Effect of a nociceptive trigeminal inhibitory splint on electromyographic activity in jaw closing muscles during sleep

The nociceptive trigeminal inhibitory (NTI) splint has been claimed to decrease the electromyographic (EMG) activity of jaw-closing muscles and relieve symptoms of various types of temporomandibular disorders (TMD) and bruxism. The present study was designed to address the question about EMG-changes during sleep. Ten patients (age: 23-39 years) with a self-report of tooth-grinding during sleep were recruited. Patients were examined at baseline and after each treatment period with the use of the Research Diagnostic Criteria for TMD. A portable EMG-device was used to record EMG-activity from the masseter muscle during sleep. The patients received two 2-week splint treatments in a randomized cross-over fashion; an NTI splint and a standard flat occlusal splint (OS). EMG data were analysed according to published criteria. Using a 10% of maximum clenching EMG-activity cut-off threshold to determine the number of EMG-events h(-1) of sleep, the NTI splint was associated with a significant reduction (9.2 +/- 3.2 events h(-1)) compared with baseline EMG (19.3 +/- 4.0; anova: P = 0.004, Tukey post hoc: P = 0.006), whereas there were no differences between the OS (16.2 +/- 4.7) and baseline EMG (19.2 +/- 4.1; P = 0.716). There were no effects of either NTI or OS on clinical outcome measures (anovas: P > 0.194). This short-term study indicated a strong inhibitory effect on EMG-activity in jaw closing muscles during sleep of the NTI, but not the OS. However, the EMG-activity was not directly related to clinical outcome. Further studies will be needed to determine long-term effects and possible side effects of the NTI splint.     

单侧脑干卒中后吞咽障碍患者双侧颏下肌群表面肌电分析

目的分析单侧脑干卒中后吞咽障碍患者吞咽时双侧颏下肌群表面肌电特点,并探讨吞咽障碍发生机制。 方法选取左侧脑干卒中后吞咽障碍患者8例,右侧脑干卒中后吞咽障碍患者7例及健康志愿者10例。采用表面肌电图记录上述对象吞咽5ml温水时双侧颏下肌群表面肌电振幅及时程。 结果左侧脑干卒中后吞咽障碍患者左侧颏下肌群表面肌电振幅［(46.2±16.2)μV］明显高于右侧［(43.0±13.8)μV］,差异具有统计学意义（P<0.05）,左侧吞咽时程［（1430.4±303.7）ms］与右侧吞咽时程［（1407.1±282.9）ms］间差异无统计学意义（P>0.05）;右侧脑干卒中后吞咽障碍患者右侧颏下肌群表面肌电振幅［(47.7±15.6)μV］明显高于左侧［（40.1±9.6）μV］,差异具有统计学意义（P<0.05）,左侧吞咽时程［（1548.1±290.8）ms］与右侧吞咽时程［（1564.3±295.8）ms］间差异无统计学意义（P>0.05）;正常人吞咽时其左、右两侧颏下肌群表面肌电振幅［分别为（30.9±2.5）μV和(30.5±3.2)μV］及时程［分别为(1288.0±221.9)ms和(1290.00±217.6)ms］间均无明显差异（P>0.05）。与正常人比较,左侧脑干卒中患者左侧颏下肌群及右侧脑干卒中患者右侧颏下肌群振幅均显著增强（P<0.05）,其时程均明显延长（P<0.05）。与正常人比较,左侧脑干卒中患者右侧颏下肌群及右侧脑干卒中患者左侧颏下肌群振幅均显著增强（P<0.05）,其时程均无显著差异（P>0.05）。 结论单侧脑干卒中后吞咽障碍患者其双侧颏下肌群功能均受损,且病灶侧受损程度较对侧严重。     

肌电图震颤分析对震颤的鉴别诊断价值

目的:探讨肌电图震颤分析对帕金森病(PD)与原发性震颤(ET)、加强生理性震颤(EPT)的鉴别诊断价值。方法:收集PD患者15例(PD组)、ET患者10例(ET组)、EPT患者10例(EPT组),行肌电图震颤分析检查,分别记录静息时、固定姿势、负重500 g和1 000 g时的震颤频率和肌肉收缩模式。结果:ET组静息、固定姿势、负重500 g和1 000 g的震颤频率分别为(5.36±1.33)Hz、(7.22±2.60)Hz、(6.49±2.08)Hz、(6.29±1.38)Hz;PD组分别为(4.53±0.41)Hz、(4.92±0.69)Hz、(5.12±0.61)Hz、(4.71±0.98)Hz;EPT组分别为(8.49±5.42)Hz、(15.7±4.50)Hz、(7.46±2.91)Hz、(9.44±1.46)Hz。PD组与ET组的频率在静止和负重后差异均无统计学意义(P0.05),PD组静止性、固定姿势、负重1 000 g后的震颤频率均与EPT组差异有统计学意义(P0.05或P0.01)。PD组肌肉收缩模式以交替性收缩为主,ET、EPT组肌肉收缩模式主要为同步性。结论:肌电图震颤分析能通过震颤频率和肌肉收缩模式的不同对PD与ET、EPT进行鉴别。     

Electromyographic Abnormalities Associated with Symptomatic Sacral Tarlov Cysts

Tarlov or perineural cysts (TC) are commonly overlooked as a cause of sacral and ischial pain, and urogenital and bowel problems. TC can be seen on MRI, but are often considered asymptomatic. This is especially true for smaller cysts. Moreover, there are only few diagnostic characteristics that can be used to confirm that the cysts are the cause of the symptoms. As a consequence, a lot of controversy remains regarding the clinical importance of TC. Because of this underdiagnosed condition, patients often suffer for several years from unrecognized chronic neuropathic pain and neurological conditions. In this article, case reports of three patients with giant and smaller symptomatic sacral cysts are presented, in which electromyographic testing was performed to demonstrate nerve damage. We suggest that electromyography of the sacral nerve roots can be a reasonable tool for the diagnosis of symptomatic TC, as well as for the differentiation from other pathological entities causing sacral and ischial pain. Moreover, using electromyography it was also documented that smaller cysts of < 1 cm can cause nerve damage. Therefore incidence of symptomatic TC may be higher than initially thought.     

高频重复经颅磁刺激对单侧大脑半球卒中后患者吞咽障碍的影响

目的 研究高频重复经颅磁刺激对健侧大脑半球舌骨上肌群皮质对应区的兴奋作用，以及对单侧大脑半球卒中后患者吞咽障碍的疗效。 方法 选取非急性期单侧大脑半球卒中后吞咽障碍患者40例，采用随机数字表法将其分为试验组和对照组，每组患者20例，试验组采用5 Hz高频经颅磁刺激相对健侧大脑舌骨上肌群皮质对应区结合传统吞咽康复训练，对照组仅予以传统吞咽康复训练。于治疗前和治疗2周后（治疗后）对2组患者行吞咽X线荧光透视检查（VFSS）和表面肌电图（sEMG）检查和分析，并以标准吞咽功能（SSA）评价量表、VFSS评价量表、渗透-误吸（PAS）评价量表进行疗效评估。 结果 治疗后，2组患者sEMG的吞咽时程和最大波幅以及SSA、PAS、VFSS评分与组内治疗前比较，均显著改善，差异均有统计学意义（P<0.05）。治疗后，实验组患者sEMG的吞咽时程和最大波幅以及SSA、PAS、VFSS评分分别为（1.50±0.30）s、（0.40±0.12）mV、（20.30±2.25）分、（2.00±1.69）分和（8.75±1.29）分，与对照组治疗后比较，差异均有统计学意义（P<0.05）。 结论 采用5Hz高频经颅磁刺激健侧大脑半球舌骨上肌群皮质对应区，可有效地改善单侧大脑半球卒中后患者的吞咽障碍。     

基于表面肌电信号的手指运动模式识别系统

目的：建立一套基于表面肌电信号（sEMG）的手指运动模式识别系统。方法：研发了基于有源电极的sEMG检测装置和包含信号采集、分析、离线识别和在线识别模块的配套软件。结果：该系统能够同时采集4个通道sEMG数据，用16种时域、频域和时频域方法对其分析，并可以对7种sEMG特征提取及分类方法进行对比研究，还能在线控制假手。结论：本系统为多指、多自由度假手sEMG控制方法的研究提供了一个实验平台．该系统不仅可以用于手指运动模式识别，而且也可以用于人体其他运动模式的sEMG特征提取方法和分类器的对比研究。     

四点跪位和手足位训练中躯干肌肉激活和共收缩模式比较

目的 分析四点跪位和手足位训练在躯干肌肉活动和共收缩模式上的异同,探究手足位训练作为核心稳定性训练的可能性,并为实际训练提供建议。方法 19名健康受试者参与研究,随机执行四点跪位（4个）和手足位（3个）动作,同时测量两侧腹直肌、腹外斜肌、竖脊肌、多裂肌的表面肌电信号。分析并比较基于表面肌电信号,得到肌电平均振幅值和肌肉共收缩指数。结果 四点跪位和手足位训练的组内和组间比较中,单一肌肉激活程度和共收缩指数都表现出统计学差异。四点跪位右手左腿抬起时,所有肌肉激活程度都高于起始位。四点跪位左腿抬起时同侧多裂肌明显高于手足位。手足位右手抬时腹外斜肌和腹直肌激活度较高。对8条肌肉两两匹配对共得到28种肌肉配对方式,四点跪位起始姿势波动最小,说明脊椎最为稳定,而其他动作指数波动范围较大。结论 从肌肉激活程度和共收缩两方面,证明了手足位训练作为核心稳定性训练的可能性。手足位训练和四点跪位训练可分别用于腹部肌肉和背部肌肉锻炼,而对侧上下肢抬起时,腹肌和背肌都能得到很好的锻炼,但需注意避免运动损伤。     

基于表面肌电信号的手势识别与分析

目的 研究利用前臂及手部表面肌电( surface electromyography,sEMG)信号进行手势识别的方法,以及不同 手势下拇指、食指的关节角度,探讨 sEMG 信号控制外骨骼手的可行性。 方法 采集 20 名健康右利手受试者右侧 前臂及手部 6 块肌肉 sEMG 信号。 提取 sEMG 信号的时域特征值,对比人工神经网络( artificial neural network, ANN)、K-近邻(K-nearest neighbor, KNN)、决策树(decision tree, DT)、随机森林( random forest, RF)和支持向量机(support vector machine, SVM)等多种分类器对 6 种日常手势进行识别。 同时,采用 Vicon 摄像机跟踪系统捕捉右手拇指、食指运动轨迹,计算拇指、食指关节角度。 结果 利用前臂及手部 sEMG 信号可以实现 6 种手势的模式识别,其中 ANN 分类器的分类预测效果最好,测试集预测精度可达 97. 9% ,Kappa 系数可达 0. 975。 同时,计算得到不同手势下拇指、食指的关节角度,并进行不同手势下关节角度相关性分析。 结论 利用前臂及手部 sEMG 信号进 行手势识别,能够实现具有几乎完全一致的分类预测结果。 研究结果证明了 sEMG 信号手势识别应用于外骨骼手 控制的可行性。     

补肾填精法治疗多系统萎缩致体位性低血压疗效及对患者自主神经功能的影响

目的:探讨补肾填精法治疗多系统萎缩(MSA)致体位性低血压(OH)的疗效及对患者自主神经功能的影响。方法: 选取MSA患者80例,随机分为观察组和对照组各40例。对照组给予单纯西药对症治疗,观察组在对照组用药基础上给予补肾填精法治疗。比较两组治疗前后卧立位收缩压差、卧立位舒张压差、肛门括约肌肌电图(EAS-EMG)情况、交感皮肤反应(SSR)情况及临床疗效。结果:治疗后,两组卧立位收缩压差、卧立位舒张压差值均明显减少,观察组更明显(均P<0.05)。治疗后,两组自发电位出现率、募集电位单纯相出现率及MUP平均时限均明显降低,且观察组更明显(均P<0.05)。观察组治疗总有效率高于对照组(P<0.05)。治疗后,两组SSR潜伏期缩短,波幅增高,且观察组更明显(均P<0.05)。结论:补肾填精法可改善多系统萎缩致体位性低血压患者的直立性低血压症状,促进患者自主神经功能康复,改善临床症状,临床疗效较为满意,且安全性高。     

Effects of Kinesio taping in rectus femoris activity and sit-to-stand movement in children with unilateral cerebral palsy: placebo-controlled,repeated-measure design

Background: Although it has been commonly used in rehabilitation sets, there is a lack of studies verifying the effects of Kinesio taping to improve functionality in children with Cerebral Palsy (CP). This information would promote evidence-based practice.

Purpose: To verify the effects of Kinesio taping in the performance of sit-to-stand movement in children with unilateral CP.

Methods and materials: A blinded, single placebo-controlled and repeated-measure design. The setting was the rehabilitation clinic of the university and care facilities. A total of 11 children from 6 to 12 years of age (mean: 10.5 years; standard deviation: 2.8 years) and classified as levels I and II by the Gross Motor Function Classification System were included. Kinesio taping was applied over the rectus femoris of the affected limb. Three taping conditions were used: Kinesio taping, without Kinesio taping and placebo. Three seat heights were used: neutral (100%), lowered (80%), and elevated (120%). Muscle activity (electromyography) and trunk and lower limb alignment (kinematics) were evaluated as body structures and function measures. The time required to perform sit-to-stand was used as a functionality measure. Mixed analysis of variation (ANOVA) measured angular variables of the hip, knee, ankle, and rectus femoris activity. Repeated ANOVA measured angular variables of trunk and pelvis and total duration. Significance was accepted for values of p?≤?0.05.

Results: Kinesio taping increased rectus femoris activity, decreased peak flexion of the trunk, knee, hip, and ankle, and increased trunk extension in the end of sit-to-stand when compared with without Kinesio taping and placebo. Total duration was decreased with lower effect sizes.

Conclusions: Immediate application of Kinesio taping modified body structures and function measures during sit-to-stand in children with unilateral CP, but it did not alter functionality.

• Implications for Rehabilitation

• Evidence-based practice about the use of Kinesio taping in Cerebral Palsy.

• Knowledge about alternative rehabilitation techniques in Cerebral Palsy.

• Knowledge about sensory stimulation in Cerebral Palsy.

• Effectiveness of Kinesio taping in muscle activation.