Postural Rest Research Articles

Comparison of muscle response in patients treated with rigid and flexible fixed functional appliances.

The present study was undertaken to evaluate and compare muscle activity after the treatment with rigid and flexible fixed functional appliance. The study was conducted on 14 skeletal Class II malocclusion patients in the age group of 13-17 years, divided into two groups comprising 7 patients in each group. Group I was treated with a rigid fixed functional appliance (MPA IV), and Group II was treated with a flexible fixed functional appliance (Churro Jumper). Masseter and anterior temporalis muscle activities were recorded using needle electromyography (EMG) at postural rest, saliva swallowing, and clenching during five intervals (T0 to T4) during fixed functional appliance treatment. Unpaired t-test, Mann-Whitney U, and Wilcoxon sign rank test were applied for statistical analysis, and a P value of <.05 was considered statistically significant. Group I (MPA IV) showed a significant increase in EMG activity during postural rest position (P = 0.003, P = 0.001), swallowing (P = 0.013, P = 0.005), and clenching (P = 0.001, P = 0.002) in masseter and anterior temporalis muscle, respectively. Group II (Churro jumper) also showed a significant increase in EMG activity during postural rest position (P = 0.000, P = 0.000), swallowing (P = 0.001, P = 0.000), and clenching (P = 0.001, P = 0.000) in masseter and anterior temporalis muscle, respectively. Both rigid (MPA IV) and flexible (Churro Jumper) fixed functional appliances caused a significant increase in EMG activity of masseter and anterior temporalis muscle during postural rest position, swallowing, and clenching in 6 months of the observation period, but the flexible appliance (Churro Jumper) showed more significant increase.

Longitudinal changes in electromyographic activity of masseter and anterior temporalis muscles before and after alloplastic total joint replacement in patients with temporomandibular ankylosis: a prospective study

The purpose of the study was to evaluate the longitudinal changes in electromyographic (EMG) activity of the masseter and temporalis muscles before and after temporomandibular joint (TMJ) total joint replacement (TJR) in ankylosis patients. A prospective longitudinal study was designed on patients undergoing unilateral or bilateral TMJ-TJR. EMG activity at rest and maximal voluntary contraction (MVC) was recorded for the muscles preoperatively (T0), and at one-week (T1) and six-month (T2) follow up. The study sample was composed of 10 (male: female 2.3:1) patients undergoing TMJ-TJR. The number of unilateral and bilateral cases was three and seven, respectively. In both unilateral and bilateral cases a statistically significant reduction in EMG activity of the masseter and anterior temporalis muscles was observed at T1. At T2, EMG activity of the muscles was found to be approaching the preoperative value. In unilateral cases, when the affected side at T0, T1, and T2 was compared with T0 for the unaffected side, statistically significant differences were seen for the masseter. In the case of the temporalis, similar results were seen except at T2 for the postural rest position. The results indicate that re-attachment of the masseter and temporalis muscles occurs progressively post TMJ-TJR.

Design of a stabilisation platform for Parkinson’s disease patient

There are an increased number of patients all over the world suffering from postural tremors and rest tremors, the types of tremors associated with Parkinson’s disease and other neurodegenerative diseases such as amyotrophic lateral sclerosis. Currently, there is no cure for such disease and patients have to deal with their condition to continue their life normally with the existing of some helpful instruments. This work presents a self-stabilising Parkinson’s disease (PD) Tray (platform) that can help them to carry objects that they hold with their hand. The proposed design includes a mechanical platform and en electronic system to control the tray and inhibits any vibrations of the base plate of the tray. An algorithm was developed that would take positional data from an Inertia movement sensors IMU, compute angles in degrees from its Euler angle raw data and then use those angles to control three servo motors in a direction counter to the changes in the IMU’s position. The platform, was capable of stabilising the base of the tray such that objects placed in it would not be dropped. The tray was tested on simulating conditions and the result should that the mean absolute value of the acceleration values in X and Y directions were reduced from 2.23 m/sec2 to 0.26 m/sec2 in the X direction and from 1.41 m/sec2 to 0.34 m/sec2 in the Y direction.

A Study of Electromyographic Activity of Masseter and Temporalis Muscles and Maximum Bite Force in Patients with Various Malocclusions

Introduction and objectives: The relationship between form and function of the stomatographic system has been studied by several researchers and it is still not clear, whether a genetically determined facial morphology decides the strength of masticatory muscles, or whether a strong musculature influences the form of the face. The present study was done to relate muscle activity with various malocclusions. Materials and methods: Sixty samples of younger age group were divided according to Angle classification. The electromyography (EMG) activity of masseter and temporalis and the maximum bite force (MBF) at intercuspal (molar) and anterior bite position (incisors) have been studied for different malocclusion groups. Influence of various independent variables like gender, overjet and overbite of the subjects on the bite force was also checked. Results: MBF at intercuspal position (molar) and anterior bite position (incisal) were not significantly different between normal, Class I, Class II Division 1 and Class III malocclusion groups. Conclusion: It was concluded that Class III malocclusion subjects showed the highest masseter and anterior temporalis postural rest activity and Class II Division I malocclusion showed the least anterior temporalis activity at both the intercuspal and interincisal positions during

Investigation on perioperative nursing demand of patients with surgery

Objective To investigate the needs of nursing care in surgical patients during perioperative period.Methods The self-made questionnaire of Questionnaire of The Needs of Patients During Perioperative Period in our hospital was applied on the subjects undergoing surgical operation.Results What the patients wanted to know the best were causes of disease,diet,medication knowledge,treatment,nursing knowledge,prevention of complications,and postural rest guidance.As for contents related with disease,patients wanted to know the postoperative pain,postoperative recovery,operation time and process,and operation cost in turn.Interview was the most accepted style in patients,it accounted for 63.28％; the majority of patients perceived a need for follow-up.Conclusion To understand all kinds of demand of perioperative patients can reduce the hospital stay,minimize the medicine source disease,improve the clinical efficacy,enhance patients' satisfaction,and let the patients obtain maximum benefits. Key words: Postoperative patients; Perioperative; Nursing; Demand

An electromyographic study to assess the minimal time duration for using the splint to raise the vertical dimension in patients with generalized attrition of teeth

To investigate the effect of restoration of lost vertical by centric stabilizing splint on electromyographic (EMG) activity of masseter and anterior temporalis muscles bilaterally in patients with generalized attrition of teeth. EMG activity of anterior temporalis and masseter muscle was recorded bilaterally for 10 patients whose vertical was restored with centric stabilizing splint. The recording was done at postural rest position and in maximum voluntary clenching for each subject before the start of treatment, immediately after placement of splint and at subsequent recall visits, with splint and without the splint. The EMG activity at postural rest position (PRP) and maximum voluntary clench (MVC) decreased till 1 month for both the muscles. In the third month, an increase in muscle activity toward normalization was noted at PRP, both with and without splint. At MVC in the third month, the muscle activity without splint decreased significantly as compared to pretreatment values for anterior temporalis and masseter, while with the splint an increase was seen beyond the pretreatment values. A definite response of anterior temporalis and masseter muscle was observed over a period of 3 months. This is suggestive that the reversible increase in vertical prior to irreversible intervention must be carried out for a minimum of 3 months to achieve neuromuscular deprogramming. This allows the muscle to get adapted to the new postural position and attain stability in occlusion following splint therapy.

Structure relates to elastic recoil and functional role in quadriceps tendon and patellar ligament

Tendons and ligaments have similar but slightly different structure and composition. Crimps of tendons and ligaments are morphological structures related to the elastic functional properties of these connective tissues. Aim of this study was to investigate the morphological arrangement of collagen fibres, fibrils and crimping pattern of suprapatellar (rectus femoris tendon-RFT and vastus intermedius tendon-VIT) and infrapatellar connective tissues (patellar ligament-PL) to relate their structural aspects to their common function role of leg extension. RFT, VIT and PL were removed from knees of Sprague–Dawley rats and light and electron microscopy (TEM and SEM) performed. Sagittal sections showed that collagen array and crimping pattern were similar in RFT and PL but differed from VIT. Morphometric analysis confirmed that crimp number was about the same in RFT and PL (5.4±1.4 and 6.1±2.8 respectively), but it was almost three times higher in VIT (14.5±4.7). Similarly crimp top angle in RFT and PL (141.5±15.0° and 146.2±12.2° respectively) was significantly higher than in VIT (122.3±14.8°) and the crimp base length was more than twice as wide in RFT (75.5±22.6μm) and PL (72.3±28.9μm) than in VIT (36±14.1μm). The smaller, fewer and most crimped crimps in VIT show that this tendon has a greater elastic recoil and responds to higher forces as among quadriceps muscles the vastus intermedius belly contributes the most during knee extension. By contrast, RFT acting as a “stopper” tendon also plays a ligament role by limiting an excessive flexion of the joint during postural rest position of the knee.

Effect of denture fabrication and wear on closest speaking space and interocclusal distance during deglutition

The accuracy of assessing maxillomandibular relationships for trial bases and dentures using phonetic and swallowing methods has not been compared to that observed with definitive prostheses. Thus, there is no evidence to prove whether measurements obtained through such methods remain the same after adaptation to dentures. This study investigated changes in the closest speaking space, interocclusal rest space, and interocclusal distance during deglutition in edentulous patients during and after complete denture treatment. Eighteen edentulous subjects participated in this study and measurements were performed after 7 intervals of time: (1) with occlusion rims and record bases following creation of the maxillomandibular relationship record, (2) with trial dentures, (3) at insertion of definitive complete dentures, (4) 1 week, (5) 2 weeks, (6) 1 month, and (7) 3 months after insertion. Recordings of interocclusal distances were made with a mandibular kinesiograph. Closest speaking space was measured during the pronunciation of the word 'seis'. The distance between postural rest position and centric occlusion, or interocclusal rest space, was measured using a kinesiograph. Interocclusal distance during deglutition was tested by recording the closest mandibular position recorded during swallowing of 20 mL of water. Data were analyzed using repeated-measure ANOVA, followed by the Student-Newman-Keuls test (alpha=.05). A significant (P<.01) reduction in the mean closest speaking space was found when it was evaluated using occlusion rims and record bases (4.6 mm) compared with other stages (3.0 to 3.4 mm). No significant differences were found in mean interocclusal rest space and interocclusal distance during deglutition among the time periods evaluated. The presence of occlusion rims can influence mandibular position during pronunciation of the /s/ sound. The arrangement of artificial teeth changes the closest speaking space. However, rest position and deglutition were not affected, either during denture fabrication or short-term use.

Evaluation of condylar position from transcranial projections in primary dentition

To evaluate the condylar position through transcranial radiographs in children between 3 years and 6 years old and to associate it with morphological characteristics of primary dentition. The extraoral transcranial radiographs were taken with plain films using the Accurad-200 head holder (Denar Company, Anaheim, CA), and then they were digitized using a Hewlett Packard 6390 Scanner. The condylar position was determined according to Gelb's template, in postural rest position (RP) and maximum intercuspal position (MI), and it was associated with the characteristics: normal occlusion (n=36), open bite with or without overjet greater than 3 mm (n=27), unilateral or bilateral posterior cross bite (n=14), overbite greater than 3 mm (n=15). The chi-square and the Fisher Exact Test were used to analyse the data. It was verified that when using Gelb's template, there was not a significant association between the occlusion type found and the position of the condyle in the glenoid fossa when considering the entire patient sample (P>0.05). There was a great variability in positions, and most of the children had asymmetric condyles (55.43% in MI and 51.09% in RP). Children with normal occlusion and malocclusion presented the same proportions of condylar position in both mandibular positions. In conclusion, the results of this study showed that the condylar position in small children with different morphological occlusions presented great variability.

Relation between speaking space of the /s/ sound and freeway space in dentate and edentate subjects

The purpose of this study is to assess the relation between the speaking space of the /s/ sound and the freeway space in two subject groups. One group had natural dentition (Group I, n = 61) and the other comprised complete denture wearers (Group II, n = 33). The analysis was done by means of a jaw-tracking device (K6-I Diagnostic System, Myotronics Research Inc., Seattle, WA, USA). Freeway space was determined by asking the subjects to occlude from the postural rest position. Speaking space of /s/ was measured during the pronunciation of the word "seis" and comprised the mean distance from the /s/ speaking position to maximal intercuspation. A weak correlation was found between the speaking space of /s/ and the freeway space in Group I (r = 0.41, p < 0.01), but in Group II, the correlation was stronger (r = 0.75, p < 0.01). The speaking space of /s/ and freeway space were different in Group I, but statistically similar in Group II (paired t-test, alpha = 0.05). It can be suggested that anatomic changes following prosthetic procedures caused a functional adaptation which resulted in more similar values for the speaking space of /s/ and the freeway space.

Kinesiographic study of mandibular movements during functional adaptation to complete dentures

After complete denture insertion, edentulous patients usually present transitory difficulties. This is one of the most critical stages of prosthetic treatment and it is strongly related to the prostheses acceptance. The aim of this study was to evaluate potential changes in the mandibular movement pattern related to insertion of the complete denture during the functional adaptation period. The kinesiograph instrument K6-I (Myotronics Research Inc., Seattle, WA) was used to evaluate eight edentulous patients that received conventional complete denture treatment. Recordings of opening and closure movement limits, movement velocity, postural rest position, chewing cycle and limits of eccentric movements were performed. Each patient was evaluated in four different stages: with the old dentures, immediately after insertion of the new dentures, and 30 days and 6 months after insertion of the dentures. The results showed that there were no remarkable changes in the mandibular motion patterns after insertion of the new dentures. It was suggested that the problems related to the process of utilization of new dentures are not strictly associated to the mandibular movement. Therefore, functional adaptation after denture insertion is not directly related to functional changes, but to the quality of the dentures and to individual features.

The role of passive muscle tensions in a three-dimensional dynamic model of the human jaw

The role of passive muscle tensions in human jaw function are largely unknown. It seems reasonable to assume that passive muscle-tension properties are optimized for the multiple physiological tasks the jaw performs in vivo. However, the inaccessibility of the jaw muscles is a major obstacle to measuring their passive tensions, and understanding their effects. Computer modelling offers an alternative method for doing this. Here, a three-dimensional, dynamic model was used to predict active and passive jaw-muscle tensions during simulated postural rest, jaw opening and chewing. The model included a rigid mandible, two temporomandibular joints, multiple dental bite points, and an artificial food bolus located between the right first molars. It was driven by 18 Hill-type actuators representing nine pairs of jaw muscles. All anatomical forms, positions and properties used in the model were based on previously published, average values. Two states were stimulated, one in which all optimal lengths for the length–tension curves in the closing muscles were defined as their fibre-component lengths when the incisor teeth were 2 mm apart (S2), and another in which the optimal lengths were set for a 12.0 mm interincisal separation (S12). At rest, the jaw attained 3.6 mm interincisal separation in S2, and 14.8 mm in S12. Activation of the inferior lateral pterygoid (ILP) and digastric (DG) muscles in various combinations always induced passive jaw-closer tensions, and compressive condylar loads. Maximum midline gape (from maximum bilateral co-activation of DG and ILP) was 16.2 mm in S2, and 32.0 mm in S12. When both model states were driven with muscle patterns typical for human mastication, recognizable unilateral and vertical “chopping” chewing cycles were produced. Both states revealed condylar loading in the opening and closing phases of mastication. During unilateral chewing, compressive force on the working-side condyle exceeded that on the balancing side. In contrast, during the “chopping” cycle, loading on the balancing side was greater than that on the working side. In S2, chewing was limited in both vertical and lateral directions. These results suggest that the assumptions used in S12 more closely approximated human behaviour than those in S2. Despite its limitations, modelling appears to provide a useful conceptual framework for developing hypotheses regarding the role of muscle tensions during human jaw function.

Variability of closest speaking space compared with interocclusal distance in dentulous subjects

Variability of closest speaking space was compared with that of interocclusal distance in 30 dentulous subjects to the nearest 0.1 mm on the screen of a mandibular kinesiograph. Postural rest position was elicited by the subjects saying /M/ and relaxing the jaw. Closest speaking space was defined as the vertical difference in the position of the mandible from the immediate end of rapid counting from 60 to 66 to centric occlusion. The two variables were measured in random order 20 times each. The subjects were examined for two data collecting sessions. The variance of the closest speaking space was smaller than the variance for interocclusal distance for 26 of 30 subjects. The difference between the mean variances was statistically significant, p > 0.1 ( t 3 and t 3.41, df 29).

Reliability of surface electromyography of the masseteric and anterior temporal areas

This was studied in 37 patients suffering from myofascial pain-dysfunction. Bipolar surface electrodes were used to record tonic, resting EMG activity for 2 consecutive trials. This protocol was repeated at a second recording session 2 weeks later. A custom-made, plastic template was constructed for each subject during the first visit in order to relocate the electrodes accurately at the second recording session. Correlation coefficients were calculated for each muscle area. Within-session (same day) r values ranged from 0.7620 to 0.8884 for the masseteric area and from 0.8686 to 0.9109 for the anterior temporal area. Across-session (different day) r values ranged from 0.5645 to 0.6503 for the masseteric area and 0.3309 to 0.4844 for the anterior temporal area. The lower correlation between different day recordings could reflect a methodological shortcoming in relocating the electrodes, particularly on the anterior temporal area. The greater variability recorded from the anterior temporal area could also reflect the dynamic role of the temporalis muscle in maintaining the postural rest position of the mandible.

The effects of treatment on masticatory muscle activity and mandibular posture in myofascial pain-dysfunction patients.

The purpose of this study was to evaluate tonic masticatory muscle activity and the postural rest position of the mandible, pre- and post-treatment, in patients with TM disorders. Forty-one patients diagnosed as suffering from myofascial pain-dysfunction (MPD) were evaluated, with electromyography (EMG) used to measure the muscle activity of the masseteric and anterior temporal areas at rest. Postural rest position was assessed by measurement of interocclusal distance. Twenty-three asymptomatic subjects were also tested as controls. Treatment for the pain group emphasized cognitive awareness of dysfunctional orofacial behavior and biofeedback training of the masseteric area to teach masticatory muscle relaxation. The pre-treatment EMG values of both the masseteric and anterior temporal areas were significantly higher for the pain group than for the control group. Post-hoc division of the pain group into successful and unsuccessful subgroups was made on the basis of the degree of symptom improvement. EMG activity decreased significantly in the masseters of both subgroups, but only the unsuccessful subgroup showed a significant decrease in anterior temporal activity following therapy. Interocclusal distance was significantly increased in both subgroups. These results suggest that tonic masticatory muscle activity may be elevated in MPD patients. They also suggest that a decrease in EMG activity in the masseter and anterior temporalis muscles and an opening of the postural rest position of the mandible may accompany completion of psychophysiological therapy, but these changes do not correspond directly with the outcome of that therapy.

Surgical Treatment of Pulmonary Tuberculosis

No field of medicine or surgery has undergone more drastic changes in the past decade than has the treatment of pulmonary tuberculosis. The modern treatment of this disease bears so little resemblance to that so generally accepted a few years ago that anyone trained in the earlier tuberculosis program but out of touch with the field for the past several years would be almost totally lost; a stranger in a strange land in today’s program. Gone are the sleeping porches, the sundecks, the backyard shacks, the postural rest, the compression jackets, the heating pads and the stone hot water pigs as well as many of the sanatoria which were so crowded with health seekers not so many years ago. Bedrest, prolonged and intensive, has been replaced by a very modified type of rest program, or none at all, plus intensive antimicrobial therapy. The old dictum of Sir William Ostler, “In tuberculosis we prescribe not drugs but a mode of life,” has now been almost reversed. Surgery of a somewhat hesitating and indirect type has given way to an aggressive definitive attack. The phthisiologist of yore who formerly boasted that he protected his patients from the attacks of the surgeon has now been displaced by one whose zeal for surgical treatment must, not infrequently, be tempered and restrained by some of his more conservative surgical brethren. The idea behind all of this is not new. The dictum of Lady Macbeth, “Out damned spot,” has long had a strong appeal to the surgeon phthisiologist. Tuffier in 1891 successfully excised a tuberculous area from the apex of the lung. Subsequently, his experience and that of other surgeons who followed the same attack proved the procedure to be too costly. It is only because of modern developments in chemotherapy, anesthesia, blood banks and transfusion techniques, oxygen therapy and a better understanding of segmental anatomy of the lung and surgical techniques that the present program has become possible. There can be no denying that many of the older forms of therapy were extremely valuable and that they contributed much to the control of tuberculosis over many years. There are thousands of people in good health today as living proof of the value of many of the procedures now abandoned. They are no longer in extensive use only because we now feel that we have something better to offer. Pneumo thorax Pneumothorax, once the stand-by and lifesaver for many who did not improve under bedrest alone, has now largely been abandoned in most sections of the country. The extent to which this has occurred is well illustrated by the fact that one large sanatorium which at one time carried more than 50 per cent of its patients under this form of therapy now has only a

Postural Rest in Pulmonary Tuberculosis

From our short experience of this form of treatment, and despite the relatively few patients who give their complete co-operation it has been the impression throughout the hospital that the response to postural rest far outweighs that of ordinary bed rest and appears to deserve more wholehearted approval and aclaim than any other single method of treatment. We are indebted to Mrs. Barton-Hoare for doing the photographic work connected with this article.

THE SURGICAL TREATMENT OF PULMONARY TUBERCULOSIS

Article1 September 1934THE SURGICAL TREATMENT OF PULMONARY TUBERCULOSISRALPH C. MATSON, M.D., F.A.C.P., F.A.C.S.RALPH C. MATSON, M.D., F.A.C.P., F.A.C.S.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-8-3-268 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAn analysis of our present knowledge of the advances made in the treatment of pulmonary tuberculosis clearly indicates that rest is the foundation and its development the only important and successful remedial furtherance in the treatment of this disease. Detweiler is credited with being the first to advocate rest as a therapeutic measure; but Joseph H. Pratt points out that Trudeau indorsed it before Detweiler. From a surgical standpoint, the development of rest as a curative method forms the basis of modern phthisiotherapy.Valuable adjuncts to bed rest are postural rest on the diseased hemithorax and shot-bags placed on the...Bibliography1. MATSON RC: Cauterization of adhesions in artificial pneumothorax by Jacobaeus-Unverricht method of closed pneumolysis; observations on 100 cases, Am. Rev. Tuberc., 1929, xix, 233-305. Google Scholar2 MATSON RC: Electrosurgical method of closed intrapleural pneumolysis in artificial pneumothorax, Arch. Surg., 1929, xix, 1175-1192. CrossrefGoogle Scholar3. MATSON RC: Operative collapse therapy in treatment of pulmonary tuberculosis, West. Jr. Surg., 1930, xxxviii, 743; 1931, xxxix, 13. Google Scholar4. MATSON RC: Severing adhesions in artificial pneumothorax by electrosurgical method, Surg., Gynec. and Obst., 1934, lviii, 619-629. Google Scholar5. PLENKMATSON ARC: Zur Phrenicotomiefrage. Beiträge zur Klinik der Tuberkulose, Band 62, Heft ¾, 1925. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Portland, Oregon*Read at the Chicago meeting of the American College of Physicians, April 17, 1934.From the Department of Medicine, University of Oregon Medical School, Portland, Oregon, and the Departments of Medicine and Thoracic Surgery, Portland Open Air Sanatorium, Milwaukie, Oregon. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byControl of tuberculosis in the Hudson River State Hospital 1 September 1934Volume 8, Issue 3Page: 268-281KeywordsPulmonary diseasesThoracic surgery ePublished: 1 December 2008 Issue Published: 1 September 1934 PDF downloadLoading ...

Intensive Postural Rest in the Treatment of Pulmonary Tuberculosis

Intensive Postural Rest in the Treatment of Pulmonary Tuberculosis

INTENSIVE POSTURAL REST IN THE TREATMENT OF PULMONARY TUBERCULOSIS

Several years ago Webb 1 and his co-workers called attention to a new method of treating pulmonary tuberculosis; namely, rest. The absence of further reports since that time leads us to believe that this method has not received the recognition it deserves. We offer this brief report in the hope that other workers may learn of its value. The object of postural rest, according to Webb, is to secure practically complete rest of the diseased lung by having the patient lie on the affected side. He showed that after from thirty minutes to an hour in this position the respiratory excursions of the chest wall are greatly diminished. In some cases there is a definite sagging of the heart and mediastinum due to gravity. Often after several months of postural rest there is a marked shrinkage of the diseased lung caused by fibrosis, with decrease in the size of