The Acute and Prolonged Effects of Different Durations of Foam Rolling on Range of Motion, Muscle Stiffness, and Muscle Strength.

"Foam Rolling" has been used in sports settings to increase range of motion and decrease muscle stiffness without decreasing muscle strength and athletic performance. However, there has been no study investigating the acute and prolonged effect of different durations of foam rolling intervention on muscle stiffness, and the minimum foam rolling intervention duration required to decrease muscle stiffness is unclear. Therefore, the purpose of this study was to investigate the acute and prolonged effect of different durations of foam rolling intervention on ROM, muscle stiffness, and muscle strength. The 45 participants were randomly allocated to 1 of 3 groups (30 s × 1 times group vs 30 s × 3 times group vs 30 s× 10 times group). The outcome measures were dorsiflexion range of motion, shear elastic modulus of medial gastrocnemius, and muscle strength before, 2 min and 30 min after foam rolling intervention. There were no significant differences before and 2 min after foam rolling intervention in 30 s×1 time group, whereas dorsiflexion range of motion was increased in both 30 s×3 times group (p = 0.042, d = 0.26) and 30 s× 10 times group (p < 0.01, d = 0.33). However, the increase in dorsiflexion range of motion was returned to baseline value after 30 minutes in both 30 s × 3 times group and 30 s × 10 times group. In addition, there were no significant changes in shear elastic modulus and muscle strength in all groups. This study suggested that foam rolling for more than 90 s or more of foam rolling was effective in order to increase the range of motion immediately without changing muscle stiffness and muscle strength.

Comparison of the Immediate Effect of Petrissage Massage and Manual Lymph Drainage Following Exercise on Biomechanical and Viscoelastic Properties of the Rectus Femoris Muscle in Women.

CONTEXT: Fast and adequate recovery after exercise and activity is important for increasing performance and preventing injuries. Inadequate recovery usually causes changes in the biomechanical and viscoelastic properties of the muscle. OBJECTIVE: To compare the immediate effect of petrissage massage (PM) and manual lymph drainage (MLD) following submaximal exercise on the biomechanical and viscoelastic properties of the rectus femoris muscle in healthy women. DESIGN: Cross-sectional, repeated-measures. SETTING: Marmara University. PARTICIPANTS: 18 healthy female students. INTERVENTION(S): Following the submaximal quadriceps strengthening exercise performed in 3 sets of 8 repetitions with intensity of 75% of 1 maximum repetition, participants' right leg received a 5-minute PM (PM group) and the contralateral leg received a 5-minute MLD application (MLD group). MAIN OUTCOME MEASURES: Skin temperature was measured using P45 thermographic thermal camera (Flir System; ThermaCAM, Danderyd, Sweden), and muscle tone, biomechanical, and viscoelastic features were measured with a myometer (Myoton AS, Tallinn, Estonia) at baseline, immediately postexercise, post-PM/MLD application, and 10 minutes postexercise. RESULTS: In the PM group, the tonus (P = .002) and stiffness (P < .001) values measured after the massage and at the end of the 10-minute resting period were found to be statistically different than those measured right after the exercise (P < .05). Relaxation time and creep values at all measurement times were significantly different (P < .05). In the MLD group, it was observed the tonus (P < .001), stiffness (P = .025), and relaxation time (P < .01) values decreased significantly after the MLD compared with the values measured after the exercise; however, the creep value was found to be significantly different in all measurements (P < .05). CONCLUSION: PM and MLD reduce passive tissue stiffness and improve the extent of muscle extensibility over time against the muscle tensile strength. PM and MLD are therapeutic methods that can be used to support tissue recovery after exercise and prevent injuries.

Physiotherapist management of a patient with spastic perineal syndrome and subsequent constipation: a case report.

Background and Purpose: The purpose of this case report is to describe the benefits of manual therapy techniques, including mobilization and stretching, in the management of a patient with chronic constipation. Case Description: A 17-year-old male with an 8-month history of constipation and complaint of incomplete evacuation after defecation was referred for therapy. The patient was diagnosed with a spastic perineal syndrome. Isolated puborectalis relaxation exercise was not successful in alleviating constipation. Physical examination showed tightness of left side piriformis, thoracic kyphosis, apparent limb shortening on the left side, and a right-on-right sacrum forward torsion. The patient was treated with stretching of left piriformis and mobilization of thoracic and lumbar vertebrae and sacroiliac joints along with puborectalis relaxation exercises. Outcomes: After 4 weeks of treatment, there was a reduction in Bowel Function Index (BFI) from 74.6 to 27.2. The patient also reported spending less time (<3 minutes) during defecation. The patient maintained his improvement at 7 months. Discussion: A detailed neuromuscular examination assisted in identifying the pathophysiology related to obstructive defecation for this patient. Controlled studies regarding the effectiveness of various physiotherapy interventions in the treatment of obstructive constipation are warranted.

Potential of Using Shear Wave Elastography in the Clinical Evaluation and Monitoring of Changes in Masseter Muscle Stiffness.

The study aimed to evaluate masseter muscle stiffness in adult healthy volunteers referred to a massage treatment and also to investigate whether shear-wave elastography can be used to monitor the effect of massage on the masseter muscle. The study included 21 healthy volunteers, who were subjected to a 30-minute massage of the masseter muscle. Muscle stiffness was measured by shear-wave elastography before and directly after the massage. Pain during the massage was assessed using the visual analogue scale (VAS). The data of 20 patients (one excluded due to severe pain) with a median age of 34.5 years were analysed. The stiffness values were 11.46 ± 1.55 kPa before and 8.97 ± 0.96 kPa after the massage (p < 0.0001). The mean drop was 2.49 ± 1.09 kPa. The greatest decrease was observed in people with higher elasticity values before the massage (r = 0.79; p < 0.0001). The median intensity of pain was 7.2 (range: 6-9.5). We concluded that shear-wave elastography is a sensitive tool to monitor changes in the stiffness of the masseter muscle.

Dry Needling for Hamstring Flexibility: A Single-Blind Randomized Controlled Trial.

CONTEXT: Hamstring muscle tightness is one of the most common problems in athletic and healthy people. Dry needling (DN) was found to be an effective approach for improving muscle flexibility, but there is no study to compare this approach with static stretching (SS) as a common technique for the increase of muscle length. OBJECTIVE: To compare the immediate effects of DN and SS on hamstring flexibility in healthy subjects with hamstring tightness. STUDY DESIGN: A single-blind randomized controlled trial. SETTING: A musculoskeletal physiotherapy clinic at Tehran University of Medical Sciences. SUBJECTS: Forty healthy subjects (female: 32, age range: 18-40 y) with hamstring tightness were randomly assigned into 2 groups of DN and SS. INTERVENTION: The DN group received a single session of DN on 3 points of the hamstring muscles, each for 1 minute. The SS group received a single session of SS of the hamstrings, consisting of 3 sets of 30-second SS with a 10-second rest between sets in the active knee extension test (AKET) position. MAIN OUTCOME MEASURES: The AKET, muscle compliance, passive peak torque, and stretch tolerance were measured at the baseline, immediately, and 15 minutes after the interventions. RESULTS: Improvements in all outcomes was better for the DN group than for the SS group. DN increased muscle compliance significantly 15 minutes after the intervention, but it did not improve in the SS group. CONCLUSION: DN is effective in improving hamstring flexibility compared with SS. One session of DN can be an effective treatment for hamstring tightness and increase hamstring flexibility. The improvements suggest that DN is a novel treatment for hamstring flexibility.

Effects of Contrast Therapy Using Infrared and Cryotherapy as Compared with Contrast Bath Therapy on Blood Flow, Muscle Tone, and Pain Threshold in Young Healthy Adults.

BACKGROUND The aim of this research was to compare the effects of contrast bath therapy (CBT) and contrast therapy (CT) using infrared (IR) and cryotherapy (CR) on blood flow, muscle tone, and pain in the forearm. MATERIAL AND METHODS Twenty healthy individuals participated in this study. Each participant received 2 kinds of CT separated by a week. CBT involved immersion in hot water (38-40°C) for 4 minutes, followed by 1 minute of immersion in cold water (12-14°C) for four rotations. CT using IR and CR was performed in the same manner as CBT. RESULTS The variables measured were blood flow, muscle tone, and pain before and after intervention. Both types of CT produced fluctuations in the blood flow (P<0.05). The pain threshold increased on both therapies; a significant increase was noted with IR and CR (P<0.05) therapies. Muscle elasticity was induced and stiffness was reduced with all therapies (P<0.05). IR and CR resulted in significant changes (P<0.05) in blood flow as compared with the CBT. CONCLUSIONS The results of this study suggest that CT using IR and CR is more effective in improving blood flow than CBT and has the same effect on muscle tone and pain. Nonetheless, using IR and CR is efficient with regard to mobility and maintaining temperature; therefore, it would be convenient to use these in clinical settings. Further studies involving CT should be carried out to determine whether our findings are clinically relevant.

The Effect of Foam Rolling Versus IASTM on Knee Range of Motion, Fascial Displacement, and Patient Satisfaction.

CONTEXT: Soft tissue restrictions have been linked to poor flexibility and decreased range of motion (ROM). To decrease the soft tissue restrictions and ultimately increase ROM/flexibility, myofascial release techniques, such as foam rolling (FR) and instrument-assisted soft tissue mobilization (IASTM), have been used. However, the benefit regarding which technique is more beneficial remains unknown. OBJECTIVE: To examine the effects of myofascial release techniques (FR vs the instrumented portion of IASTM) on knee joint ROM, rectus femoris (RF) and biceps femoris (BF) fascial displacement, and patient satisfaction. DESIGN: Randomized controlled clinical trial. SETTING: Mid-Atlantic University. PARTICIPANTS: Twenty moderately active participants (age 21.1 [2.0] y) with variable levels of soft tissue restriction in the quadriceps and hamstrings started and completed the study. Participants were randomly assigned to 2 groups, FR or IASTM. INTERVENTIONS: All participants completed the same warm-up prior to the intervention. The FR group followed the proper FR protocol for gluteals/iliotibial band, quadriceps, and hamstrings/adductors, and the participants were monitored while the protocol was completed. The IASTM group received treatment on the gluteals/iliotibial band followed by the quadriceps, adductors, and hamstrings. Participants in both groups attended intervention sessions twice per week for 3 weeks. Prior to the start, knee ROM measurements were taken, along with fascial displacement measured via ultrasound. Upon completion of the study, posttest measurements were completed. A patient satisfaction survey was also administered at this time. MAIN OUTCOME MEASURES: Pretest to posttest knee ROM measurements, RF and BF fascial displacement, and patient satisfaction. RESULTS: Both groups improved pretest to posttest for knee-extension ROM, with a slight trend toward increased knee-extension ROM for the FR group. Both groups improved pretest to posttest for BF and RF fascial displacement, in favor of the IASTM group for BF fascial displacement. Both groups were equally satisfied. CONCLUSIONS: As both groups improved pretest to posttest, either treatment could be used.

MRI Assessment of Arm and Calf Muscle Toning With High-Intensity Focused Electromagnetic Technology: Case Study.

Arms and calves have long been a subject of interest in aesthetic medicine. Current surgical and non-invasive procedures focus on sagging skin and fat deposits without targeting the muscles. The aim of this study is to investigate the feasibility of high-intensity focused electromagnetic (HIFEM) technology for arm and calf toning through simultaneous fat reduction and muscle strengthening. In this case study, two subjects received four 20-minute HIFEM treatments of biceps, triceps, and calves, with the outcomes assessed by MRI. The analysis of MRI images showed an average increase in all three muscle groups, biceps muscle mass 17.1%, triceps muscle mass 10.2%, and gastrocnemius muscle mass increased by 14.6%. In addition, the arm fat thickness was decreased by 12.8% on average and the calf fat thickness decreased by 9.9%. The results suggest that HIFEM technology is a feasible modality for both arm and calf toning. However, it will be necessary to continue to validate this outcome in a larger sample size study. J Drugs Dermatol. 2020;19(5): doi:10.36849/JDD.2020.4546.

Reduced risk of vasovagal reactions in Australian whole blood donors after national implementation of applied muscle tension and water loading.

BACKGROUND: A new national donor safety initiative was introduced in Australia in 2018, which aimed to encourage all whole blood donors to water load and to use applied muscle tension. This study evaluated the effect of this initiative on the rate of vasovagal reactions (VVR). STUDY DESIGN AND METHODS: Routinely collected data were used to identify whole blood donations and any associated VVRs before (n = 167,056 donations) and after implementation (n = 215,572 donations). Multivariate logistic regression analyses were performed to evaluate the differences in VVR rates. RESULTS: The total rate of VVRs declined from 22.5 per 1000 donations to 20.6 per 1000 donations after implementation, a reduction of 8% (p < 0.001). The rate of presyncopal reactions decreased by 8% in new donors and 12% in repeat donors. No impact was observed on the rate of syncope in any of the groups. The multivariate logistic regression analysis demonstrated the odds of experiencing a presyncopal reaction was reduced by 13% following implementation, with no significant effects on syncope. CONCLUSION: The findings of this study support the use of water loading and applied muscle tension in routine whole blood collection to reduce the incidence of VVRs.

The Effect of Functional Electrical Stimulation and Therapeutic Exercises on Trunk Muscle Tone and Dynamic Sitting Balance in Persons with Chronic Spinal Cord Injury: A Crossover Trial.

Background and objectives: Functional electrical stimulation (FES) has shown good results in improving static and dynamic sitting balance in persons with spinal cord injuries. There is limited information about how regular surface FES combined with therapeutic exercise (TE) affect dynamic sitting balance and muscle tone. The objective of this study was to evaluate the effectiveness of a six-week physical therapy program consisting of FES and TE on muscle tone and sitting balance in persons with spinal cord injury (SCI). It was also important to explore the relationship between muscle tone and dynamic sitting balance. The third objective was to assess the change of characteristics over a six month period, when no intervention was carried out. Material and methods: Five men with SCI were alternately allocated to two study groups: SCI_FES+TE and SCI_TE. Eight healthy control group participants were recruited to collect reference data. SCI participants' intervention lasted for six weeks in their homes. SCI_FES+TE conducted exercises with FES applied on erector spinae (ES) and rectus abdominis (RA) muscles. SCI_TE conducted exercises only. Muscle oscillation frequency (MOF; characterizing muscle tone) and limits of stability (LOS; characterizing sitting balance) were measured. A crossover study design was used. The time between the initial intervention and the crossover was seven months (ClinicalTrials registration ID NCT03517787). Results: MOF in SCI_FES+TE increased by 6.0% for ES and 6.1% for RA muscles. LOS of flexion increased 30.1% in SCI_FES+TE. Increase in lateral directions was similar for both study groups. Moderate to high negative correlation was found between MOF and LOS. After seven months, MOF of ES decreased 0.8%, MOF or RA decreased 1.4%, LOS of flexion decreased 31.9%, and LOS of lateral flexion to the left decreased 46.4%. Conclusions: The six-week therapy program combining FES and TE increased trunk muscle tone and dynamic sitting balance in flexion more than TE alone. Higher antagonist muscle tone negatively affects dynamic sitting balance and center of pressure (COP) trajectory distance in various directions. After seven months, a slight decline in trunk muscles tone values and an extensive decrease in sitting balance values were noticed.

Managing Paratonia in Persons With Dementia: Short-term Effects of Supporting Cushions and Harmonic Techniques.

OBJECTIVES: Paratonia, a form of hypertonia typically seen in dementia, is often associated with difficulties in positioning and daily care. No evidence-based therapy or clinical guideline for management is available. In this study, the short-term effect of harmonic techniques (HT) and supporting cushions (SC) on paratonia was explored. DESIGN: This was a multicenter interventional clinical trial with AB/BA crossover design. Each intervention (SC or HT) was subsequently implemented over 1 week in each of the participants. SETTING AND PARTICIPANTS: The study included 22 participants with moderate to severe paratonia from 9 different nursing homes in Flanders, Belgium. METHODS: Measurements of biceps brachii and rectus femoris muscle tone (MyotonPRO), maximal elbow and knee extension (goniometer), and pain (Pain Assessment Checklist for Seniors With Limited Ability to Communicate) were performed on 3 different days within 1 week. The effect of HT on nursing care was evaluated with the Pain Assessment Checklist for Seniors With Limited Ability to Communicate and visual analog scale ratings of discomfort items. RESULTS: After 30 minutes of positioning with SC, participants had lower biceps brachii muscle tone (P = .041) and higher maximal elbow extension (P = .006) than without SC. After a 30-minute session of HT, a significant increase in biceps brachii muscle tone (P = .032) and maximal extension of elbow (P < .001) and knee (P = .028) was found. Pain (P = .003) and discomfort (P = .001 to P = .019) during morning care were significantly lower when care was preceded by 30 minutes of HT. CONCLUSIONS/IMPLICATIONS: This explorative study revealed beneficial short-term effects on range of motion for both SC and HT and a positive effect of SC on upper limb muscle tone. Beneficial effects of HT were found on resident's pain and caregiver's discomfort during care. The results of the present study are encouraging and can contribute to the development of evidence-based interventions for paratonia.

A soft massage tool is advantageous for compressing deep soft tissue with low muscle tension: Therapeutic evidence for self-myofascial release.

OBJECTIVES: This study aimed to compare the amount of deep tissue pressure and muscle relaxation between a soft inflatable rubber ball (SIRB) and a hard massage ball (HMB). DESIGN: Crossover experimental design study. INTERVENTIONS: Thirty participants with neck pain (age: 65.9 ± 3.4, Neck Disability Index score: 34.0% ± 15.2) pillowed a SIRB or an HMB beneath the suboccipital region in the supine position. For the baseline condition, participants pillowed a foam block without a ball. MAIN OUTCOME MEASURES: To quantify the amount of deep-tissue pressure by a ball, compressed soft tissue thickness was measured with lateral cervical radiographs. To assess muscle relaxation, the amount of muscle tension was determined using electromyography of the sternocleidomastoid and upper trapezius muscles. To monitor the cervical lordosis in each condition, the extension angles of the cervical vertebrae were quantified using the relative rotation angles. RESULTS: The compressed soft tissue thickness in the SIRB condition was significantly lower than that in the HMB condition. The normalised muscle activities exhibited that right sternocleidomastoid muscle activity in the HMB condition was significantly higher than that in the baseline and SIRB conditions. In the SIRB and HMB conditions, Numeric Rating Scale for pain was 0.2 ± 0.5 and 5.2 ± 1.4, respectively. CONCLUSIONS: Our findings demonstrate that a SIRB is more advantageous than an HMB for pressing the soft tissue deeply. This finding would be related to reduced muscle tension and discomfort in the SIRB condition when compared with the HMB condition.

The use of adaptive neuro-stimulation for rebalancing posture and muscular tone in a soccer team.

BACKGROUND: Posture and somatic structure could positively influence athletic gestures for their biomechanical implications. Working on neuromuscular activity, offers the possibility of intervention on postural control. The aim of this study was to demonstrate the possibility of interacting with the human body system through the spinal reflex pathway, starting from the stimulation of cutaneous receptors. METHODS: Twenty soccer players were recruited: all were male aged 25.5±10.6 years. Patients were divided using a single-blind criterion into two groups, each containing ten subjects. The experimental group was treated with 2 pre-set programs 4 times a week with an adaptive neuro-stimulation (ANS) able to interact with cutaneous receptors through an ENF Physio® device with a range of electrical frequency of about 15-350 Hz; the placebo-controlled group received the treatment with the device switched off. Patients performed a myometric evaluation with the MyotonPRO® system and a postural one with the Rarog software at T0 before the treatment and at T1 after the four-week treatment. RESULTS: After our intervention, we identified an improvement in muscular tone, in particular in the hamstring muscles (17.69%, right P<0.01 / left P<0.05) and a rebalancing of the principal bone points in the postural system (shoulder 71%, P<0.05, hips 65.6%, P=0.056, sagittal AP and frontal LL center of gravity, respectively 40%, P<0.05 and 52.7%, P=0.01). CONCLUSIONS: In conclusion, we could hypothesize the usefulness of an ANS to act on these parameters. ANS could be used not only for treatment of injuries but also in the field of prevention.

Understanding Symptoms of Muscle Tightness, Weakness, and Rigidity From a Nursing Perspective.

PURPOSE: This study examined the nature of muscle tightness from nurses' perspectives and explored how the symptoms of muscle tightness are communicated, managed, and differentiated from other conditions, such as muscle rigidity and muscle weakness. DESIGN: An exploratory, descriptive qualitative design was used. METHODS: Eight rehabilitation nurses described lexicons, care strategies, and communication for muscle tightness, weakness, and rigidity. FINDINGS: Nurses used conflicting terms to describe muscle tightness, weakness, and rigidity. They identified medications and range of motion as the best strategies to manage muscle conditions. Nurses approach care holistically and do not differentiate care strategies that are based only on a symptoms lens. CONCLUSIONS: Nurses were unable to clearly differentiate between muscle tightness and rigidity. CLINICAL RELEVANCE: Nurses influence patients' choice of vocabulary; therefore, they must use simple but precise terminologies to educate their patients. Miscommunication between nurses and patients can lead to errors, which can have negative consequences.

Effect of a 1-week intense myofunctional training on obstructive sleep apnoea in children with Down syndrome.

BACKGROUND: Obstructive sleep apnoea (OSA) is common in children with Down syndrome (DS), yet difficult to treat. As muscular hypotonia of the upper airway may cause OSA and is also common in DS, we tested whether intense myofunctional therapy improves OSA in children with DS. PATIENTS AND METHODS: Forty-two children underwent cardiorespiratory sleep studies immediately before and after a 1-week intensive training camp consisting of three daily 45 min sessions of myofunctional exercises according to Padovan. Primary outcome was the mixed-obstructive-apnoea/hypopnoea index (MOAHI), secondary outcomes the ≤3% oxygen desaturation index (DI3), the ≤90% desaturation index (DI90) and the lowest pulse oximeter saturation (SpO2nadir). RESULTS: Eighteen recordings had ≥3 hours of artefact-free recording in both the pretreatment and post-treatment sleep study and were therefore included in the analysis. Mean age was 6.3 years (SD 2.5); 83% had OSA prior to intervention. Mean MOAHI was 6.4 (SD 8.6) before and 6.4 (SD 10.8) after the intervention (p>0.05); the DI3 and SpO2nadir also did not change. Only the DI90 decreased significantly from 2.7 (SD 4.5) to 2.1 (SD 3.7) (p<0.05). CONCLUSION: The 1-week intense myofunctional training camp evaluated here in children with DS had only a marginal effect on OSA. Whether a longer follow-up period or duration of intervention would yield stronger effects remains to be determined.

Effects of orofacial myofunctional therapy on masticatory function in individuals submitted to orthognathic surgery: a randomized trial.

OBJECTIVES: The esthetic and functional results of orthognathic surgery of severe dentofacial deformities are predictable, however there are differences regarding the effects on stomatognathic system. The aim was to investigate the effects of orofacial myofunctional therapy (OMT) on the masticatory function in individuals with dentofacial deformity submitted to orthognathic surgery (OGS). MATERIAL AND METHODS: Forty-eight individuals (18-40 years) were evaluated, 14 undergoing OMT (treated group-TG), 10 without this treatment (untreated group-UTG) and 24 in a control group with normal occlusion; for clinical aspects the data of an individual was missed (n=46). Chewing was performed using the Expanded protocol of orofacial myofunctional evaluation with scores (OMES-E). Muscle tone and mobility were also analyzed before (P0), three (P1) and six months (P2) after OGS. Surface electromyography of the masseter and temporalis muscles was performed, considering the parameters amplitude and duration of act and cycle, and the number of masticatory cycles. The OMT consisted of ten therapeutic sessions along the postoperative period. The results were compared using parametric and non-parametric tests. RESULTS: TG showed higher scores in P1 and P2 than P0; for the masticatory type the scores in P2 were significantly higher than P0. In addition, the proportion of individuals with adequate tone of lower lip and adequate tongue mobility for TG increased significantly from P1 and P2 in relation to P0. The EMG results showed a decrease in act and cycle duration in P2 in relation to P0 and P1 for the TG; furthermore the values were close to controls. An increase in the number of cycles from P0 to P2 was also observed, indicating faster chewing, which may be attributed to an improvement of balanced occlusion associated with OMT. CONCLUSION: There were positive effects of OMT on the clinical and electromyography aspects of chewing in individual submitted to orthognathic surgery.

Effects of orofacial myofunctional therapy on masticatory function in individuals submitted to orthognathic surgery: a randomized trial

Abstract Objectives: The esthetic and functional results of orthognathic surgery of severe dentofacial deformities are predictable, however there are differences regarding the effects on stomatognathic system. The aim was to investigate the effects of orofacial myofunctional therapy (OMT) on the masticatory function in individuals with dentofacial deformity submitted to orthognathic surgery (OGS). Material and Methods: Forty-eight individuals (18-40 years) were evaluated, 14 undergoing OMT (treated group-TG), 10 without this treatment (untreated group-UTG) and 24 in a control group with normal occlusion; for clinical aspects the data of an individual was missed (n=46). Chewing was performed using the Expanded protocol of orofacial myofunctional evaluation with scores (OMES-E). Muscle tone and mobility were also analyzed before (P0), three (P1) and six months (P2) after OGS. Surface electromyography of the masseter and temporalis muscles was performed, considering the parameters amplitude and duration of act and cycle, and the number of masticatory cycles. The OMT consisted of ten therapeutic sessions along the postoperative period. The results were compared using parametric and non-parametric tests. Results: TG showed higher scores in P1 and P2 than P0; for the masticatory type the scores in P2 were significantly higher than P0. In addition, the proportion of individuals with adequate tone of lower lip and adequate tongue mobility for TG increased significantly from P1 and P2 in relation to P0. The EMG results showed a decrease in act and cycle duration in P2 in relation to P0 and P1 for the TG; furthermore the values were close to controls. An increase in the number of cycles from P0 to P2 was also observed, indicating faster chewing, which may be attributed to an improvement of balanced occlusion associated with OMT. Conclusion: There were positive effects of OMT on the clinical and electromyography aspects of chewing in individual submitted to orthognathic surgery.

Lived Experiences of Muscle Tightness Symptoms From Patients' Perspectives.

The aims of this study were to understand symptoms of chronic muscle tightness from the patient's perspective and explore symptom management strategies used by them. Muscle tightness, a common symptom, is a challenge to manage in clinical practice because it is commingled with other orthopedic conditions. Nurses may not be aware of the negative impact of tight muscles because this symptom is presumed to be self-limiting; however, if not treated appropriately, muscle tightness can become chronic. The focus of this study is the lived experience of patients with chronic muscle tightness. The researchers used a qualitative descriptive design in which patients provided insights into the experiences and self-management of chronic muscle tightness. Sixteen adult subjects experiencing physical impairments who were managed by physical therapists in a specialty clinic participated in the study. The subjects participated in 45- to 60-minute semistructured interviews to provide understanding of chronic muscle tightness. The interviews were recorded and transcribed for content analysis. Results indicate that patients identify day-to-day experiences of chronic muscle tightness as unresolving; these patients experience myriads of sensations and live with life restrictions that negatively affect their quality of life. Uses of complementary therapies are commonplace in managing this symptom. The symptom of chronic muscle tightness may linger, and patients use workarounds to manage their lives. Nurses must understand patients' perspectives to assist them in achieving an acceptable quality of life.

Effectiveness of Spiritist "passe" (Spiritual healing) for anxiety levels, depression, pain, muscle tension, well-being, and physiological parameters in cardiovascular inpatients: A randomized controlled trial.

BACKGROUND: Biofield therapies, such as laying on of hands, are used in association with Conventional Medicine as Spiritist "passe", among others. The aim of this study was to evaluate anxiety, depression, pain, muscle tension and well-being, as well as physiological parameters in cardiovascular inpatients submitted to the Spiritist "passe", sham, and no intervention. METHODS: In the total, 41 cardiovascular inpatients submitted to the Spiritist "passe", sham, and no intervention during a 10-min period on 3 consecutive days. They were evaluated through anxiety and depression level, pain, the perceptions of muscle tension and well-being and physiological parameters, before and after interventions. RESULTS: A significant reduction (p=0.001) in anxiety scores and muscle tension (p=0.011), improvement of well-being (p=0.003) and a significant increase in peripheral oxyhemoglobin saturation scores (p=0.028) were observed in Spiritist "passe" patients, and a significant reduction (p=0.028) of muscle tension and improvement of well-being (p=0.045) in sham patients. However, muscle tension reduction (p=0.003) and improvement of well-being (p=0.003) were more accentuated in the Spiritist "passe" compared to sham and no intervention. CONCLUSIONS: Results suggest that the Spiritist "passe" appeared to be effective, reducing anxiety level and the perception of muscle tension, consequently improving peripheral oxyhemoglobin saturation and the sensation of well-being compared to sham and no intervention in cardiovascular inpatients.

Individuals with high obsessive-compulsive tendencies or undermined confidence rely more on external proxies to access their internal states.

BACKGROUND AND OBJECTIVES: The Seeking Proxies for Internal States (SPIS) hypothesis predicts that obsessive-compulsive disorder (OCD) is associated with a deficit in subjective convictions, which may lead to a reliance on external substitutes for the perceptions of an individual's internal states. Two well-designed studies were performed for the present work that adopted a false bio-feedback procedure in a muscle tension task to examine the SPIS hypothesis. METHODS: The false bio-feedback paradigm was used to investigate our hypothesis. NeXus-10 Mark II hardware and V2011 BioTrace + software (Mind Media B.V., Herten, Netherlands) were utilized to measure the muscle tension of the flexor carpiulnaris muscle, which characterized the target's internal state. In addition, false EMG changes were recorded and displayed on a computer monitor and were considered external proxies. RESULTS: Study 1 demonstrated that the participants with high obsessive-compulsive (OC) tendencies were more affected by the false bio-feedback and exhibited lower confidence in their judgments regarding their muscle tension compared with the participants with low OC tendencies. These findings indicate that subjects with high OC tendencies were more influenced by self-perception effects. In contrast, the subjects in the undermined confidence group in Study 2 were more easily influenced by the false bio-feedback compared with the control group, which suggests that the subjects in the undermined confidence group were more affected by self-perception effects. LIMITATIONS: We did not combine the undermined confidence with OC tendencies or OCD symptoms in our paradigm to investigate their joint effects on self-perception. CONCLUSIONS: Our findings provide further evidence that supports the SPIS hypothesis, which indicates that OC tendencies and the confidence in an individual's recognition of internal states appear to have similar effects on the assessment of internal states and reliance on proxies.