This study aimed at evaluating tile relationship between pressure pain threshold(PPT) and electromyographic(EMG) activity in 30 healthy volunteers and 30 patients with temporomandibular disorders. PPTs were determined with electric pressure algometry over masseter, temporalis anterior, sternocleidomastoid, and trapezius muscle during resting and clenching. To obtain more reliable result, two examiners measured PPTs two times on each muscles, randomly. Resting and clenching EMG activity and tenderness of all muscles were measured to evaluate the relationship with PPTs. The collected data were processed by SAS/STAT program. The obtained results were as follows : 1. Pressure pain thresholds in tendered muscles were lower than those in non-tendered muscles. This tendency was more prominant in masticatory muscles than in cervical muscles and in clenching than in resting. 2. There ware a tendency of higher PPTs in unaffected side than in affected side, but there were no significant difference statistically. 3. There wert no difference of PPTs between in preferred side and in ipsilateral side, significantly. 4. There was a significantly positive correlation between resting and clenching PPTs, but there were no correlation between PPTs and EMG activities. 5. Comparison of EMG activity between in higher group and in lower group by resting PPTs didn't show any significant difference. But resting EMG activity in the higher group of clenching PPTs were lower, on the contrary, clenching activity were higher than those in lower groups of clenching PPTs. From this results, the author concluded that the clenching PPTs was more important than resting PPTs in diagnosis of muscle dysfunction. And the author recommanded that all of three following test were performed for the proper diagnosis and treatment of orofacial Pain : muscle tenderness, EMG activity, and PPT.
Pressure pain thresholds are routinely used in orofacial pain research to evaluate the response of deep orofacial tissues to mechanical stimulation. Like other psychophysical measurements, however, this technique must stimulate cutaneous tissues before stimulating deeper tissues. This study aimed at evaluating the influence of the cutaneous hypoesthesia on the pressure pain threshold in 30 healthy volunteers. PPTs were determined with electric pressure algometry over masseter, temporalis anterior, sternocleidomastoid, and trapezius muscle before and after skin hypoesthesia. A local anesthetic cream and a control cream were applied following a placebo-controlled double-blind design and PPTs were reassessed. Two examiners measured PPTs two times on each muscles, randomly. And the EMG activity of all muscles were measured to evaluate the relationship with PPTs. The collected data were processed by SAS/STAT program. The obtained results were as follows : 1. There were a tendency to increase PPTs after than before cutaneous hypoesthesia, but, there were no significant difference statistically. 2. PPTs were consistently higher in anterior temporalis than in masseter muscle. 3. In all occasions, PPTs were higher in males than in females(p<0.001). 4. A statistically significant correlation was obtained from values of intra-examiners and inter-examiners in all measured muscles. 5. A significantly positive correlation was not found between PPT and functional EMG activity.
Background: This study aimed to compare pressure pain thresholds (PPTs) in the vertebral segments between patients with chronic lower back pain (CLBP) and healthy participants without back pain and to determine the correlation between vertebral bone-segment PPT and pain level, lower back pain dysfunction, and psychological status in patients with CLBP. Methods: The subjects of this study were 23 healthy adults and 23 adults with CLBP. PPT was measured in 23 spinal bone segments using a PPT device, and the CLBP group was subjected to a pain level test (NRS) and a psychological test using the Korean version of the pain catastrophizing scale (KPCS). The functional level was assessed using the Korean version of the Oswestry disability index (KODI). Results: PPTs of the spinal sclerotomes were significantly lower in patients with CLBP than in healthy participants. In the CLBP group, the composite score of lumbar PPTs showed a high correlation with the composite scores for all segments, but not with the pain level (NRS), KPCS score, and spinal sclerotome PPT. Moreover, PPT in the sacral sclerotomes showed a significant negative correlation coefficient with function, with a KODI score of -.462 (p<.01). Conclusion: In this study, PPTs in all spinal segments in patients with CLBP was significantly lower than that in healthy subjects. The PPTs of the lumbar region was significantly correlated with the PPTs of other spinal regions. Through this study, it was found that there were changes in PPTs in CLBP patients not only in the lumbar region but also in other spinal regions. This information should be considered during clinical treatment of patients with low back pain.
Purpose: This study sought to identify the utilization and confidence in assistive technology (AT) for pediatric physical therapists (PPTs) and pediatric occupational therapists (POTs) for the purpose of improving the utilization of AT in clinics. Methods: The subjects of this study were 167 therapists (98 PPTs and 69 POTs) who work at general hospitals, welfare centers, facilities for the disabled, and special education schools in Seoul and Gyeonggi province. The frequency analysis and chi-squared test were used. Results: This study found that both PPTs and POTs recognize that AT benefits infants with disabilities; however, they show low confidence in using AT. Applications of AT are concentrated on wheelchairs for mobility and assistance with seating position, with orthotics/prosthetics for both purposes. POTs were found to use a wider variety of AT devices. While both PPTs and POTs frequently select/recommend devices, both groups are less involved with delivery methods, manufacture of devices, and education on AT use. Conclusion: These findings show the actual conditions of utilization and confidence in AT of PPTs and POTs deeply involved with AT, and emphasize that AT training is essential for pediatric treatment by comparing domestic and foreign studies.
PURPOSE: This study was designed to evaluate the current state of training in assistive technology(AT) for pediatric physical therapists(PPTs) and pediatric occupational therapists(POTs), in addition, investigate therapists' preferred training methods and contents. The eventual purpose was to suggest the essential fundamental factors to adapt the assistive technology in clinics. METHODS: The subject of this study were 167 therapists(98 PPTs and 69 POTs) who work at general hospitals, welfare center, facilities for the disabled, and special education school in Seoul and Gyeonggi province. Frequency analysis and Chi-squared test were used. RESULTS: Significant numbers of PPTs(66 therapists, 67.3%) and POTs(50 therapists, 72.5%) answered that they had received training in AT. More than 48% answered no training experience or low adequacy in each classification scheme for questions. The most difficulty in the training was indicated by lack of education opportunity(90 therapists, 53.9%). The most required device training was seating and position device training(43 therapists, 21.9%) for PPTs and orthosis and prosthesis device training(29 therapists, 21.0%) for POTs. In assistive technology service, PPTs needed evaluation to AT device training(69 therapists, 35.2%) and POTs needed evaluation to disabilities for AT training(41 therapists, 29.7%). Both therapists answered that the most effective training is continuous education(52 therapists, 31.1%) and college education(48 therapists, 28.7%). CONCLUSION: Our findings indicate that PPTs and POTs need more opportunities for training in AT. For effective clinical app lication of AT, there should be continuous education such as on-the-job training, mentoring program, technical manual, and college education.
Purpose: This study is to identify the muscle fatigue and pain by various cervical positions in the VDT work. Methods: Twenty two volunteers (11 males and 11 females) participated in this study. Each subject gazes monitor in front of them for thirty minutes in the three cervical positions (neutral, 30 degree flexed, and 30 degree extended positions). Visual analogue scale (VAS) for the pain and pressure pain threshold(PPT) of the trapezius and levator scapula for the muscle fatigue were measured every fifteen minutes. Results: VASs after 15 minutes were $1.23{\pm}0.43$ in neutral, $3.0{\pm}0.93$ in flexed, and $5.27{\pm}1.03$ in extended position respectively and increased to $1.5{\pm}0.67$, $4.59{\pm}1.26$, and $7.73{\pm}0.98$ after 30 minutes. The order of magnitude of VAS was extended, flexed, and neutral position(p<0.01). PPTs in both sides of upper trapezius and levator scapula muscles were decreased at the three positions after 15 and 30 minutes respectively(p<0.01). There were no statistical differences of PPTs in neutral and flexed positions after 15 and 30 minutes(p<0.01). Extended position showed lowest PPTs in both side of upper trapezius and levator scapula muscles after 15 and 30 minutes(p<0.01). There were statistical differences of PPTs in extended position and the other two positions after 15 and 30 minutes(p<0.01). Conclusion: The cervical position that has the most influence on the cervical muscle fatigue and pain in the VDT work is extended position.
Park, Jong Hoon;Kim, Jeong Hoon;Kwon, Do Hoon;Kim, Chang Jin;Khang, Shin Kwang;Cho, Young Hyun
Journal of Korean Neurosurgical Society
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제58권4호
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pp.334-340
/
2015
Objective : Pineal parenchymal tumors (PPTs) in adults are rare, and knowledge regarding their optimal management and treatment outcome is limited. Herein, we present the clinical results of our series of PPTs other than pineoblastomas managed by stereotactic radiosurgery (SRS) at upfront setting. Methods : Between 1997 and 2014, nine consecutive adult patients with the diagnosis of PPTs, either pineocytoma or pineal parenchymal tumor of intermediate differentiation, were treated with SRS. There were 6 men and 3 women. The median age was 39 years (range, 31-53 years). All of the patients presented with symptoms of hydrocephalus. Endoscopic third ventriculostomy and biopsy was done for initial management. After histologic diagnosis, patients were treated with Gamma Knife with the mean dose of 13.3 Gy (n=3) or fractionated Cyberknife with 32 Gy (n=6). Results : After a mean follow-up of 78.6 months (range, 14-223 months), all patients were alive and all of their tumors were locally controlled except for one instance of cerebrospinal fluid seeding metastasis. On magnetic resonance images, tumor size decreased in all patients, resulting in complete response in 3 patients and partial response in 6. One patient had experienced temporary memory impairment after SRS, which improved spontaneously. Conclusion : SRS is effective and safe for PPTs in adults and can be considered as a useful alternative to surgical resection at upfront setting.
The purpose of this study was to identify the effects of two types of stretching extensor carpi radialis on the visual analog scale (VAS), pressure-pain thresholds (PPTs), grip strength (GS), and strength of wrist extensor (SWE) in patients with lateral epicondylalgia. Sixteen patients with lateral epicondylalgia were recruited for this study and randomly assigned to two groups; the conventional stretching group (CS) and the stretching of proximal functional massage group (PFM); the VAS, PPTs, GS, and SWE were measured before and after the intervention. Over a period of stretching exercises were performed for five minutes per day, five days per week. The paired t-test and Wilcoxon signed-rank test were used to determine the statistical differences in the VAS, PPTs, GS, and SWE (pre- and post-test). The Independent t-test and Mann-Whitney U test were used to compare the effects of stretching exercises between the CS and PFM groups. The results of this study demonstrated that in the PFM group, the PPTs, GS, and SWE significantly increased, and the VAS decreased (p<.05). In the CS group, the VAS and GS increased significantly after the three-week intervention (p<.05). Pain was decreased and strength (GS and SWE) was increased in the PFM group, compared to the CS group (p<.05). The findings of this study indicate that PFM technique can be applied for decreasing pain and increasing the GS and SWE in patients with lateral epicondylalgia.
Purpose: To determine whether a fatiguing clench significantly affects the changes in pressure pain threshold (PPT) in men compared to women. Methods: The changes of PPTs from before to after a sustained clench in 12 men and 12 women were obtained. We used a decrease in median frequencies of surface electromyography (EMG) power spectra from the start to the end of the sustained clench as evidence of fatigue. Endurance time for the clench was used as a covariate. Results: The median frequencies decreased after the clench in both the anterior temporalis and masseter muscles, did not differ with the muscle or the gender of the subjects, and none of the interaction terms were significant. The PPTs were lower for women for both muscles, were decreased after the sustained clench, but failed to show the hypothesized gender by time interaction. Conclusions: Our results show that women have lower PPTs than men, but do not respond differently than men to jaw muscle fatigue.
Purpose: Temporomandibular disorder (TMD) is a condition defined as pain and dysfunction of temporomandibular joints and masticatory muscles. Abnormal interconnections between temporomandibular muscles and cervical spine structures can cause the changes of postural alignment and balance ability. The aim of this study was to investigate changes in static balance ability in subjects with painrelated TMD. Methods: This study conducted on 25 subjects with TMD and 25 control subjects with no TMD. Pressure pain thresholds (PPTs) of the masseter and temporalis muscles were measured using a pressure algometer. Static balance ability was assessed during one leg standing using an Inertial Measurement Unit (IMU) sensor. During balance task, the IMU sensors measured motion and transfer movement data for center of mass (COM) motion, ankle sway and hip sway. Results: PPTs of masseter and temporalis muscles were significantly lower in the TMD group than in the control group (p<0.05). One leg standing, hip sway, and COM sway results were significantly greater in the TMD group (p<0.05), but ankle sways were not different between group. Conclusion: We suggest pain-related TMD is positively related to reduced PPTs of masticatory muscles and to static balance ability. These results should be considered together with global body posture when evaluating or treating pain-related TMD.
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