Muscle Tension Score Research Articles

The influence of bariatric surgery on body image in obesity patients

Obesity is a worldwide epidemic that threats the health and body image of those who suffer from this condition. While bariatric surgery has been shown to effectively assist patients to achieve weight loss goals and to improve body image, related research on this intervention is lacking in Taiwan. The purpose of this research is to investigate the effect of bariatric surgery on body image in obese patients. This study used a longitudinal design. Data was collected from 2 hospitals located in northern and southern Taiwan. A total of 56 obese patients who had undergone bariatric surgery enrolled as participants, and the completion rate was 93.3%. Participants responded to a validated body image questionnaire immediately prior to and 3 months after bariatric surgery, with data used to assess the effects of the surgery. SPSS 20.0 software for windows was used for data analysis. Participant scores for body image were low on the questionnaire administered prior to surgery, with a significant negative correlation identified between body mass index (BMI) and the value of appearance (r = -.36, p < .01). After bariatric surgery, the average EWL was 42.08%, which effectively achieved expected weight loss goals. Variables including overall body image, appearance evaluation, orientation, and body satisfaction of participants were significantly improved. Only the variable of muscle tension did not improve significantly. Postoperative body image did not correlate with either BMI or EWL. Three months after the bariatric surgery, the body image, appearance evaluation, and physical appearance satisfaction of participants had significantly improved. However, there was no improvement in muscle tension scores. In order to improve the post-surgery body image of patients, we recommend that healthcare workers provide patients with proper expectations of bariatric surgery and teach patients appropriate muscle-tension exercises. This paper reports the relation between bariatric surgery and body image. The results provide evidence for clinical and future research in this field.

Participatory ergonomic intervention versus strength training on chronic pain and work disability in slaughterhouse workers: study protocol for a single-blind, randomized controlled trial

BackgroundThe prevalence of musculoskeletal pain in the shoulder, arm and hand is high among slaughterhouse workers, allegedly due to the highly repetitive and forceful exposure of these body regions during work. Work disability is a common consequence of these pains. Lowering the physical exposure through ergonomics intervention is the traditional strategy to reduce the workload. An alternative strategy could be to increase physical capacity of the worker through strength training. This study investigates the effect of two contrasting interventions, participatory ergonomics versus strength training on pain and work disability in slaughterhouse workers with chronic pain.Methods/design66 slaughterhouse workers were allocated to 10 weeks of (1) strength training of the shoulder, arm and hand muscles for 3 x 10 minutes per week, or (2) participatory ergonomics involving counseling on workstation adjustment and optimal use of work tools (~usual care control group). Inclusion criteria were (1) working at a slaughterhouse for at least 30 hours per week, (2) pain intensity in the shoulder, elbow/forearm, or hand/wrist of at least 3 on a 0–10 VAS scale during the last three months, (3) pain lasting for more than 3 months, (4) frequent pain (at least 3 days per week) (5) at least moderate work disability, (6) no strength training during the last year, (7) no ergonomics instruction during the last year.Perceived pain intensity (VAS scale 0–10) of the shoulder, elbow/forearm and hand/wrist (primary outcome) and Disability of the Arm, Shoulder and Hand (Work module, DASH questionnaire) were measured at baseline and 10-week follow-up. Further, total muscle tenderness score and muscle function were assessed during clinical examination at baseline and follow-up.DiscussionThis RCT study will provide experimental evidence of the effectiveness of contrasting work-site interventions aiming at reducing chronic pain and work disability among employees engaged in repetitive and forceful work.Trial registrationClinicalTrials.gov:NCT01671267

Effect of contingent electrical stimulation on jaw muscle activity during sleep: A pilot study with a randomized controlled trial design

Objective. To determine the effect of contingent electrical stimulation (CES) on jaw muscle activity during sleep in a double-blinded randomized controlled trial (RCT). Materials and methods. Eleven patients with myofascial TMD (mean age 37 years) and with a clinical diagnosis of bruxism were included. EMG activity (Grindcare®) was recorded from the anterior temporalis muscle during sleep and analyzed online. Jaw muscle activity related to clenching or grinding triggered an electrical square-wave pulse train (450 ms) adjusted to a clear, but non-painful intensity. TMD patients were randomized into two groups: active treatment with CES or no CES (placebo). Number of EMG episodes/hour sleep was the primary outcome parameter. The following variables were assessed as secondary outcome parameters; number of painful muscles, maximum pain-free jaw opening, characteristic pain intensity, depression scores and Oral Health Impact Profile scores. Numerical Rating Scale scores for self-reported pain and muscle tension were registered for at least 4 nights per week during the experiment. Results. The number of EMG episodes/hour sleep was significantly reduced (52 ± 12%) in the CES group during the sessions with CES (ANOVA: p = 0.021) compared to baseline. There were no significant differences in the secondary outcome parameters (ANOVA: p > 0.513) or pain or muscle tension scores between groups (p = 0.645). The average duration of sleep hours during the nights with and without CES was not significantly different (p = 0.646). Conclusions. These results demonstrate a significant inhibitory effect of CES on jaw muscle EMG activity during sleep in a RCT, but with no effects on self-reported pain.

Symptoms of Anxiety and Depression Are Correlates of Angina Pectoris by Recent History and an Ischemia-Positive Treadmill Test in Patients with Documented Coronary Artery Disease in the Pimi Study

Objective. We tested the association of specific psychological characteristics in patients having stable coronary disease with the reporting of anginal symptoms during daily activities, and positive exercise testing. Methods. One hundred and ninety-six patients with documented CAD enrolled in the Psychophysiological Investigations of Myocardial Ischemia (PIMI) Study completed an anginal history questionnaire and a battery of psychometric tests. They also underwent standardized exercise treadmill tests. Results. Patients with a recent history of angina were more likely to be female, and had higher Beck Depression (P = .002), State Anxiety (P = .001), Trait Anxiety (P = .03), Harm Avoidance (P = .04) and Muscle Tension (P = .004) scores than patients who had no recent history of angina. Along with several treadmill variables indicating more severe disease state and reduced exercise tolerance, patients who developed angina on a positive treadmill test also displayed higher scores on the Beck Depression Inventory (P = .003) and State Anxiety (P = .004) scales. Conclusions. Several psychological characteristics, and most notably anxiety and depression, are strong correlates of recent angina and angina in the presence of ischemia provoked by treadmill testing.

Cervicogenic headache in the general population: The Akershus study of chronic headache

The objective was to study the prevalence of cervicogenic headache (CEH) in the general population. An age- and gender-stratified random sample of 30,000 persons aged 30-44 years received a mailed questionnaire. Those with self-reported chronic headache were interviewed by neurological residents. The criteria of the Cervicogenic Headache International Study Group and the International Classification of Headache Disorders, second edition, were applied. The questionnaire response rate was 71% and the participation rate of the interview was 74%. The prevalence of CEH was 0.17% in the general population, with a female preponderance. Fifty per cent had co-occurrence of medication overuse and 42% had co-occurrence of migraine. The pericranial muscle tenderness score was significantly higher on the pain than non-pain side (p < .005). The cervical range of motion was significantly reduced compared to healthy controls (p < .005). The mean duration of CEH was eight years. Based on patients' self-reports, greater occipital nerve (GON) blockage and cryotherapy was reported effective in 90% of those who had this procedure, while other treatment alternatives were reported less effective.

Side‐to‐side differences in pressure pain thresholds and pericranial muscle tenderness in strictly unilateral migraine

Previous studies dealing with pressure pain sensitivity or muscle tenderness in migraine have shown conflicting results. Our aim was to explore the differences in mechanical pain sensitivity and pericranial muscle tenderness between patients with unilateral migraine and healthy controls, and to analyse side-to-side differences in both study groups. Pressure pain thresholds (PPT) at cephalic and neck points, plus local and total tenderness scores were blindly assessed in 25 patients with strictly unilateral migraine and 25 healthy subjects. For PPT in the neck there were significant differences between groups (F = 47.029; P < 0.001) and sides (F = 6.363; P < 0.01), and a significant interaction between group and side (F = 5.201; P = 0.02), while PPT in the cephalic point showed differences between groups (F = 11.774; P < 0.001), but not sides (F = 2.838; P = 0.1). The total tenderness score showed significant differences between groups (F = 6.800; P < 0.01) and sides (F = 17.699; P < 0.001), along with a significant interaction between group and side (F = 14.420; P < 0.001). Patients had lower PPT and increased pericranial tenderness on the symptomatic side as compared with the non-symptomatic side and to either side in controls (P < 0.001), whereas no significant differences were identified between the non-symptomatic side and controls (P > 0.9). In migraine patients, PPT levels and muscle tenderness scores were negatively correlated (P < 0.001). The enhancement of local tenderness scores was related to hyperesthesia of specific muscles (sternocleidomastoid, suboccipital, and temporalis) rather than a generalized pericranial tenderness. Future studies should investigate the neuro-physiological basis for the laterality of allodynic and hyperalgesic responses in unilateral migraine.

Comparison of carcass and meat characteristics of Brahman grade cattle (Bos indicus) and crossbred water buffalo (Bubalus bubalis)

ABSTRACTThis study was conducted to determine and compare the live traits, carcass yield and the physical, chemical, processing and sensory properties of meat from 20 Brahman grade cattle (crossbred cattle) and crossbred water buffalo (Philippine carabao × Murrah, Bulgarian or Indian) with an average age and weight of 29 months and 434 kg, respectively. The animals were fed a similar diet for 180 days before slaughter. A survey was performed to establish consumer meat preference between the two species. Live weights before slaughter of the two species were found to be different (P &lt; 0.05) with the crossbred water buffalo showing higher bodyweight. However, the crossbred water buffalo had a lower (P &lt; 0.05) dressing yield based on hot carcass weight and chilled carcass weight. The lower dressing yield of crossbred water buffalo can be attributed to its higher (P &lt; 0.05) weights of edible and non‐edible slaughter by‐products. The chilled carcass yield of the forequarters and hindquarters from crossbred cattle and crossbred water buffalo were comparable when expressed as percent of live weight and chilled carcass weight. The estimated lean yield was higher in crossbred cattle than crossbred water buffalo. Crude protein, ash, fat, cholesterol, myofibrillar, sarcoplasmic and insoluble protein contents of the beef and carabao meat were all similar. Water holding capacity, pH, muscle fiber diameter, tenderness, firmness and marbling score in carabeef were all comparable to the beef. Redness was found to be higher (P &lt; 0.05) in carabeef than the beef as measured with a color meter. The consumer meat preference survey showed that 55.9% selected the beef while 44.1% preferred carabeef. The color and amount of fat on the outside of the beef sample were primary in buyer selection.

Muscle tenderness in different types of facial pain and its relation to anxiety and depression: A cross-sectional study on 649 patients

To evaluate in patients with different types of facial pain the association between muscle tenderness and a set of characteristics, 649 consecutive outpatients with facial myogenous pain (MP), TMJ disorder, neuropathic pain (NP) and facial pain disorder (FPD) (DSM-IV) were enrolled. For each patient a psychological assessment on the Axis 1 of the DSM-IV and standardized palpation of pericranial and cervical muscles were carried out. A pericranial muscle tenderness score (PTS), a cervical muscle tenderness score (CTS) and a cumulative tenderness score (CUM, range 0–6) were calculated. Univariate analyses (one-way analysis of variance or χ 2 test) indicated that both age- and sex-distribution, tenderness scores and prevalence of psychiatric disorders markedly differed between groups. The prevalence of depression was highest in FPD patients (44.9%). Both muscle tenderness scores (either PTS or CTS) and prevalence of anxiety were higher in patients with MP than in those with TMJ or NP. To assess associations between CUM score and patients’ demographic and clinical characteristics an ordered logit model was fit and interactions between psychiatric disorders and diagnostic groups were tested. The analysis showed that, regardless of the diagnostic group, anxiety and depression independently increase the likelihood of having one point higher muscle tenderness score (OR = 1.55, 95% CI: 1.13–2.12 and OR = 1.56, 95% CI: 1.10–2.21, respectively). A careful screening for the presence of an underlying psychiatric disorder, either anxiety or depression, should be part of the clinical evaluation in patients suffering from facial pain.

Laryngeal Biomechanics in Middle Eastern Singing

We would like to describe the muscle tension patterns observed in Middle Eastern singing and correlate these findings with demographic data. A total of 42 candidates were included in this study. The medical charts and video records of their fiberoptic nasopharyngeal laryngoscopy were reviewed. Demographic information included age, sex, history of smoking, history of reflux, history of voice overuse/abuse, status in singing (professional vs. amateur), and style of singing (classical vs pop). Each frame was analyzed for each of the four muscle tension patterns (MTPs): MTP I, MTP II, MTP III, and MTP IV. Nonparametric Mann-Whitney U test was conducted. Twenty-six subjects were professional singers and half sang classical singing. The mean MTP total score for all subjects was 35.58 +/- 21.98% (+/- standard deviation). The highest muscle tension score was obtained for type III pattern followed by type II. There were no statistical differences in the mean MTP total, MTP II, and MTP III scores among the professional singers versus the amateurs. Similar results were obtained when MTP scores were compared by style of singing. The vocal technique and status of singing did not seem to affect the muscle tension score.

A comparative analysis of personality profile and muscle tenderness between chronic migraine and chronic tension-type headache

This study was aimed at comparing the personality profile, the psychiatric comorbidity (depression and anxiety) and the tenderness of the pericranial and cervical muscles in women with chronic migraine (CM) and chronic tension-type headache (CTTH). Forty-one CM and 34 CTTH women were enrolled. A clinical evaluation (according to SCID-I) and a psychometric assessment (MMPI-2, STAI-1 and STAI-2) were performed. After palpation, a Pericranial muscle Tenderness Score (PTS) and a Cervical Muscle Tenderness Score (CTS) were calculated. No significant difference was detected in MMPI-2, STAI-1, STAI-2, PTS and CTS scores between the two groups. Anxiety and depression were present in 80% of CM and in 63% of CTTH women. We did not find any significant difference either in the personality profile or in the muscle tenderness between CM and CTTH patients. This similarity points to a role of these factors, in association with psychiatric comorbidity, in the chronicisation of headache.

Muscle tenderness in different headache types and its relation to anxiety and depression

To assess in patients with migraine and tension type headache, both episodic and chronic, the extent to which muscle tenderness may relate to anxiety and depression, 459 patients with Episodic Migraine (EM, 125), Chronic Migraine (CM, 97), Episodic Tension Type Headache (ETTH, 82), Chronic Tension Type Headache (CTTH, 83), and EM+ETTH (72) were enrolled. For each patient, a psychological assessment on the Axis 1 of the DSM-IV and muscle palpation of pericranial and cervical muscles were carried out. A Pericranial Muscle Tenderness Score (PTS) and a Cervical Muscle Tenderness Score (CTS) were calculated (range 0–3). Logistic and linear regression analyses were employed to assess relations between muscle tenderness, the demographic variables and psychiatric disorders in the different patient groups. Odds ratio for ‘male gender’ was higher in groups with tension type headache. Only EM patients showed a positive association with increasing age. Anxiety and depression were significantly associated to CM. A significant negative correlation of PTS and CTS was observed in EM patients. In relation to male gender, the PTS was significantly lower in EM, ETTH and CTTH; CTS was significantly lower in EM, CM, and CTTH. Anxiety and, even more, anxiety and depression combined were positively associated to higher PTS and CTS in EM patients. Anxiety and depression were also positively associated to higher CTS in patients with EM+ETTH. In CTTH patients, PTS only was positively associated to anxiety and depression. We conclude that in patients with EM, the presence of anxiety or anxiety and depression combined considerably increases the level of muscle tenderness in the head and, even more, in the neck, and might facilitate the evolution into CM.

Treatment of temporomandibular disorders among adolescents: a comparison between occlusal appliance, relaxation training, and brief information

In a randomized trial the effects of occlusal appliance and relaxation therapy, each combined with brief information, were compared with brief information only, in adolescents with temporomandibular disorder (TMD) pain. One-hundred-and-twenty-two adolescents (93 F and 29 M aged 12-18 years) were randomly assigned to one of the following 3 groups: brief information + occlusal appliance (BI + OA), brief information + relaxation therapy (BI + RT), or brief information (BI). Included were subjects reporting pain once a week or more often, in addition to receiving a diagnosis of TMD according to the Research Diagnostic Criteria (RDC/TMD). They were evaluated before and after treatment and at a 6-month follow-up by means of self-reports and clinical assessment. The result revealed a significantly higher reduction in frequency of pain, in pain intensity (visual analog scale [VAS]), and in a composite pain index (intensity x frequency) for patients treated with BI + OA compared with those treated with BI alone. In the BI + OA group, 60% of the patients attained a clinically significant improvement (at least 50% or more) on the pain index, a significantly higher proportion compared to that obtained in the other 2 treatment groups. Analgesic consumption was also significantly more reduced in the BI + OA group compared to the BI group. However, no significant differences were found between the treatment groups in jaw opening or in muscle and TMJ tenderness scores. Occlusal appliance was found to be superior to both relaxation therapy and brief information regarding pain reduction and can therefore be recommended when treating adolescents with TMD pain.

Laryngeal biomechanics of the singing voice

By transnasal fiberoptic laryngoscopy, patients with functional voice disorders often demonstrate abnormal laryngeal biomechanics, commonly supraglottic contraction. Appropriately, such conditions are sometimes termed muscle tension dysphonias. Singers working at the limits of their voice may also transiently demonstrate comparable tension patterns. However, the biomechanics of normal singing, particularly for different singing styles, have not been previously well characterized. We used transnasal fiberoptic laryngoscopy to study 100 healthy singers to assess patterns of laryngeal tension during normal singing and to determine whether factors such as sex, occupation, and style of singing influence laryngeal muscle tension. Thirty-nine male and 61 female singers were studied; 48 were professional singers, and 52 were amateurs. Examinations of study subjects performing standardized and nonstandardized singing tasks were recorded on a laser disk and subsequently analyzed in a frame-by-frame fashion by a blinded otolaryngologist. Each vocal task was graded for muscle tension by previously established criteria, and objective muscle tension scores were computed. The muscle tension score was expressed as a percentage of frames for each task with one of the laryngeal muscle tension patterns shown. The lowest muscle tension scores were seen in female professional singers, and the highest muscle tension scores were seen in amateur female singers. Male singers (professional and amateur) had intermediate muscle tension scores. Classical singers had lower muscle tension scores than nonclassical singers, with the lowest muscle tension scores being seen in those singing choral music (41%), art song (47%), and opera (57%), and the highest being seen in those singing jazz/pop (65%), musical theater (74%), bluegrass/country and western (86%), and rock/gospel (94%). Analyzed also were the influences of vocal nodules, prior vocal training, number of performance and practice hours per week, warm-up before singing, race, smoking, and alcohol consumption. (Otolaryngol Head Neck Surg 1996;115:527-37.)

Laryngeal biomechanics of the singing voice.

By transnasal fiberoptic laryngoscopy, patients with functional voice often demonstrate abnormal laryngeal biomechanics, commonly supraglottic contraction. Appropriately, such conditions are sometimes termed muscle tension dysphonias. Singers working at the limits of their voice may also transiently demonstrate comparable tension patterns. However, the biomechanics of normal singing, particularly for different singing styles, have not been previously well characterized. We used transnasal fiberoptic laryngoscopy to study 100 healthy singers to assess patterns of laryngeal tension during normal singing and to determine whether factors such as sex, occupation, and style of singing influence laryngeal muscle tension. Thirty-nine male and 61 female singers were studied; 48 were professional singers, and 52 were amateurs. Examinations of study subjects performing standardized and nonstandardized singing tasks were recorded on a laser disk and subsequently analyzed in a frame-by-frame fashion by a blinded otolaryngologist. Each vocal task was graded for muscle tension by previously established criteria, and objective muscle tension scores were computed. The muscle tension score was expressed as a percentage of frames for each task with one of the laryngeal muscle tension patterns shown. The lowest muscle tension scores were seen in female professional singers, and the highest muscle tension scores were seen in amateur female singers. Male singers (professional and amateur) had intermediate muscle tension scores. Classical singers had lower muscle tension scores than nonclassical singers, with the lowest muscle tension scores being seen in those singing choral music (41%), art song (47%), and opera (57%), and the highest being seen in those singing jazz/pop (65%), musical theater (74%), bluegrass/country and western (86%), and rock/gospel (94%). Analyzed also were the influences of vocal nodules, prior vocal training, number of performance and practice hours per week, warm-up before singing, race, smoking, and alcohol consumption.

EFFECTS OF ELEVATED BILIRUBIN AND PHOTOTHERAPY ON INFANT BEHAVIOR

Neuro-psychological effects of elevated serum bilirubin (Bili) and treatment with phototherapy (Rx) were studied In full term infants. The Graham/Rosenblith Neonatal Assessment Scales were administered at 12 hour intervals to infants throughout their hospital stay. Group I (n=12) had Bili ≤7mg%. Group II (n=18) had Bili ≥10mg% without Rx. Group III had Bili >10mg% and were treated from 7-85 hrs (X-39.6±6.5 hrs). Bili for Group III Infants dropped from 14.4±.3mg% to 10.1±.6mg% post-Rx (t=6.68, p<.01). By post hoc analyses the groups appeared similar in all birth, maternal, and delivery characteristics evaluated. Age, amount fed, and time since feeding were significantly correlated with specific measures. Variance due to these uncontrolled factors were statistically removed for evaluation of differences between groups. Further adjustments were made for Bili to isolate affects of phototherapy treatment from those related to bilirubin alone. Scores on general maturation items, muscle tension scores, limb extension responses, and strength of cry were lowered by Bili and apparently not further affected by Rx. Prolonged limb elevation increased in response to passive movement, and pitch of cry was lowered for treated Infants and were not related to Bill. Severity of trembling was Increased both by Bili and by Rx. Location of trembling responses and the types of stimuli eliciting trembling were increased by Bili and perhaps also by pre-delivery medication. Infant neuro-psychological behavior is significantly affected by hyperbillrubinemia and by treatment with phototherapy.