Central effects of mouth rinses on endurance and strength performance.

Rinsing the mouth with a carbohydrate (CHO) solution has been shown to enhance exercise performance while reducing neuromuscular fatigue. This effect is thought to be mediated through the stimulation of oral receptors, which activate brain areas associated with reward, motivation, and motor control. Consequently, corticomotor responsiveness is increased, leading to sustained levels of neuromuscular activity prior to fatigue. In the context of endurance performance, the evidence regarding the central involvement of mouth rinse (MR) in performance improvement is not conclusive. Peripheral mechanisms should not be disregarded, particularly considering factors such as low exercise volume, the participant's fasting state, and the frequency of rinsing. These factors may influence central activations. On the other hand, for strength-related activities, changes in motor evoked potential (MEP) and electromyography (EMG) have been observed, indicating increased corticospinal responsiveness and neuromuscular drive during isometric and isokinetic contractions in both fresh and fatigued muscles. However, it is important to note that in many studies, MEP data were not normalised, making it difficult to exclude peripheral contributions. Voluntary activation (VA), another central measure, often exhibits a lack of changes, mainly due to its high variability, particularly in fatigued muscles. Based on the evidence, MR can attenuate neuromuscular fatigue and improve endurance and strength performance via similar underlying mechanisms. However, the evidence supporting central contribution is weak due to the lack of neurophysiological measures, inaccurate data treatment (normalisation), limited generalisation between exercise modes, methodological biases (ignoring peripheral contribution), and high measurement variability.Trial registration: PROSPERO ID: CRD42021261714.

Effect of increased inspiratory muscle work on blood flow to inactive and active limbs during submaximal dynamic exercise.

NEW FINDINGS: What is the central question of this study? Increased respiratory muscle activation is associated with neural and cardiovascular consequences via the respiratory muscle metaboreflex. Does increased sympathetic vasoconstriction originating from the respiratory musculature elicit a reduction in blood flow to an inactive limb in order to maintain blood flow to an active limb? What is the main finding and its importance? Arm blood flow was reduced whereas leg blood flow was preserved during mild leg exercise with inspiratory resistance. Blood flow to the active limb is maintained via sympathetic control of blood flow redistribution when the respiratory muscle-induced metaboreflex is activated. ABSTRACT: The purpose of this study was to elucidate the effect of increasing inspiratory muscle work on blood flow to inactive and active limbs. Healthy young men (n = 10, 20 ± 2 years of age) performed two bilateral dynamic knee-extension and knee-flexion exercise tests at 40% peak oxygen uptake for 10 min. The trials consisted of spontaneous breathing for 5 min followed by voluntary hyperventilation either with or without inspiratory resistance for 5 min (40% of maximal inspiratory mouth pressure, inspiratory duty cycle of 50% and a breathing frequency of 40 breaths min-1 ). Mean arterial blood pressure was acquired using finger photoplethysmography. Blood flow in the brachial artery (inactive limb) and in the femoral artery (active limb) were monitored using Doppler ultrasound. Mean arterial blood pressure during exercise was higher (P < 0.05) with inspiratory resistance (121 ± 7 mmHg) than without resistance (99 ± 5 mmHg). Brachial artery blood flow increased during exercise without inspiratory resistance (120 ± 31 ml min-1 ) compared with the resting level, whereas it was attenuated with inspiratory resistance (65 ± 43 ml min-1 ). Femoral artery blood flow increased at the onset of exercise and was maintained throughout exercise without inspiratory resistance (2576 ± 640 ml min-1 ) and was unchanged when inspiratory resistance was added (2634 ± 659 ml min-1 ; P > 0.05). These results suggest that sympathetic control of blood redistribution to active limbs is facilitated, in part, by the respiratory muscle-induced metaboreflex.

Pulmonary and respiratory muscle function in response to 10 marathons in 10 days.

PURPOSE: Marathon and ultramarathon provoke respiratory muscle fatigue and pulmonary dysfunction; nevertheless, it is unknown how the respiratory system responds to multiple, consecutive days of endurance exercise. METHODS: Nine trained individuals (six male) contested 10 marathons in 10 consecutive days. Respiratory muscle strength (maximum static inspiratory and expiratory mouth-pressures), pulmonary function (spirometry), perceptual ratings of respiratory muscle soreness (Visual Analogue Scale), breathlessness (dyspnea, modified Borg CR10 scale), and symptoms of Upper Respiratory Tract Infection (URTI), were assessed before and after marathons on days 1, 4, 7, and 10. RESULTS: Group mean time for 10 marathons was 276 ± 35 min. Relative to pre-challenge baseline (159 ± 32 cmH2O), MEP was reduced after day 1 (136 ± 31 cmH2O, p = 0.017), day 7 (138 ± 42 cmH2O, p = 0.035), and day 10 (130 ± 41 cmH2O, p = 0.008). There was no change in pre-marathon MEP across days 1, 4, 7, or 10 (p > 0.05). Pre-marathon forced vital capacity was significantly diminished at day 4 (4.74 ± 1.09 versus 4.56 ± 1.09 L, p = 0.035), remaining below baseline at day 7 (p = 0.045) and day 10 (p = 0.015). There were no changes in FEV1, FEV1/FVC, PEF, MIP, or respiratory perceptions during the course of the challenge (p > 0.05). In the 15-day post-challenge period, 5/9 (56%) runners reported symptoms of URTI, relative to 1/9 (11%) pre-challenge. CONCLUSIONS: Single-stage marathon provokes acute expiratory muscle fatigue which may have implications for health and/or performance, but 10 consecutive days of marathon running does not elicit cumulative (chronic) changes in respiratory function or perceptions of dyspnea. These data allude to the robustness of the healthy respiratory system.

Effect of External Counterpulsation on Exercise Recovery in Team Sport Athletes.

External counterpulsation (ECP), an electrocardiogram-led sequential compression of lower limbs, has been recently proposed for sports recovery, but research is scant. This study examined the effects of an ECP session upon neuromuscular function (vertical jump and torque/velocity characteristics), biochemical responses (creatine kinase, cortisol, testosterone, alpha-amylase and immunoglobulin-A), and muscle soreness (visual analogue scale) following high-intensity exercise. Twenty-one male team sport athletes (age: 21.6±3.4 yrs; height: 182.7±7.3 cm; body mass: 82.7±9.3 kg) recovered from the fatiguing exercise using either ECP or rest. Data collection was conducted at three separate time points: upon arrival (Pre), post-recovery (Post), and 24 h post-recovery (24hPost). Significant main effects for time were observed for increased torque/velocity slope and for decreased isometric extension peak torque (p<0.001). Significant main effects for time were observed for increased creatine kinase, testosterone, alpha-amylase, and muscle soreness (all p<0.001). Significant interaction effects were observed at post-testing following ECP: Cortisol release and the related decline in testosterone/cortisol ratio were attenuated, and immunoglobulin-A was increased following ECP in comparison to the control (all p<0.05). Following high-intensity exercise, ECP has potentially beneficial effects upon biomarkers of recovery, without affecting the neuromuscular function.

The effect of inspiratory muscle fatigue on acid-base status and performance during race-paced middle-distance swimming.

The aim of this study was to investigate the effect of pre-induced inspiratory muscle fatigue (IMF) on race-paced swimming and acid-base status. Twenty-one collegiate swimmers performed two discontinuous 400-m race-paced swims on separate days, with (IMF trial) and without (control trial) pre-induced IMF. Swimming characteristics, inspiratory and expiratory mouth pressures, and blood parameters were recorded. IMF and expiratory muscle fatigue (P < 0.05) were evident after both trials and swimming time was slower (P < 0.05) from 150-m following IMF inducement. Pre-induced IMF increased pH before the swim (P < 0.01) and reduced bicarbonate (P < 0.05) and the pressure of carbon dioxide (PCO2) (P < 0.05). pH (P < 0.05), bicarbonate (P < 0.01) and PCO2 (P < 0.05) were lower during swimming in the IMF trial. Blood lactate was similar before both trials (P > 0.05) but was higher (P < 0.01) in the IMF trial after swimming. Pre-induced IMF induced respiratory alkalosis, reduced bicarbonate buffering capacity and slowed swimming speed. Pre-induced and propulsion-induced IMF reflected metabolic acidosis arising from dual role breathing and propulsion muscle fatigue.

Neuromuscular, physiological and perceptual responses to an elite netball tournament.

To examine responses to an International netball tournament, female athletes (n= 11) played three matches over consecutive days. External (accelerometry) and internal (heart rate; HR, session; sRPE, and differential; dRPE, rating of perceived exertion) load measures quantified match intensity. On match-day mornings, and three days after match 3, well-being (brief assessment of mood; BAM+), biochemical (creatine kinase concentration; CK), neuromuscular (jump height; JH, peak power output; PPO) and endocrine function (salivary cortisol; C, testosterone; T, concentrations) were assessed. External load was similar between matches whereas dRPE and sRPE were greatest for match 3. Following match 1, CK increased, whereas BAM+, JH, C and T decreased. Following two matches, BAM+, PPO, and T decreased with CK increasing versus baseline. Following consecutive matches, CK (likely moderate; 27.9% ± 19.5%) and C (possibly moderate; 43.3% ± 46.8%) increased, whilst BAM+ (possibly moderate; -20.6% ± 24.4%) decreased. Three days post-tournament BAM+, T, PPO, and JH decreased. Mid-court elicited higher mean HR (possibly moderate; 3.7% ± 3.8%), internal and external intensities (possibly very large; 85.7% ± 49.6%) compared with goal-based positions. Consecutive matches revealed a dose-response relationship for well-being and physiological function; a response evident three days post-tournament.

Physical Response to a Simulated Period of Soccer-Specific Fixture Congestion.

Page, RM, Marrin, K, Brogden, CM, and Greig, M. Physical response to a simulated period of soccer-specific fixture congestion. J Strength Cond Res 33(4): 1075-1085, 2019-The aim of this study was to assess the physiological, perceptual, and mechanical measures associated with the completion of a simulated period of short-term soccer-specific fixture congestion. Ten male semiprofessional soccer players completed 3 trials of a treadmill-based match simulation, with 48 hours interspersing each trial. A repeated measures general linear model identified significantly (p = 0.02) lower knee flexor peak torque (PT) recorded at 300°·s in the second (141.27 ± 28.51 N·m) and third trials (139.12 ± 26.23 N·m) when compared with the first trial (154.17 ± 35.25 N·m). Similarly, muscle soreness (MS) and PT data recorded at 60°·s were significantly (p ≤ 0.05) different in the third trial (MS = 42 ± 25 a.u; PT60 = 131.10 ± 35.38 N·m) when compared with the first trial (MS = 29 ± 29 a.u; PT60 = 145.61 ± 42.86 N·m). Significant (p = 0.003) differences were also observed for mean electromyography (EMGmean) of bicep femoris between the third trial (T0-15 = 126.36 ± 15.57 µV; T75-90 = 52.18 ± 17.19 µV) and corresponding time points in the first trial (T0-15 = 98.20 ± 23.49 µV; T75-90 = 99.97 ± 39.81 µV). Cumulative increases in perceived exertion, heart rate, oxygen consumption, blood lactate concentrations, EMGmean, and PlayerLoad (PL) were recorded across each trial. Muscle soreness and PT were also significantly different after trial. There were, however, no significant main effects or interactions for the salivary immunoglobulin A and the medial-lateral PL metrics. These data suggest a biomechanical and muscular emphasis with residual fatigue, with implications for injury risk and the development of recovery strategies.

Delayed-onset muscle soreness in human masticatory muscles increases inhibitory jaw reflex responses.

The effects of masticatory muscles' overloading on jaw-motor control are not yet fully clarified. Therefore, it was tested whether eccentric and concentric exercises of the human masticatory muscles would influence inhibitory jaw reflex responses. Eleven participants (6 males, 5 females) performed 6, 5-minutes bouts of eccentric-concentric contractions. Before, immediately after, 24 hours, 48 hours and 1 week afterwards, visual analogue scale (VAS) scores for jaw muscle fatigue and pain, maximum voluntary bite force (MVBF) and inhibitory jaw reflexes were recorded. Reflex data were analysed with the cumulative sum control chart error box method. Immediate and delayed masticatory muscle fatigue and pain were provoked. Further, 24 hours after the exercises, MVBF tended to decrease (P = .056), suggesting that delayed-onset muscle soreness (DOMS) was provoked in the masticatory muscles. In addition, the inhibitory jaw reflex showed a delayed increase in size 24 hours after the exercise (P < .05). In conclusion, DOMS provoked in the masticatory muscles alters jaw motor control by inducing a delayed increase in the size of the inhibitory jaw reflex.

Two repetitive bouts of intense eccentric-concentric jaw exercises reduce experimental muscle pain in healthy subjects.

High-intensity eccentric-concentric contractions of the jaw-closing muscles induce muscle soreness, fatigue and functional impairment of the jaw, resembling the symptoms of myalgia, according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). However, it is claimed that repetition of similar exercises can minimise these detrimental effects. This study aimed to evaluate the response of jaw-closing muscles following two series of intense eccentric-concentric exercises of the masticatory muscles in healthy subjects. Twelve pain-free participants underwent 2 sessions of intense eccentric-concentric jaw exercises, with 1-week interval in between. Each session of jaw exercises comprises 6 sets of 5-minute-long bouts of concentric-eccentric contractions. Self-reported muscle fatigue and pain, maximum mouth opening without pain (MMO), pain pressure thresholds (PPTs) of temporalis and masseter muscles and maximum voluntary bite force (MVBF) were recorded before, immediately after, 24 and 48 hours after each bout of exercises. ANOVA for repeated measurements was used to analyse the data. During session 2, muscle pain and fatigue were statistically significantly decreased (P < .05) as compared to session 1. Furthermore, statistically significant increases of MVBF (P < .005), MMO (P < .005) and PPTs (P < .005) were found at session 2 as compared to session 1. Within the limitations of the study, is can be concluded that the repetition of eccentric-concentric jaw-closing exercises results in signs of muscle training. Future studies can elucidate whether this motor training might be useful for the treatment of myalgia.

Carbohydrate Mouth Rinsing Does Not Prevent the Decline in Maximal Strength After Fatiguing Exercise.

Black, CD, Schubert, DJ, Szczyglowski, MK, and Wren, JD. Carbohydrate mouth rinsing does not prevent the decline in maximal strength after fatiguing exercise. J Strength Cond Res 32(9): 2466-2473, 2018-Carbohydrate (CHO) rinsing has been shown to attenuate the decline of maximal voluntary contractions (MVCs) after fatiguing exercise-perhaps through a central mechanism. This study sought to determine the effect of a CHO rinse on MVC, voluntary activation, and contractile properties after fatiguing exercise. Thirteen adults participated in a double-blind, cross-over study. Maximal voluntary contraction of the dominant knee extensors was assessed, and voluntary activation (%VA) was determined using twitch interpolation. Participants then held 50% of MVC until volitional fatigue followed by a 20-second rinse with a solution of 8% maltodextrin (CHO) or placebo (PLA). Maximal voluntary contraction and %VA were reassessed immediately and 5 minutes after exercise. Maximal voluntary contraction did not differ between the CHO and PLA conditions initially (230 ± 90 vs. 232 ± 90 N·m; p = 0.69). Maximal voluntary contraction declined after exercise (p ≤ 0.01), but no differences were found between the CHO and PLA conditions (p ≥ 0.59). %VA did not differ between conditions (91.9 ± 2.9% vs. 91.5 ± 3.8%; p ≥ 0.11) nor did it change after exercise (p = 0.57). Twitch torque, rate of torque development, and rate of torque relaxation were reduced after exercise (p ≤ 0.05) but were unaffected by CHO rinsing (p > 0.05). Unlike a previous study, a CHO rinse did not preserve MVC after fatiguing exercise. This was likely due to a lack of central fatigue induced by the exercise protocol (as %VA was unaffected) as the CHO rinse is thought to work through a central mechanism.

Comparison of EMG activity and blood flow during graded exertion in the orbicularis oris muscle of adult subjects with and without lip incompetence: a cross-sectional survey.

Background/Objectives: The peri-oral muscles-including orbicularis oris-are critical in maintaining equilibrium in tooth position. Lip incompetence (LI) can thus be a factor in malocclusion. We therefore aimed to validate a technique to evaluate not only muscle activity via electromyography (EMG) but also muscle endurance and fatigue via blood flow (BF) for LI. Subjects/Methods: Subjects were classified into increased muscle tension/lip incompetent (experimental) and normal muscle tension/lip competent (control) groups. Each subject then exerted force on a custom-made traction plate connected to a tension gauge. Using laser speckle imaging and electromyographic measurements, we characterized muscle activity and corresponding BF rates in these subjects in various states of resting, loading, and recovery. Results: Results showed a significant difference between the experimental and control groups, notably in the rate of change in BF to the inferior orbicularis oris muscle under conditions of increasing load (graded exertion). Furthermore, the data suggested that the muscles in the control group undergo a more prolonged (and therefore presumably more complete) recovery than muscles in the experimental group. These factors of reduced BF and short recovery may combine to accelerate muscle fatigue and produce LI. Limitations: The sample used here was controlled for malocclusion (including open bite) to eliminate this type of confounding effect. Conclusions/Implications: From these findings, we conclude that reduced BF and inadequate recovery in the orbicularis oris muscles may be more significant than EMG activity in the assessment of LI.

The 6-min mastication test: a unique test to assess endurance of continuous chewing, normal values, reliability, reproducibility and usability in patients with mitochondrial disease.

In patients with mitochondrial disease, fatigue and muscle problems are the most common complaints. They also experience these complaints during mastication. To measure endurance of continuous mastication in patients with mitochondrial diseases, the 6-min mastication test (6MMT) was developed. This study included the collection of normal data for the 6MMT in a healthy population (children and adults). During 6 min of continuous mastication on a chew tube chewing cycles per minute, total amount of chewing cycles and the difference between minute 1 (M1 ) and minute 6 (M2 ) were collected in 271 healthy participants (5-80 years old). These results were compared with those of nine paediatric and 25 adult patients with a mitochondrial disease. Visual analogue scale (VAS) scores were collected directly after the test and after 5 min. A qualitative rating was made on masticatory movements. The reproducibility of the 6MMT in the healthy population with an interval of approximately 2 weeks was good. The inter-rater reliability for the observations was excellent. The patient group demonstrated lower total amount of chewing cycles or had greater differences between M1 and M6 . The 6MMT is a reliable and objective test to assess endurance of continuous chewing. It demonstrates the ability of healthy children and adults to chew during 6 min with a highly stable frequency of mastication movements. The test may give an explanation for the masticatory problems in patient groups, who are complaining of pain and fatigue during mastication.

Delayed-onset muscle soreness does not influence occlusal sensitivity and position sense of the mandible.

Masticatory muscle-pain patients often complain about sensorimotor changes, but the effects of pain on the psychophysical properties remain unclear. This study aimed to investigate the effects of delayed-onset muscle soreness (DOMS) on the jaw's position sense (PS) and occlusal sensitivity (OS). In all, 12 participants underwent intense concentric-eccentric jaw exercises. Self-reported muscle fatigue and pain, pain-free maximum mouth opening (MMO), pain pressure thresholds (PPTs) at right and left masseter and right and left anterior temporalis, maximum voluntary bite force (MVBF), PS and OS were recorded before, immediately after, 24 h, 48 h and 1 week after the exercises. Data were analysed with repeated measures anova. Pain and fatigue increased significantly after the exercises, while fatigue also increased 24 h afterwards. Time and site had a significant effect for PPTs, not for MVBF. MMO decreased significantly 24 h after the exercises. OS and PS did not change significantly. Experimentally induced DOMS does not influence the psychophysical properties of the masticatory system.

Leg Stiffness in Female Soccer Players: Intersession Reliability and the Fatiguing Effects of Soccer-Specific Exercise.

De Ste Croix, MBA, Hughes, JD, Lloyd, RS, Oliver, JL, and Read, PJ. Leg stiffness in female soccer players: intersession reliability and the fatiguing effects of soccer-specific exercise. J Strength Cond Res 31(11): 3052-3058, 2016-Low levels of leg stiffness and reduced leg stiffness when fatigue is present compromise physical performance and increase injury risk. The purpose of this study was to (a) determine the reliability of leg stiffness measures obtained from contact mat data and (b) explore age-related differences in leg stiffness after exposure to a soccer-specific fatigue protocol in young female soccer players. Thirty-seven uninjured female youth soccer players divided into 3 subgroups based on chronological age (under 13 [U13], under 15 [U15], and under 17 [U17] year-olds) volunteered to participate in the study. After baseline data collection, during which relative leg stiffness, contact time, and flight time were collected, participants completed an age-appropriate soccer-specific fatigue protocol (SAFT). Upon completion of the fatigue protocol, subjects were immediately retested. Intersession reliability was acceptable and could be considered capable of detecting worthwhile changes in performance. Results showed that leg stiffness decreased in the U13 year-olds, was maintained in the U15 age group, and increased in the U17 players. Contact times and flight times did not change in the U13 and U15 year-olds, but significantly decreased and increased, respectively, in the U17 age group. The data suggest that age-related changes in the neuromuscular control of leg stiffness are present in youth female soccer players. Practitioners should be aware of these discrepancies in neuromuscular responses to soccer-specific fatigue, and should tailor training programs to meet the needs of individuals, which may subsequently enhance performance and reduce injury risk.

Evaluating the Training Effects of Two Swallowing Rehabilitation Therapies Using Surface Electromyography--Chin Tuck Against Resistance (CTAR) Exercise and the Shaker Exercise.

In this study, the efficacy of two dysphagia interventions, the Chin Tuck against Resistance (CTAR) and Shaker exercises, were evaluated based on two principles in exercise science-muscle-specificity and training intensity. Both exercises were developed to strengthen the suprahyoid muscles, whose contractions facilitate the opening of the upper esophageal sphincter, thereby improving bolus transfer. Thirty-nine healthy adults performed two trials of both exercises in counter-balanced order. Surface electromyography (sEMG) recordings were simultaneously collected from suprahyoid muscle group and sternocleidomastoid muscle during the exercises. Converging results using sEMG amplitude analyses suggested that the CTAR was more specific in targeting the suprahyoid muscles than the Shaker exercise. Fatigue analyses on sEMG signals further indicated that the suprahyoid muscle group were equally or significantly fatigued (depending on metric), when participants carried out CTAR compared to the Shaker exercise. Importantly, unlike during Shaker exercise, the sternocleidomastoid muscles were significantly less activated and fatigued during CTAR. Lowering the chin against resistance is therefore sufficiently specific and intense to fatigue the suprahyoid muscles.

Blood oxygenation of masseter muscle during sustained elevated muscle activity in healthy participants.

Myofascial pain associated with temporomandibular disorders has often been linked to pathological muscle hyperactivity. As a result, localised disturbances of intramuscular blood flow could lead to a lower level of oxygen distribution, hypoxia and microcirculatory changes. To assess haemodynamic changes in the masseter muscle during sustained elevated muscle activity (SEMA). Sixteen healthy participants performed thirty 1-min bouts of SEMA with intervals of 1-min 'rest' periods between the bouts on a bite force transducer device. The participants completed three sessions with different percentage of their maximal voluntary occlusal bite force (MVOBF): 0% (no task), 10% or 40% MVOBF tasks. The order of the sessions was randomised with 1- to 2-week intervals. Haemodynamic characteristics of the masseter muscle were estimated with use of a laser blood oxygenation monitor. Tissue blood oxygen saturation (StO2 ) during SEMA was lower than during rest (P < 0·001). The relative changes in total haemoglobin (Total-Hb) and StO2 were influenced by condition (SEMA and rest) and with interactions between condition and session (0%, 10% and 40% MVOBF tasks). These results suggest that SEMA may lead to hypoxia in the masseter muscle and that the haemodynamic characteristics and muscle symptoms depend on the magnitude of muscle contractions. Overall, the present findings may help to provide better insights into relationships between jaw muscle activity, haemodynamic changes and symptom developments with implications for clinical conditions such as bruxism characterised by different levels of tooth-grinding and tooth-clenching muscle activity.

Fundamentals of Embouchure in Brass Players: Towards a Definition and Clinical Assessment.

Brass players may experience problems producing an optimal sound (or range of sounds) in their instrument. Assessing and treating dysfunctional embouchure requires knowledge of functional embouchure, but peer-reviewed literature on dysfunctional and functional embouchure is scarce. OBJECTIVE: This study aimed to provide a narrative overview of embouchure based on information from different scientific and clinical fields. This should be regarded as a first step in constructing a reliable, valid, and practical multi-item method to assess embouchure for brass players. METHODS: Literature reviews were conducted concerning: 1) the definition of embouchure, 2) physics and acoustics of embouchure, 3) functioning of embouchure-related structures, and 4) instruments to assess embouchure. Also, embouchure experts (clinicians, scientists, and elite wind players) were consulted for information and discussion. RESULTS: A proposal for a new definition of embouchure, an overview of the relevant physics and acoustics, functions of embouchure-related body structures, and the main methods to measure embouchure in brass playing are presented. CONCLUSION: Peer-reviewed information about the fundamentals of dysfunctional embouchure is scarce and sometimes contradictory. A new definition for embouchure is proposed: embouchure is the process needed to adjust the amount, pressure, and direction of the air flow (generated by the breath support) as it travels through the mouth cavity and between the lips, by the position and/or movements of the tongue, teeth, jaws, cheeks, and lips, to produce a tone in a wind instrument. An integrative overview is presented which can serve as a transparent foundation for the present understanding of functional and dysfunctional embouchure and for developing an evidence-based multi-item assessment instrument.

Symptoms and physiological responses to prolonged, repeated, low-level tooth clenching in humans.

BACKGROUND: The traditional view contends bruxism, such as tooth grinding/clenching, is part of the etiology of temporomandibular disorders (TMD) including some subtypes of headaches. The purpose of this study is to investigate if a low-level but long-lasting tooth-clenching task initiates TMD symptoms/signs. METHODS: Eighteen healthy participants (mean age ± SD, 24.0 ± 4.3 years) performed and repeated an experimental 2-hour tooth-clenching task at 10% maximal voluntary occlusal bite force at incisors (11.1 ± 4.6 N) for three consecutive days (Days 1-3). Pain and cardiovascular parameters were estimated during the experiment. RESULTS: The task evoked pain in the masseter/temporalis muscles and temporomandibular joint after 40.0 ± 18.0 minutes with a peak intensity of 1.6 ± 0.4 on 0-10 numerical rating scale (NRS) after 105.0 ± 5.0 minutes (Day 1). On Day 2 and Day 3, pain had disappeared but the tasks, again, evoked pain with similar intensities. The onset and peak levels of pain were not different between the experimental days (P = .977). However, the area under the curve of pain NRS in the masseter on Day 2 and Day 3 were smaller than that on Day 1 (P = .006). Cardiovascular parameters changed during the task but not during the days. CONCLUSIONS: Prolonged, low-level tooth clenching evoked short-lived pain like TMD. This intervention study proposes that tooth clenching alone is insufficient to initiate longer lasting and self-perpetuating symptoms of TMD, which may require other risk factors.

Carbohydrate Mouth Rinse Counters Fatigue Related Strength Reduction.

The purpose was to determine the effect of carbohydrate (CHO) mouth rinse on maximal voluntary contraction (MVC) and neuromuscular output in a fatigued state. It was hypothesized that CHO mouth rinse would potentiate torque output in a fatigued state. In a double-blind, cross-over design, 12 competitive male athletes (9 rowers, 1 cyclist, 1 runner and 1 volleyball player) initially performed 3 × 5 s MVC isometric knee extensions followed by a 50% MVC contraction until volitional exhaustion, with quadriceps muscle activity measured via electromyography (EMG). Immediately after, either an 8% CHO maltodextrin (WASH), or noncaloric artificial sweetener (PLA) was mouth rinsed for 10sec, before 3 × 5 s final MVCs. Fatigue caused a significant decline in post fatigue MVC trial 1 for 3 s average torque (p = .03) and peak torque (p = .02) for PLA. This fatigue related decline in torque was not noticed for WASH, with a 2.5% and 3.5% less attenuation in peak and average torque, respectively in post fatigue MVC1 compared with PLA. The effect size for MVC trial 1 between WASH/PLA was seen to be small positive (ES = 0.22; 55% likelihood of positive). Overall for EMG RMS, there were no significant differences between PLA and WASH among all muscles. EMG median frequency showed comparable results between conditions with significant reductions due to fatigue. Taken together, this evidence suggests that the attenuation of torque post fatigue was less for CHO mouth rinse than a placebo. Even though the gains were marginal, these discoveries may play an important role in sport performance, as small performance effects can have significant outcomes in real-world competitions.

Muscle characterization of reactive oxygen species in oral diseases.

IMPORTANCE AND OBJECTIVE: Reactive Oxygen Species (ROS) are oxygen-derived molecules that are unstable and highly reactive. They are important signaling mediators of biological processes. In contrast, excessive ROS generation, defective oxidant scavenging or both have been implicated in the pathogenesis of several conditions. This biological paradox of ROS function contributes to the integrity of cells and tissues. So, the aim of this review was examined for published literature related to 'reactive oxygen species and dentistry and muscle'. MATERIALS AND METHODS: A PubMed search was performed by using the following key words: 'reactive oxygen species and dentistry and muscle'. RESULTS: Involvement of ROS in pathologic conditions can be highlighted in oral diseases like periodontitis, orofacial pain, temporomandibular disorders and oral cancer. Also, several studies have correlated the increase in ROS production with the initiation of the muscle fatigue process and the process of muscle injury. However, studies evaluating the relation of ROS and orofacial muscles, which can prove very important to understand the fatigue muscle in this region during oral movements, have not yet been conducted. CONCLUSIONS: It is concluded that the data on skeletal muscles, especially those of mastication, are not commonly published in this data source; therefore, further studies in this field are strongly recommended.