective clinical data were assessed at a sleep laboratory using all-night polysomnography, and Epworth Sleepiness Scale (ESS), taken at three moments: Baseline, CPAP titration, and using DIORS®. Analysis of respiratory parameters as apnea/hypopnea index (AHI), oxyhemoglobin saturation levels, the arousal index and daytime sleepiness were taken as criteria for a successful OAT. RESULTS: Respiratory and arousal parameters improved in both therapies, while DIORS® promoted a better ESS. CONCLUSION: Results from the present work support that DIORS® is a viable and effective adjuvant therapy for patients with moderate to severe OSA non-adherent to CPAP.

When tongue strength exercises reflect in the cervical region. / Quando exercícios de fortalecimento da língua refletem na região cervical.

PURPOSE: To compare the impact of isokinetic exercise (tongue suction on the palate) in the cervical region of Class I and Class II / 2nd Division participants, considering the average and the symmetry of Root Means Square (RMS) of suprahyoid and suboccipital muscles and cervical sensory reports. METHOD: 11 participants Class I and 19 Class II / 2nd Division, both genders, mean age 33.4 ± 14.1 years. For the analysis of RMS average and symmetry, electromyography was performed in the suboccipital and suprahyoid muscles, bilaterally, at rest and suction of water in the initial, intermediate and final phases. The cervical sensation was evaluated qualitatively during the exercises. RESULTS: the mean RMS did not differ between Classes (p=0.7), but showed an increase in the intermediate phase in the suboccipital musculature (p=0.0001) and decrease in the suprahyoid musculature. In symmetry, the suprahyoid musculature showed a significant difference between classes (p=0.0001) during the intermediate phase. In the Class I participant the symmetry was reestablished in the final phase, a fact that did not occur in Class II / 2nd Division. Regarding the cervical sensation, only the Class II / 2nd Division had expressive complaints. CONCLUSION: The Isokinetic suctioning exercise of the tongue against the palate, had an expressive repercussion with reports of discomfort and neck pain in the Class II / 2nd Division participants. On average RMS, there was no difference between the classes, but in the intermediate phase, the suboccipital muscles showed a significant increase in the activity. Symmetry in the suprahyoid musculature had a significant difference between the classes and asymmetry in the intermediate phase.

Fatigue analysis in the masseters and temporalis muscles in patients with temporomandibular disorder during short period of mastication.

The purpose of this experiment was to look for signals of muscle fatigue in volunteers with Temporomandibular Disorders (TMD) during short period of mastication. Twenty female volunteers selected by Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) participated, 10 with myogenic TMD (experimental) and 10 clinically normal (control). The Masseter and Temporalis muscles were evaluated electromyographically with active differential surface electrodes. The masticatory activity was recorded for 15 seconds and the signals were normalized by 4 seconds of teeth clenching. Three complete masticatory cycles were taken to calculating the median frequency (MF) and electromyographic amplitude (RMS). The data were submitted to statistics analysis and non-parametric tests. The results showed that RMS and median frequency did not change during the mastication period analyzed, indicating the absence of muscle fatigue, for the Masseter and Temporalis muscles in both groups (p> 0.05). These results confirm the absence of signals of muscle fatigue in masticatory muscles during short period of mastication even in individuals with TMD, possibly due to increased of blood flow, consequence of dynamic muscle contraction and the individual characteristics of muscle fiber composition and recruitment.

Effect of Pilates Mat Exercises on Neuromuscular Efficiency of the Multifidus and Internal Oblique Muscles in a Healthy Ballerina.

Physical training has frequently been indicated for ballet dancers to strengthen their trunk muscles, improve their performance, and avoid injuries. The current authors hypothesized that these dancers could benefit from Pilates exercises to stabilize their trunk muscles and improve joint stability and neuromuscular efficiency (NME). Our study aimed at evaluating the NME and isometric strength of the internal oblique (IO) and multifidus (MU) muscles in a healthy 24-year-old classical ballerina before and after an 8-week Pilates exercise intervention. The muscles were tested with electromyography (EMG) and a dynamometer, and the resulting torque and EMG values were used to calculate the NME. Based on the results, the Pilates exercises could improve the NME of the muscles tested, since the torque increased and the EMG activity decreased after the intervention.

Electromyographic evaluation of trunk core muscles during Pilates exercise on different supporting bases.

OBJECTIVE: To evaluate the electromyographic (EMG) activity of the rectus abdominis (RA) and internal oblique (IO) muscles during Pilates exercise on different trunk supporting bases. METHODS: Sixteen female Pilates practitioners participated in the study. EMG of the RA and OI muscles was evaluated during the double leg stretch (DLS) exercise on three different supporting bases - mat, long box, and short box. Trunk stability varies according to the size and type of the base. To normalize the data, the RMS value (EMG) obtained during the DLS exercise was divided by the RMS value from the torque test - the maximal voluntary isometric contraction (MVIC) - and multiplied by 100 (%MVIC). One-way repeated-measured analysis of variance (ANOVA) and Bonferroni tests were used to compare data concerning the supporting bases and Student t-test regarding the muscles (p < 0.05). RESULTS: The comparison among the bases involving each muscle - RA or IO (p < 0.05) - showed significant difference (%MVIC) between the mat and the short box. No significant difference was observed between the muscles concerning the exercise on the mat (p = 0.9266), on the long box (p = 0.5113) and on the short box (p = 0.2972). CONCLUSION: The short box increased the activity of the rectus abdominis and internal oblique muscles during exercise. The DLS exercise was able to challenge the stability of the trunk and thus recruit its stabilizer and mobilizer muscles at the same intensity.

Mouth Breathing Syndrome: cervical muscles recruitment during nasal inspiration before and after respiratory and postural exercises on Swiss Ball.

OBJECTIVE: This study aimed to evaluate the recruitment of cervical muscles during nasal inspiration before and after breathing and postural exercises on the Swiss Ball in children with Mouth Breathing Syndrome (MBS). METHOD: Surface electromyography from the sternocleidomastoid (SCM), sub-occipitals and upper Trapezius muscles was recorded during nasal inspiration, before and at the end of three months of the treatment. A physical therapy program consisting in muscular stretching and strengthening exercises along with naso-diaphragmatic breathing on the Swiss Ball were carried out for body posture realignment and respiratory training. Nineteen mouth breathing children, mean age of 10.6 years, both genres, were the subjects of this study. In order to establish a comparison between the eletromyographic results (normalized values) obtained from pre and post-physical therapy program it was used the Wilcoxon non-parametric test for dependent data. RESULTS: It was found a significant decrease (p<0.01) in the electromyographic activity during nasal inspiration in all tested muscles after treatment (11.3-3.6% in the SCM, 22.4-11.7% in the sub-occipitals and 8.9-3.1% in the upper Trapezius). At the end of the treatment, the assessed muscles reached lower activity electromyographic levels during nasal inspiration and they became closer of those in the quiet position. CONCLUSION: The lower activity after the physical therapy program in these muscles indicates a less effort of the accessory inspiratory muscles, probably due to a better performance of diaphragm muscle with the improvement of the body posture.

Relationship between the inclination of the coronoid process of the mandible and the electromyographic activity of the temporal muscle in skeletal Class I and II individuals.

The aim of this study was to verify the relationship between the inclination of the coronoid process of the mandible, and electromyographic activity of the anterior part of the temporal muscle in skeletal Class I and II individuals. Forty-seven volunteers (mean age 24.5 +/- 3.9 years) were subdivided into two groups, according to angle ANB: Class I (n = 25) and II (n = 22). Two radiographic examinations were performed; one lateral cephalogram to measure angle ANB, and one frontal cephalogram to measure the inclination of the coronoid process. Electromyographic (EMG) examination of the anterior part of the subjects' temporal muscles was performed. Statistical analysis of the data showed that Class II individuals presented lower electromyographic activity of the anterior part of the temporal muscle. Based on the results obtained, it was concluded that the skeletal classes analyzed had no influence on the inclination of the coronoid process. The inclination of the coronoid process was not influenced by the electromyographic activity of the anterior part of the temporal muscle in Class I and II individuals; however, the lower electromyographic activity of the anterior part of the temporal muscle could be influenced by the skeletal class in Class II individuals.

Asymmetric activation of temporalis, masseter, and sternocleidomastoid muscles in temporomandibular disorder patients.

The aim of this study was to analyze the symmetry of the electromyographic (EMG) activity of the temporalis, masseter, and sternocleidomastoid (SCM) muscles in volunteers divided into a control group and a temporomandibular disorder (TMD) group. The surface EMG recordings were made during mandibular rest position, maximal intercuspal position, and during the chewing cycle. Normalized EMG waves of paired muscles were compared by computing a percentage overlapping coefficient (POC). The difference between the groups and between the static and dynamic clenching tests was analyzed through repeated measures, ANOVA. Symmetry of the temporalis, masseter, and SCM muscles activity was smaller in the TMD group compared to the control group. The mandibular postures were also significantly different among themselves. The asymmetric activation of jaw and neck muscles was interpreted as a compensatory strategy to achieve stability for the mandibular and cervical systems during masticatory function.

Neuromuscular efficiency of the multifidus muscle in pilates practitioners and non-practitioners.

BACKGROUND: Pilates exercises help stabilize the vertebral segments by recruiting the abdominal and spinal muscles. Pilates training may increase joint stability and improve neuromuscular efficiency (NME). OBJECTIVE: This study aimed to evaluate NME of the multifidus (MU) muscle through electromyography (EMG) analysis and torque test, applied to practitioners and non-practitioners of Pilates. METHODS: Participants included thirty women: Pilates practitioners (n = 15) and non-practitioners (n = 15). They were tested for trunk extension. Their right and left MU muscles were submitted to EMG to estimate NME. Results concerning torque, EMG, and NME from all participants were compared. RESULTS: Statistical analysis concerning isometric torque peak (p = 0.0275) and NME (p = 0.0062) showed significant difference (Student t test; p < 0.05) between practitioners and control. No significant difference (p = 0.3387) in EMG was observed. CONCLUSION: Our results suggest Pilates exercises is effective in training spinal muscles to improve NME in women.

Normalization of the electromyographic signals of masticatory muscles during non-habitual chewing activity

There is no consensus on the most appropriate method for normalizing electromyography (EMG) signals from masticatory muscles during isotonic activity. Aim: To analyze the best method for data processing of the EMG signal of the masticatory muscles during isotonic activity (non-habitual chewing), comparing raw data and different types of normalization. Methods: This is a cross-sectional study. Women aged between 18 and 45 years were selected. Anthropometric data were collected (age, height, body mass index ­ BMI, masticatory preference) as well as EMG signal (root mean square ­ RMS) data for the anterior temporal and masseter bilaterally, and for the suprahyoid muscles, during isotonic (non-habitual chewing) and isometric tasks. EMG data were processed offline using Matlab® Software. The normalization of the EMG signal was carried out using the 2nd masticatory cycle, chosen at random, of the 20 cycles collected, the maximum RMS value, and the maximum voluntary contraction (MVC). To analyze the best method of data processing for the isotonic data, the coefficient of variation (CV) was calculated. Descriptive data analysis was adopted, using the mean and standard deviation. ANOVA with repeated measures was used to detect significant differences between the methods of normalization. Statistical significance was set at 5% (α<0.05). Results: The final sample of this research was composed of 86 women. The volunteers presented an average age of 27.83±7.71 years and a mean BMI of 22.85±1.91 Kg/m2. Regarding masticatory preference, 73.25% reported the right side, and 26.75% the left side. Considering the comparison between the methods, the %CV measure of the 2nd cycle showed the lowest variation coefficient during biting for all the muscles from the raw data, RMS Max, and MVC (p=0.001, p=0.003, and p=0.001 respectively). Conclusion: In conclusion, for non-habitual chewing activity, the results of this study recommend data processing using normalization with the second cycle during chewing

Maximum bilateral bite strength and RMS EMG for the diagnosis of myogenic TMD

Aim: The study aimed to evaluate the accuracy of the maximum bilateral molar bite force and the Root Mean Square (RMS) Electromyography (EMG) index of the masticatory muscles in the maximum bilateral molar bite (MMBMax) of women with myogenic Temporomandibular Disorder (TMD) and asymptomatic. Methods: This is a cross-sectional study, composed of 86 women allocated to the TMD Group (n=43) and Control Group (n=43) diagnosis through the Diagnostic Criteria for Temporomandibular Disorders. The maximum bilateral molar bite force was evaluated using a bite dynamometer and the RMS EMG index of the masticatory muscles (anterior temporalis, masseter) during 5 seconds of the MMBMax task. Student t-test was used for data comparison between accuracy of the bite force and RMS EMG of masticatory muscles during the MMBMax. Results: The maximum bilateral molar bite force showed high accuracy (AUC=0.99) for the diagnosis of women with myogenic TMD and asymptomatic women, and the RMS EMG index evaluated during the MMBMax showed a moderate level of accuracy for all masticatory muscles (AUC=0.70 to 0.75). Conclusion: The bilateral bite dynamometer with a surface EMG during bilateral bite can be used to diagnose TMD in young women

Efficacy of physical therapy on cervical muscle activity and on body posture in school-age mouth breathing children.

INTRODUCTION: The mouth breathing resulting from nasal obstruction has been highly incident, mostly as a consequence of allergic rhinitis. In children, such condition is more concerned because it causes alteration during their development, which may generate deformities. OBJECTIVE: To evaluate the efficacy of a program of combined postural exercise and breathing, on the cervical muscles and body posture in school-age mouth breathing children. MATERIALS AND METHODS: Nineteen mouth breathing children, mean age of 10.6 years, both genders, were recruited either from a public school or from a speech-therapy service. The evaluation procedures were electromyographic recordings from the sternocleidomastoid (SCM), sub-occipitals (SOC) and upper trapezius (UT) muscles and computerized photographic analysis pre and post-treatment. The subjects were submitted to a 12-week of a Physical Therapy Program (PTP) consisted by (a) muscular stretching and strengthening exercises using a Swiss ball combined to (b) naso-diaphragmatic re-education. RESULTS: There was a significant reduction (p<0.05) in the electrical activity on the assessed muscles during quiet position (5, 19 and 7.1% to 3, 2 and 10.3% for SCM, SOC and UT, respectively) and aligned posture (7, 19 and 8% to 4, 9 and 2.6% for SCM, SOC and UT, respectively) after treatment. Improvement in the postural deviation, especially reduction in forward head posture and abducted scapula were demonstrated in the computerized photographic analysis. CONCLUSION: A combination of postural and breathing exercises was effective in restoring muscle imbalances and posture in a group of school-age mouth breathing children, as measured by changes in electrical activity and positional data.