Effects of mat Pilates on older adult women with knee osteoarthritis: A randomized controlled trial.

INTRODUCTION: Osteoarthritis is the most common joint disorder in the world and its incidence is rising, and one of the most frequent causes of pain, loss of function and disability in adults. AIM: The aim of this study was to evaluate the effects of Mat Pilates on health status, pain, stiffness, and functionality of older adult women with knee osteoarthritis (KOA). METHODS: A randomized-controlled trial to preliminarily test an intervention protocol of Mat Pilates in older women with KOA on health status, pain, stiffness, and functionality. This study included 41 volunteers with age over 40 years, which mean was 52.1 ± 8.9 years, and were allocated into Mat Pilates and control groups. The protocol was developed to be performed in 60 min, twice a week; the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Medical Outcomes Study 36 (SF-36) were used to assess pain, to evaluate functionality and stiffness. RESULTS: The Mat Pilates group significantly improved the functional capacity assessed by SF-36 (33.12 ± 22.03 to 69.37 ± 22.43, p < 0.05), and by WOMAC (29.75 ± 6.92 to 9.75 ± 9.35, p < 0.05). The pain domain also improved in Mat Pilates group assessed by SF-36 (39.50 ± 12.89 to 71.75 ± 18.66, p < 0.05) and by WOMAC (8.00 ± 2.56 to 2.75 ± 3.01, p < 0.05). The total score of WOMAC (41.75 ± 10.39 to 14.25 ± 13.88, p < 0.05), and the general health status assessed by SF-36 (59.44 ± 18.07 to 82.75 ± 12.03, p < 0.05) only improved for Mat Pilates group. No differences were observed in outcomes for the control group in both questionnaires. CONCLUSION: Our results show that Mat Pilates protocol can improve the health status, pain, and functionality of older women with KOA.

Effectiveness of Biofeedback in Individuals with Awake Bruxism Compared to Other Types of Treatment: A Systematic Review.

Excessive masticatory muscle activity is generally present in awake bruxism, which is related to increased anxiety and stress. It has been hypothesized that biofeedback could potentially manage awake bruxism, however, its effectiveness has not been empirically analyzed in a systematic manner. Therefore, this systematic review was designed to determine the effectiveness of biofeedback compared to other therapies in adults with awake bruxism. Extensive searches in five databases looking for randomized controlled trials (RCTs) that included biofeedback to manage awake bruxism were targeted. The risk of bias (RoB) assessment was conducted using the Cochrane RoB-2 tool. Overall, four studies were included in this systematic review, all of which used the electromyographic activity of the masticatory muscles during the day and night as the main endpoint. Auditory and visual biofeedback could reduce the excessive level of masticatory muscle activity in a few days of intervention. The majority of the included studies had a high RoB and only one study had a low RoB. The standardization of the biofeedback protocols was also inconsistent, which makes it difficult to establish the ideal protocol for the use of biofeedback in awake bruxism. Thus, it is proposed that future studies seek to reduce methodological risks and obtain more robust samples.

Biofeedback no controle do bruxismo: uma revisão de escopo / Biofeedback for the control of bruxism: a scoping review

Objetivo: Compreender como os diversos tipos de biofeedback agem, e se são eficazes no controle do bruxismo do sono e vigília. Métodos: trata-se de uma revisão de escopo, com busca em três bases de dados, Medline (Pubmed e BVS), PEDRo e Cochrane, e redigida de acordo com as diretrizes do PRISMA-ScR. Resultados: Foram encontradas 595 referências. Após a remoção das duplicatas e da aplicação dos critérios de elegibilidade, trinta e cinco artigos foram incluídos. A maioria investigou o bruxismo do sono e o uso de placas orais integradas a sistemas de biofeedback, principalmente através de estímulos exteroceptivos. Na maioria dos artigos, o biofeedback foi efetivo a curto prazo para o bruxismo do sono, reduzindo a duração dos episódios, mas não alterando o número de episódios do bruxismo, mas com retorno aos níveis do pré-tratamento. O uso do biofeedback foi mais efetivo para o bruxismo de vigília e nos estudos que investigaram ambos os tipos de bruxismo, mas, com o uso do biofeedback apenas no período diurno, foi possível observar uma redução tanto nos eventos do bruxismo de vigília como nos do sono. Conclusão: A maioria das pesquisas se utilizou do biofeedback por meio de estímulo exteroceptivo, com reforço negativo a um estímulo aversivo; poucos estudos utilizaram o biofeedback com o propósito de condicionamento motor ou de mudança comportamental, sendo esses mais eficazes, mesmo após a retirada do estímulo.

Aim:To comprehend the functioning of various biofeedback types and their effectiveness in controlling sleep and awake bruxism. Methods: This is a scoping review, conducted in three databases: Medline (Pubmed and VHL), PEDRo, and Cochrane, and was written according to PRISMA-ScR guidelines. Results: Our study found 595 references; after removing duplicates and applying the eligibility criteria, thirty-five articles were included. Most studies examined the effectiveness of biofeedback systems that integrated oral splints, primarily through the use of exteroceptive stimuli, to manage sleep bruxism. Although biofeedback was found to reduce the duration of bruxism episodes in the short term in most articles, it did not significantly change the number of episodes, which reverted to pre-treatment levels. The use of biofeedback was more effective for awake bruxism. Moreover, in the studies that investigated both types of bruxism, but with the use of biofeedback only during the day, it was possible to observe a reduction in both the events of awake and sleep bruxism. Conclusion: Most studies used biofeedback with negative reinforcement through exteroceptive stimulation to an aversive stimulus. Few studies use biofeedback for motor conditioning or behavioral change. The latter approaches proved to be more effective, even after discontinuing the stimulus.

Short-term transcutaneous electrical nerve stimulation reduces pain and improves the masticatory muscle activity in temporomandibular disorder patients: a randomized controlled trial.

OBJECTIVE: To investigate the short-term effect of transcutaneous electrical nerve stimulation (TENS) by examining pain intensity, pressure pain threshold (PPT) and electromyography (EMG) activity in patients with temporomandibular disorder (TMD). MATERIAL AND METHODS: Forty patients with myofascial TMD were enrolled in this randomized placebo-controlled trial and were divided into two groups: active (n=20) and placebo (n=20) TENS. Outcome variables assessed at baseline (T0), immediately after (T2) and 48 hours after treatment (T1) were: pain intensity with the aid of a visual analogue scale (VAS); PPT of masticatory and cervical structures; EMG activity during mandibular rest position (MR), maximal voluntary contraction (MVC) and habitual chewing (HC). Two-way ANOVA for repeated measures was applied to the data and the significance level was set at 5%. RESULTS: There was a decrease in the VAS values at T1 and T2 when compared with T0 values in the active TENS group (p<0.050). The PPT between-group differences were significant at T1 assessment of the anterior temporalis and sternocleidomastoid (SCM) and T2 for the masseter and the SCM (p<0.050). A significant EMG activity reduction of the masseter and anterior temporalis was presented in the active TENS during MR at T1 assessment when compared with T0 (p<0.050). The EMG activity of the anterior temporalis was significantly higher in the active TENS during MVC at T1 and T2 when compared with placebo (p<0.050). The EMG activity of the masseter and anterior temporalis muscle was significantly higher in the active TENS during HC at T1 when compared with placebo (p<0.050). CONCLUSIONS: The short-term therapeutic effects of TENS are superior to those of the placebo, because of reported facial pain, deep pain sensitivity and masticatory muscle EMG activity improvement.

Short-term transcutaneous electrical nerve stimulation reduces pain and improves the masticatory muscle activity in temporomandibular disorder patients: a randomized controlled trial

Abstract Studies to assess the effects of therapies on pain and masticatory muscle function are scarce. Objective To investigate the short-term effect of transcutaneous electrical nerve stimulation (TENS) by examining pain intensity, pressure pain threshold (PPT) and electromyography (EMG) activity in patients with temporomandibular disorder (TMD). Material and Methods Forty patients with myofascial TMD were enrolled in this randomized placebo-controlled trial and were divided into two groups: active (n=20) and placebo (n=20) TENS. Outcome variables assessed at baseline (T0), immediately after (T2) and 48 hours after treatment (T1) were: pain intensity with the aid of a visual analogue scale (VAS); PPT of masticatory and cervical structures; EMG activity during mandibular rest position (MR), maximal voluntary contraction (MVC) and habitual chewing (HC). Two-way ANOVA for repeated measures was applied to the data and the significance level was set at 5%. Results There was a decrease in the VAS values at T1 and T2 when compared with T0 values in the active TENS group (p<0.050). The PPT between-group differences were significant at T1 assessment of the anterior temporalis and sternocleidomastoid (SCM) and T2 for the masseter and the SCM (p<0.050). A significant EMG activity reduction of the masseter and anterior temporalis was presented in the active TENS during MR at T1 assessment when compared with T0 (p<0.050). The EMG activity of the anterior temporalis was significantly higher in the active TENS during MVC at T1 and T2 when compared with placebo (p<0.050). The EMG activity of the masseter and anterior temporalis muscle was significantly higher in the active TENS during HC at T1 when compared with placebo (p<0.050). Conclusions The short-term therapeutic effects of TENS are superior to those of the placebo, because of reported facial pain, deep pain sensitivity and masticatory muscle EMG activity improvement.

Use of low-power laser to assist the healing of traumatic wounds in rats.

PURPOSE: To investigate the morphological aspects of the healing of traumatic wounds in rats using low-power laser. METHODS: Twenty four non isogenic, young adult male Wistar rats (Rattus norvegicus) weighing between 200 and 300 g was used. The animals were randomly distributed into two groups: Control (GC) and Laser (GL), with 12 animals each. After shaving, anesthesia was performed in the dorsal region and then a surgical procedure using a scalpel was carried out to make the traumatic wound. GL received five sessions of laser therapy in consecutive days using the following laser parameters: wavelength 660 nm, power 100 mW, dose 10 J/cm2. The wounds were evaluated through measurement of the area and depth of the wound (MW) and histological analysis (HA). RESULTS: When comparing the GC with the GL in MW there was a difference in area (p<0.001) and depth (p=0.003) measurement of the wounds in GL. The laser group presented more epithelization than GC (p=0.03). The other histological parameters were similar. CONCLUSION: The healing of wounds in rats was improved with the use of the laser.