Muscle Activity In Patients Research Articles

Effects of a plank-based strength training programme on muscle activation in patients with long COVID: a case series.

This study aimed to analyse the effects of a plank-based strength training programme on muscle activation in patients with long COVID. Case series study that included patients with long COVID who participated in a 12-week trunk and pelvic muscle strength training programme. Clinical variables and the modified fatigue impact scale (MFIS) were used to assess fatigue levels. Percentage of muscle activation during a core muscle plank was measured via surface electromyography. Pre- and post-intervention results were compared using the Wilcoxon signed-rank test and evaluated with Cohen's D effect size (ES). Twenty-one subjects participated in the study; 81% female, mean age 47.5 years (range: 28-55 years), and median duration of symptoms 21 months (range: 5-24 months); 90.5% of the participants experienced fatigue (MFIS score = 38). Muscle activation during plank exercises improved across all muscles after the intervention, with significant increases in the left (p = 0.011, medium ES) and right external oblique (p =0.039, small ES) muscles and the right latissimus dorsi muscle (p = 0.039, small ES). Additionally, significant reductions in fatigue were observed in the total MFIS score (p = 0.004, medium ES) and in the physical (p < 0.001, large ES) and psychosocial subscales (p = 0.033, small ES). Results suggest that a plank-based strength training programme may be effective in enhancing trunk and pelvic muscle activation in individuals with long COVID.

Amplitude of Lower Limb Muscle Activation in Different Phases of the Illinois Test in Parkinson's Disease Patients: A Pilot Study.

Background: Parkinson's disease (PD) is a neurodegenerative disorder with high prevalence in men and is characterized by symptoms such as tremors and gait difficulties. This study aimed to determine muscle activation in patients with PD by considering sex differences. Methods: This pilot study used analytical, quantitative, observational, and case-control methods. Surface electromyography was used to assess muscle activity during a variant of the Illinois agility test. The study population comprised an experimental group of patients with PD (N = 30) and a control group of healthy individuals without the disease (N = 10). Results: The Illinois agility test revealed significant differences in completion times between the groups. The Parkinson's disease group took longer overall (p = 0.004), especially for standing up (p < 0.001) and sitting down (p = 0.002), than the control group. In the control group, sex influenced gastrocnemius muscle activation, with women showing higher activation (rs = -0.87). Women also had greater rectus femoris activation during standing and sitting, with higher activation on the right side when standing (rs = -0.66) and the left side when sitting (rs = -0.87). In the control group, men exhibited greater activation of the right biceps femoris (rs = 0.87). However, in the Parkinson's disease group, sex did not affect muscle activation. Conclusions: Patients with Parkinson's showed lower muscle activation than healthy individuals while standing up, sitting down, and walking.

Immediate effects of thoracic mobilization versus soft tissue release on trunk motion, pain, and lumbar muscle activity in patients with chronic low back pain

IntroductionThoracic mobilization and tissue release are common manual techniques in clinical practice. However, the relative effects of these two treatments on chronic low back pain (CLBP) have not yet been explored. Thus, this study aimed to investigate and compare the immediate effects of thoracic mobilization with those of soft tissue release on trunk movement, pain sensation, and muscle activity in patients with CLBP. Methods28 participants were randomly assigned to two intervention groups. The mobilization group received mobilization treatment at the hypomobile joints of the trunk segment, while the soft tissue release group received thoracolumbar fascia release and massage in the lumbar region. The trunk range of motion (ROM), tissue hardness, pressure pain threshold (PPT), and erector spinae activity during light-weight lifting tasks were measured before and immediately after both interventions. FindingsAll measured outcomes in both groups improved after intervention (p < 0.05). The mobilization technique significantly improved side bending and rotation, PPT, and tissue hardness compared to soft tissue release. However, lumbar muscle activation reduced to a greater extent in the soft-tissue release group. ConclusionBoth techniques improved trunk ROM and PPT and reduced tissue hardness and muscle activation. Therefore, both these techniques are recommended for patients with CLBP. Trial registrationISRCTN75190733.

Effect of a semirigid ankle brace on the in vivo kinematics and muscle activity of patients with functional ankle instability during simulated ankle sprain.

Ankle braces can effectively decrease the incidence of recurrent ankle sprain; however, whether the brace can decrease the severity of sprain and its related mechanism during sprain remain unknown. Twenty-two patients with functional ankle instability (FAI) (12 males and 10 females) and 16 healthy subjects (8 males and 8 females) were enrolled in this study. All of the subjects walked on a custom-built tilting platform that offered a 30° inversion (IV) to mimic the IV of ankle sprain. We collected the kinematic and surface electromyography data of patients with FAI with or without ankle brace and normal controls 6 times. The FAI without brace group showed significantly higher maximum IV angles and average IV velocities than the control group (P < .001). The FAI with brace group revealed significantly lower maximum IV angles and average IV velocities than the FAI without brace group (P < .001); this group also showed significantly higher maximum external rotation (ER) angle and average ER velocities than the FAI with brace (P < .001) and control (P < .001) groups. The FAI with brace group indicated significantly lower average EMGPrep (P = .047), EMGTilt (P = .037), and EMGafterTilt (P = .004) of the peroneus longus than the FAI without brace group. The ankle brace could effectively decrease IV angles and their velocities and increase ER angles and their corresponding velocities during ankle sprain in patients with FAI. It could also decrease the activity of the peroneus longus muscle during ankle sprain.

Assessment of Gastrocnemius Muscle Activity in Patients with Chronic Mechanical Low Back Pain

Assessment of Gastrocnemius Muscle Activity in Patients with Chronic Mechanical Low Back Pain

Neurophysiological assessment of the condition of the masticatory muscle group in patients with occlusion disorders and chronic generalized periodontitis

Background. Recently, the interest of dentists and physiologists has been focused on the development of a set of informative computerized techniques for an objective analysis of the functional state of the dentofacial apparatus. Achieving certain successes in conducting functional diagnostic examinations contributes to the development of algorithms for complex treatment of patients with generalized periodontitis and premature occlusal contacts.Goal. Study of the functional state of the dentofacial apparatus according to the parameters of bioelectrical activity of muscles in patients with chronic generalized periodontitis and occlusal disorders in static and dynamic conditions of the lower jaw.Materials and methods. The study involved 37 people with clinically healthy periodontium, physiological occlusion, and absence of occlusal disorders (Group 1) and 45 patients with physiological types of occlusion, generalized chronic periodontitis and premature occlusal contacts (Group 2). Functional methods included electronic registration of occlusal relationships with the T-Scan® III computer occlusion analysis system and study of the bioelectrical activity of the masticatory muscles using the Bio-EMG® III electromyography using standard functional tests.Results. In patients of group 2, in comparison with patients of group 1, neuromuscular discoordination of the functional activity of the masticatory muscles was diagnosed. This condition is confirmed by the asymmetry and lack of muscle synergy when performing the “Maximum volitional compression” test, an improvement in the symmetry of the work of the muscles of the same name on the right and left sides and the synergy of the work of the muscles of the right and left masticatory groups, as well as a statistically significant increase in the values of biopotentials m. temporalis and m. masseter during the “Maximum volitional compression on rollers” test.Conclusions. Disturbances in the coordinated work of the muscles of the craniofacial region in patients with chronic generalized periodontitis and premature occlusal contacts are realized in a statistically significant increase in the biopotentials of the masticatory muscle group at rest, a decrease in biopotentials during functional loading, as well as a reduction in the values of symmetry and synergy in relation to similar values patients of group 1.

Effects of scapular treatment on chronic neck pain: a systematic review and meta-analysis of randomized controlled trials

BackgroundChronic neck pain (CNP) is a common public health problem that affects daily living activities and quality of life. There is biomechanical interdependence between the neck and scapula. Studies have shown that shoulder blade function might be related to chronic neck pain. We therefore evaluated the effects of scapular targeted therapy on neck pain and function in patients with CNP.MethodsDatabases, including MEDLINE (via PubMed), EMBASE (via Ovid), Ovid, Web of Science, and Scopus, were systematically searched for randomized controlled trials published in English investigating treatment of the scapula for CNP before July 16, 2023.ResultsA total of 313 participants were included from 8 RCTs. Compared with those in the control group, the intervention in the scapular treatment group exhibited greater improvement in pain intensity (standardized mean difference (SMD) = 2.55; 95% CI = 0.97 to 4.13; P = 0.002), with moderate evidence. Subgroup analysis for pain intensity revealed a significant difference between the sexes, with only the female population (SMD = 6.23, 95% CI = 4.80 to 7.65) showing better outcomes than those with both sexes (SMD = 1.07, 95% CI = 0.57 to 1.56) (p < 0.00001). However, moderate evidence demonstrated no improvement in neck disability after scapular treatment (SMD of 0.24[-0.14, 0.62] of Neck Disability Index or Northwick Park Neck Pain Questionnaire). No effect of scapular treatment was shown on the pressure pain threshold (PPT). The cervical range of motion (CROM) and electromyographic activity of neck muscles could not be conclusively evaluated due to limited support in the articles, and further study was needed. However, the patient’s head forward posture appeared to be corrected after scapular treatment.ConclusionScapular therapy was beneficial for relieving pain intensity in patients with CNP, especially in women. Head forward posture might also be corrected with scapular therapy. However, scapular therapy may have no effect on the PPT or neck disability. However, whether scapular therapy could improve CROM and cervical muscle activation in patients with CNPs had not been determined and needed further study.

Effects of ankle joint mobilization on dynamic balance muscle activity and dynamic balance in persons with chronic ankle instability - Feasibility of a cross-over study

IntroductionStudies with focus on effects of manual therapy techniques on postural control and muscle activity in patients with chronic ankle instability (are lacking. The purpose of this study was to evaluate the feasibility of a planned cross-over study to assess efficacy of manual therapy techniques applications in patients with chronic ankle instability. MethodsThis feasibility study used a randomized controlled, blinded assessor cross-over design. Criteria of success under evaluation were adherence and attrition rates and adverse events. while preliminary treatment effects of manual therapy techniques on muscular activity (measured by surface electromyography) and on dynamic balance (measured by time to stabilization test) were secondary aims. ResultsThirteen participants (mean age: 24.4 ± 3.8 years) with chronic ankle instability volunteered in this feasibility study. Success criteria showed a high adherence (98.7%) and low attrition (0%). No missing data were reported but four out of 26 data sets could not be used for statistical analysis because of non-readability of the recorded data. Preliminary treatment effect showed divergent results for surface electromyography and time to stabilization. One significant result (p = 0.03, ES = 1.48) in peroneus longus muscle activity after jump landing between 30 and 60 ms could be determined. ConclusionsThis study showed that the study protocol is feasible but should be modified by offering participants the opportunity to familiarize to the jumps and to the test repetitions. This study generates better understanding of manual therapy techniques for patients with chronic ankle instability.

Use of Surface Electromyography to Evaluate Effects of Therapeutic Methods on Masticatory Muscle Activity in Patients with Temporomandibular Disorders: A Narrative Review

The presented narrative review aims to present the impact of therapeutic methods on the masticatory muscle activity measured using surface electromyography (sEMG) in patients with temporomandibular disorders (TMDs). Original interventional studies with baseline data for diagnosed TMD groups with full-text articles in English published in scientific journals in the last ten years were included in the evaluation process. The following narrative review considered only clinical, controlled, and randomized studies. Articles that included the following parameters were qualified for this review: adult participants, diagnosis of temporomandibular disorder, the presence of a musculoskeletal dysfunction, no other severe comorbidities, use of therapeutic interventions, and sEMG measurement before and after the intervention. Ten papers were accepted and analyzed for the final evaluation in the presented review. Several studies using surface electromyographic examination prove the effectiveness of various therapies to normalize the bioelectrical activity of the masticatory muscles, either reduction during rest or increase during a functional task in patients diagnosed with temporomandibular disorders. This narrative review shows the influence of manual and physical treatments on electromyographic masticatory muscle activity, including soft tissue mobilization, transcutaneous electrical nerve stimulation, low-level laser therapy, and moist heat therapy. Changes in masticatory muscle activity coincided with changes in TMD-associated pain and range of mandibular mobility.

Analysis of the Effect of Limb Rehabilitation Therapy Combined with Transcranial Magnetic Stimulation Therapy on Muscle Activity in Patients with Upper Limb Dysfunction After Cerebral Infarction

Objective: To analyze the effect of limb rehabilitation therapy combined with transcranial magnetic stimulation therapy on muscle activity in patients with upper limb dysfunction after cerebral infarction (CI). Methods: 320 patients with upper limb dysfunction after CI were selected, all of whom were treated in our hospital between June 2021 and June 2023. They were randomly grouped according to the lottery method into the control group (limb rehabilitation therapy, 160 cases) and the intervention group (transcranial magnetic stimulation therapy + limb rehabilitation therapy, 160 cases).The upper limb function scores, neuro-electrophysiological indicators, daily living ability scores, and quality of life scores of the two groups were compared. Results: Compared with the control group, upper limb function scores and daily living ability scores in the intervention group were higher after treatment, and the neuro-electrophysiological indicators of the intervention group were lower after treatment (P &lt; 0.05). Conclusion: Transcranial magnetic stimulation therapy combined with limb rehabilitation therapy has significant effects in patients with upper limb dysfunction after CI and is worthy of promotion and application.

The effect of the diaphragm stretching technique in the diaphragm contraction rate and trunk muscle activity in back pain patients.

The diaphragm plays an important role in trunk stability. Therefore, diaphragmatic dysfunction is associated with low back pain. This study aimed to confirm the effectiveness of diaphragm stretching technique as a treatment method for low back pain by evaluating the diaphragm contraction rate, trunk muscle activity in patients with low back pain. Thirty-four patients with low back pain were randomly divided into two group: an experimental group and a control group. The diaphragm stretching technique was conducted in the experimental group and the placebo intervention was conducted in the control group. The diaphragm stretching technique was conducted once, maintaining the tension for 7 min. The placebo intervention was conducted in the same position as the diaphragm stretching technique but with only light contact maintained without pressure. The diaphragm contraction rate and trunk muscle activity were measured before and after the intervention, and the changes were compared and analyzed. A paired sample t-test was used to compare measurements before and after the intervention within the group. An independent t-test was used to compare the experimental and control group. Statistical significance (α) was set at 0.05. In the experimental group, the diaphragm contraction rate increased significantly after the intervention. Trunk muscle activity decreased significantly (p< 0.05). However, all domains in the control group receiving the placebo intervention were not significantly different (p> 0.05). Comparative analysis of changes before and after the intervention between the groups showed significant differences in the diaphragm contraction rate and trunk muscle activity in the experimental group (p< 0.05). The diaphragm stretching technique improved the diaphragm contraction rate and trunk muscle activity was lower due to the improved trunk stabilization function of the diaphragm. Therefore, the diaphragm stretching technique can be recommended as a physical therapy intervention to improve pain in patients with low back pain.

Effects of progessive vs. constant protocol whole-body vibration on muscle activation, pain, disability and functional performance in non-specific chronic low back pain patients: a randomized clinical trial.

Non-specific chronic low back pain (NSCLBP) is a prevalent condition causing significant disability and functional impairment. Whole-body vibration exercise (WBVE) has emerged as a new treatment method, but additional research is necessary to determine the optimal parameters of WBVE that would be beneficial for patients experiencing chronic low back pain (CLBP). This study aims to investigate the effects of two type of WBVE (constant vs progressive) on pain, disability, functional performance, and muscle activity in patients with NSCLBP. Thirty-two individuals diagnosed with chronic low back pain (CLBP) without any specific causes were enrolled and randomly assigned to one of two intervention groups: a constant/fixed protocol WBVE group or a progressive protocol WBVE group. Participants underwent WBVE sessions for around 30 min, thrice weekly over a period of 8 weeks. Primary outcomes assessed included pain intensity, functional disability, functional performance, and electromyographic activity of core musculature, measured at baseline and upon completion of the intervention period. Temporal changes of each outcome variable across different periods and between groups were measured with repeated measures 2×2 mixed ANOVA. Further, the paired t-test was performed to compare pre- and post-treatment values within each group. Significant improvements were observed in both the constant and progressive WBVE protocol groups. Pain intensity decreased by 64.2% (p<0.001) in the constant group and by 61.1% (p<0.001) in the progressive group. Functional disability decreased by 48.1% (p<0.001) in the constant group and by 53.3% (p<0.001) in the progressive group. Functional performance improved by 16.5% (p<0.001) in the constant group and by 16.9% (p<0.001) in the progressive group. Electromyography (EMG) demonstrated significant improvements across all measured variables except % maximum voluntary isometric contraction (%MVIC) of external obliques (EO) in both intervention groups with time (p<0.001). There was no statistically significant difference in the magnitude of improvement between the constant and progressive WBVE protocols (p>0.05), indicating both modalities' effectiveness in ameliorating CLBP symptoms and associated functional impairments. The study demonstrates that both progressive and constant WBVE protocols are equally effective in reducing pain and disability in NSCLBP patients. These findings support the inclusion of progressive WBVE in clinical practice, offering a flexible treatment option that can be tailored to individual patient needs, ensuring both tolerability and effectiveness. This contributes valuable evidence towards optimizing WBVE protocols for managing NSCLBP.

Sensorimotor rhythm and muscle activity in patients with stroke using mobile serious games to assist upper extremity rehabilitation.

Exercise rehabilitation is crucial for neurological recovery in hemiplegia-induced upper limb dysfunction. Technology-assisted cortical activation in sensorimotor areas has shown potential for restoring motor function. This study assessed the feasibility of mobile serious games for stroke patients' motor rehabilitation. A dedicated mobile application targeted shoulder, elbow, and wrist training. Twelve stroke survivors attempted a motor task under two conditions: serious mobile game-assisted and conventional rehabilitation. Electroencephalography and electromyography measured the therapy effects. Patients undergoing game-assisted rehabilitation showed stronger event-related desynchronization (ERD) in the contralateral hemisphere's motor perception areas compared to conventional rehabilitation (p < 0.05). RMS was notably higher in game-assisted rehabilitation, particularly in shoulder training (p < 0.05). Serious mobile game rehabilitation activated the motor cortex without directly improving muscle activity. This suggests its potential in neurological recovery for stroke patients.

Comparing Three Wearable Brassiere Braces Designed to Correct Rounded Posture.

Rounded shoulder posture (RSP) causes shoulder pain and can lead to shoulder impingement and thoracic outlet syndromes, ultimately resulting in a frozen shoulder. Altered scapular positions in RSP patients affect muscle activity. Many studies have explored methods to correct and prevent RSP, including shoulder braces, muscle strengthening, stretching, and inhibition techniques. Using a shoulder brace reduces RSP and improves shoulder discomfort and function, similar to conventional rehabilitation. However, despite their effectiveness, these braces are bulky and inconvenient, which makes continuous daily wear challenging. This is especially true for women who are sensitive to their appearance. To address this issue, methods have been developed to convert women's underwear bra straps into braces. This study aimed to evaluate the immediate effects of three underwear-mounted rounded shoulder braces and to identify the brace that is most effective in decreasing RSP and upper trapezius (UT) muscle activity and increasing lower trapezius (LT) muscle activity in patients with RSP. The study included 18 patients with an RSP. The RSP amount and UT and LT muscle activities were measured before and after three interventions. The interventions were scapular posterior tilting (SPT) exercises with the X strap, X + 8 strap, and inner brace. Compared with the baseline value, the RSP amount was significantly lower with the three braces. The RSP was significantly lower with the X + 8 strap and the inner brace than with the X strap. The inner brace showed significantly lower UT muscle activity than those with the X strap and X + 8 straps and significantly greater LT muscle activity than that with the X + 8 strap. These results show underwear-mounted braces as a potential RSP solution, but long-term sustainability and improving comfort, especially for those concerned about appearance, require further research and development.

Analysis of abnormal muscle activities in patients with loss of cervical lordosis: a cross-sectional study

BackgroundThis study aimed to detect the differences in cervical muscle activation patterns in people with versus without cervical lordosis and explore the possible mechanism of cervical pain originating therein.MethodsThis cross-sectional design included 39 participants without and 18 with normal cervical lordosis. Muscular activation was measured for 5 s in both groups using surface electromyography. Subsequently, the root mean square (RMS) of muscle amplitude was obtained at the bilateral splenius capitis, upper and lower parts of the splenius cervicis, upper and lower parts of the semispinalis cervicis, sternocleidomastoid, upper trapezius, and rhomboid muscles in five cervical positions: 0° (resting), 30° of flexion, 30° of extension, 60° of extension, and upon a 1-kg load on the head in a resting posture.ResultsThe RMS values of the upper trapezius muscle at all postures and the rhomboid muscles at 60° of extension were significantly lower in the loss of lordosis than control group. Comparing the RMS ratio of each posture to the resting position, the ratio of the upper trapezius at flexion was significantly higher and that of the rhomboids at 60° of extension and upon loading was significantly lower in the loss of lordosis than control group. Moreover, the pattern changes in the RMS values according to posture showed a similar shape in these two muscles, and lower in the loss of lordosis than the normal group.ConclusionsThe loss of normal cervical alignment may correlate with predisposed conditions such as reduced muscle activation of the trapezius and rhomboid muscle, and may also provoke over-firing of the upper trapezius muscle, possibly increasing neck musculoskeletal pain.Trial registration.Clinicaltrials.gov, registration number: NCT03710785.

Muscle activity between dentate and edentulous patients rehabilitated with dental prostheses: A systematic review.

Adequate muscle activity is important for the success of oral rehabilitation: it maintains the integrity of the stomatognathic system and is responsible for chewing movements needed to break, crush and grind food. To compare muscle activity using electromyography (EMG) while clenching or chewing soft and/or hard foods among individuals with natural dentition (ND) and edentulous patients rehabilitated with dental prostheses. This review was conducted until March, 2023, and the research question was "Is the muscle activity of edentulous patients rehabilitated with dental prostheses similar to that of dentate individuals?" A search strategy was conducted in PubMed/MEDLINE, The Cochrane Library, Web of Science, Lilacs, Embase and manual journal searches. Ten studies were included in the analysis. Most of them reported that individuals with ND had significant higher muscle activity (clenching or chewing) than complete dentures (CD) users. However, no difference was observed between patients with full mouth implant-supported fixed dental prosthesis (ISFDP) and ND. Additionally, two studies compared patients with mandibular ISFDP with maxillary CD and individuals with ND and found no differences; however, one study concluded that patients with ISFDP with CD (maxillary or mandibular) had lower muscle activity than individuals with ND. Only one study reported a higher muscle activity in patients with full-mouth ISFDP than in individuals with ND. Bimaxillary CD users had lower muscle activity than individuals with ND. During rehabilitation, the muscle activity of patients with full-mouth ISFDP and mandibular ISFDP with maxillary CD is similar to individuals with ND.

Influence of Robot-Assisted Gait Training on Lower-Limb Muscle Activity in Patients With Stroke: Comparison With Conventional Gait Training.

To measure muscle activity before and after robot-assisted gait training (RAGT) in patients with stroke and examine the differences in muscle activity changes compared with conventional gait training (CGT). Thirty patients with stroke (RAGT group, n=17; CGT group, n=13) participated in the study. All patients underwent RAGT using a footpad locomotion interface or CGT for 20 minutes for a total of 20 sessions. Outcome measures were lower-limb muscle activity and gait speed. Measurements were performed before the start of the intervention and after the end of the 4-week intervention. The RAGT group showed increased muscle activity in the gastrocnemius, whereas the CGT group showed high muscle activity in the rectus femoris. In the terminal stance of the gait cycle, the gastrocnemius, the increase in muscle activity was significantly higher in the RAGT group than in the CGT group. The results suggest that RAGT with end-effector type is more effective than CGT to increase the gastrocnemius muscle activity.

Hemophilic Arthropathy of the Knee and Its Association with Reduced Muscle Strength and Activation and the Pressure Pain Threshold: A Case-Control Study.

(1) Background: Hemophilia is characterized by recurrent hemarthrosis leading to degenerative arthropathy. The aim was to evaluate the differences in muscle strength and activity and the pressure pain threshold between patients with knee arthropathy and their healthy peers; (2) Methods: A case-control study in which 23 adult patients with knee arthropathy and 24 healthy peers matched in terms of characteristics were recruited. The study variables were quadriceps muscle strength, muscle activation and the pressure pain threshold; (3) Results: There were significant differences between the two groups in quadriceps strength on the dominant (CI95%: 64.69, 129.2) and non-dominant (CI95%: 29.95, 93.55) sides and in the pressure pain threshold on the dominant (CI95%: 3.30, 43.54) and non-dominant (CI95%: 3.09, 45.25) sides. There were differences in neuromuscular fatigue on the non-dominant side in the vastus medialis (CI95%: 8.72, 21.51), vastus lateralis (CI95%: 4.84, 21.66) and rectus femoris (CI95%: 6.48, 24.95) muscles; (4) Conclusions: Muscle strength and the pressure pain threshold are lower in patients with hemophilia. Quadriceps muscle activation in patients with hemophilic knee arthropathy does not in any way differ from activation in healthy subjects. However, muscle fatigue is greater in patients with knee arthropathy. Strength training in patients with hemophilia should focus on the activation of the vastus medialis and lateralis muscles.

Surface electromyography in the assessment of masticatory muscle activity in patients with pain-related temporomandibular disorders: a systematic review.

Temporomandibular disorders (TMD) are a set of painful conditions affecting the orofacial region that are prevalent and constitute the most frequent type of non-dental pain complaint in the maxillofacial area. Pain-related TMD (TMD-P) is characterized by ongoing pain in the masticatory muscles, the temporomandibular joint, or surrounding structures. Due to the multiple factors that contribute to the development of this condition, it can be challenging to accurately diagnose. One of the useful method for assessing patients with TMD-P is surface electromyography (sEMG). The aim of this systematic review was to provide a comprehensive overview of the current scientific literature on the evaluation of masticatory muscle activity (MMA) in individuals diagnosed with TMD-P, through the utilization of sEMG. To gather relevant information, electronic databases such as PubMed, Web of Science, Scopus, and Embase were searched using specific keywords including: "pain" AND ("temporomandibular disorder*" OR "temporomandibular dysfunction*") AND "surface electromyography" AND "masticatory muscle activity." The inclusion criteria were studies assessing MMA in patients with TMD-P using sEMG. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies was utilized to evaluate the quality of the studies that were included in the review. The search strategy identified 450 potential articles. Fourteen papers met the inclusion criteria. Global quality rating for significant part of the articles was weak. Most studies showed greater sEMG activity of the masseter (MM) and temporal anterior (TA) muscles at rest in TMD-P subjects than in the asymptomatic controls, while the MM and TA muscles were less active in the pain-related TMD group compared to the non-TMD group during maximal voluntary clenching (MVC). There were differences in MMA in the TMD-pain population compared to a healthy control group during various tasks. The diagnostic efficacy of surface electromyography in assessing individuals with TMD-P remains unclear.

Isometric chin tuck exercise with and without scapular postural correction for patients with chronic neck pain: a longitudinal study

Background/Aims Chronic neck pain is common in individuals with poor posture and motor control impairments. There has been increased interest in scapular postural correction in conjunction with the isometric chin tuck exercise. The aim of this study was to investigate the clinical efficacy of scapular postural correction while performing isometric chin tuck exercises for the improvement of neck pain, neck and shoulder alignment and superficial neck muscle activity in patients with chronic neck pain. Methods A total of 32 participants with chronic, non-specific neck pain were randomly divided into two groups (groups A and B, both n=16), who performed isometric chin tuck exercises alone or isometric chin tuck with scapular postural correction respectively. The participants were instructed to perform five sets of the exercise with 10 repetitions for 6 weeks. Measurements were taken pre- and post-intervention to determine Neck Disability Index scores, postural parameters (head, cervical and shoulder angle) and superficial cervical muscle activity (sternocleidomastoid, anterior scalene, splenius capitis). Analysis of covariance was used to compare the post-intervention scores. Results Significant differences were observed between groups A and B in the cervical angle (F1,29=4.538, P=0.042) and shoulder angle (F1,29=8.357, P=0.007), when compared to baseline values. Both group A (t=12.097, P&lt;0.001) and group B (t=8.032, P&lt;0.001) showed a significant reduction in Neck Disability Index scores compared to baseline scores. Both group A and group B showed a significant decrease in sternocleidomastoid (group A: t=6.637, P&lt;0.001; group B: t=10.143, P&lt;0.001), anterior scalene (group A, t=5.484, P&lt;0.001; group B, t=8.063, P&lt;0.001), and splenius capitis (group A, t=8.591, P&lt;0.001; group B, t=8.258, P&lt;0.001) muscle activity compared to baseline values. Conclusions Isometric chin tuck alone and isometric chin tuck combined with scapular postural correction both showed significant reductions in neck pain and superficial neck muscle activity. Additional scapular postural correction training significantly increased the cervical angle and decreased the shoulder angle.