Effect of muscle relaxation splint therapy on the electromyographic activities of masseter and anterior temporalis muscles

The purpose of this study was to compare the effectiveness of splint therapy on the electromyographic activity of masticatory muscles (anterior temporalis and masseter) before and after the application of a muscle relaxation splint. Electromyography recordings from the masseter and anterior temporalis muscles were analyzed quantitatively during maximal biting in the intercuspal position both before and after treatment without a splint. Fourteen patients whose chief complaint was masticatory muscle pain were selected for the study. After the initial evaluations muscle relaxation splints were applied, and the patients were instructed to use the splints for 6 weeks. Surface electromyographic recordings were taken from each patient before the beginning of clinical therapy and after 6 weeks of wearing the splints. The data obtained were analyzed through paired sample t tests and Wilcoxon's signed rank tests. The results of the study were as follows: (1) the electromyographic activity of the two muscles during maximal biting was not markedly changed after the muscle relaxation splint was used; and (2) the changes observed in electromyographic activity of the involved and noninvolved sides were insignificant as well.     

Production of recombinant goldfish growth hormone I in a baculovirus expression system

The authors studied the effect of a positioning orifice introduced in the anterior palatine region of occlusal splints for patients with craniomandibular disorders of swallowing and speech patterns. The patients were evaluated in four distinct situations. It was concluded that the splint orifice significantly favored swallowing and speech while the splint was being used, and is more comfortable for the patient.     

Tendon repair using flexor tendon splints: an experimental study

Mechanical strength of tendon repair using Dacron tendon splints across the laceration site were evaluated in human cadaver profundus tendons; the splints were placed both on the dorsal surface and internally within the tendon substance. Comparison was made to modified Kessler, Becker, and Savage repair techniques. Ultimate tensile strength was 2.55 kgf for the Kessler, 3.00 kgf for the Becker, 8.29 kgf for the Savage, 8.46 kgf for the internal tendon splint, and 8.10 kgf for the dorsal tendon splint; the Savage and both Tendon Splints techniques had significant higher tensile strength than the Kessler and Becker. Gap strength was 1.44 kgf for the Kessler, 2.22 kgf for the Becker, 2.45 kgf for the Savage, 2.05 kgf for internal tendon splint, and 3.15 kgf for the dorsal tendon splint. The dorsal tendon splint technique showed significant greater gap strength than the other four techniques. There was no significant difference in the magnitude of the gap during cyclic testing of these techniques; however, three of seven Kessler repairs failed and one of six Becker repairs failed. The results of these cadaver studies suggest that both tendon splint repair techniques are comparable to the Savage and may have sufficient strength to allow postoperative active motion against minimal resistance. Further in vivo testing is in order.     

Some biomechanical aspects of the foot and ankle in athletes with and without shin splints

Thirteen adult male athletes (long-distance runners and orienteerers without foot problems) and 35 male athletes with shin splints were compared with respect to: 1) the position of the lower leg and the heel while standing, 2) the passive range of mobility in the subtalar joint, and 3) the angular displacement between the calcaneus and the midline of the lower leg (Achilles tendon angle) while running with bare feet on a treadmill. In standing, the two groups differed statistically significantly in the Achilles tendon angle, which values were greater in the shin splint group. With respect to passive mobility, the athletes with shin splints had significantly greater (P less than 0.05-0.01) angular displacement values in inversion, eversion, and in their sum than the control group. While running, the Achilles tendon angle of the shin splint group was significantly greater (P less than 0.01) at the heel strike. Further, the shin splints group had a significantly greater (P less than 0.01) angular displacement between the heel strike and the maximal everted position. The results suggest structural and functional differences in the feet and ankles between healthy athletes and those with shin splints.     

Reflections on the Michigan splint and other intraocclusal devices

It seems obvious in retrospect that the treatment of disorders by interocclusal devices followed two paths: stabilization splints and functional orthopedic appliances. The dividing line between them is not always clear. Both have some function related to the position of the mandible. They may not differ significantly in their control of occlusal stability (e.g., telescoping devices anchored to stabilization splints). The stabilization splint, as well as other conservative measures, will play an increasing role in accepted therapy for TMD. The use of anterior repositioning devices for TMD, including MPD syndrome, will decrease. Research may provide answers that allow them to be used more specifically and predictably. Perhaps there will be but little change in their use where there is an association of TMD and Class II malocclusion. There will be an increase in the use of interocclusal devices for the treatment of snoring and obstructive apnea. Some additional directions seem to have emerged in the late 1980s and early 1990s: In the absence of pain and significant debilitation, treatment for TMD, if any, is to be reversible. Prevention or aggravation of TMD should be practiced to the extent possible during dental procedures. One long-term, well-designed, prospective study indicated that the incidence and severity of TMD could be reduced by appropriate occlusal adjustment. There is a small, but nevertheless important minority of patients with TMD who progress to persistent pain and/or dysfunction. Initial management of the vast majority of patents with TMD should be use of noninvasive reversible therapies. Surgery is indicated in only a relatively small percentage of cases of TMD. Research on interocclusal devices should not terminate simply because they are in part dental devices (i.e., biomechanical forms of treatment). The diagnosis and treatment of TMD has been called a dilemma, especially for those patients with chronic pain for whom no treatment has been effective. However, it would be ill-advised to abandon what treatment is already known to be effective by allowing those few but psychosocially important patients with chronic pain to determine what should be done for the vast majority of patients with TMD: reversible forms of treatment, including physiotherapy, pharmacologicals, and the stabilization occlusal bite plane splint.     

Shin splints and forefoot contact running: a case report

Many athletes develop shin splints after athletic activity. The purpose of this case report is to describe the treatment of a patient with posteromedial tibial pain (shin splints) who habitually ran with a forefoot contact running style. The 20-year-old male patient, who played volleyball and basketball about 7 hours a week, complained of pain in the middle one-third of the posteromedial tibia after an acute but prolonged episode of running. Routine observational analysis and in-shoe pressure analysis of the patient's running style showed that he habitually ran on his toes with an absence of heelstrike (forefoot contact running). After instructing the patient on heel-toe running, he no longer complained of posteromedial tibial bone pain. Several possible reasons are proposed for the reduction of leg pain following cessation of forefoot contact running. This case report proposes forefoot contact running as a possible contributor to posteromedial shin splints and that a change in running style may be the optimal treatment for some patients.     

Assessment of treatment outcome in patients with craniomandibular dysfunction

Psychosocial, socio-demographic and symptom characteristics have been shown to be associated with treatment outcome in patients with craniomandibular dysfunction (CMD). This study was performed to assess to what extent symptoms and correlates of CMD change as a consequence of conservative treatment for CMD. Treatment outcome in a group of CMD patients treated with a stabilization splint (experimental group) was compared with that of a group of patients with CMD who were not treated for CMD (control group). Patients in the experimental group had fewer symptoms of CMD at the end of treatment. However, several symptoms and correlates of CMD also improved in the control group (severity of pain, joint noises, ear symptoms). It was therefore questioned whether all improvements in symptoms and correlates of CMD in the experimental group could be attributed to the treatment received. Results suggest that the main improvement that might be ascribed to therapy was a decrease in 'jaw symptoms'. There was a noticeable decrease in depression and an increased use of 'planned actions and rational thinking' as a coping style in the experimental group whereas these variables did not change in the control group. Implications and suggestions for further research are discussed.     

To whom are roller-skaters harmful? A questionnaire among roller-skaters

The number of roller-skaters in Denmark has increased visibly during recent years. We found a high incidence of serious injuries among patients (n = 112) who attended our emergency department from June 14th to October 14th 1996. One third of the patients were diagnosed with a fracture. Increasing numbers of the injured roller-skaters use protective gear, mostly wrist splints (37%). Wrist splints probably reduce the number of fractures, but do not completely eliminate the risk of fracture. It seems that roller-skaters are less harmful to other pedestrians than previously assumed.     

Titanium screw implants for intermaxillary fixation of partially edentulous jaw

Establishment of the best possible relationship between upper and lower teeth is very important when treating jaw fractures and orthognathic deformities in partially edentulous patients. Many surgeons use arch bars and acrylic splints for intermaxillary fixation (IMF) to obtain the best occlusal relationships after the operation. In patients with sufficient teeth, IMF is not so difficult to realize. However, in partially edentulous patients, the available teeth may not be sufficient to apply arch bars or splints. This paper describes a system for IMF of a partially edentulous jaw. Screws made of medical-grade titanium are implanted into the alveolar ridges where two or more teeth are missing. Arch bars or acrylic splints secured on these implants and available teeth can be used safely for IMF. In vitro axial pull-out tests demonstrated that these implants can withstand the traction forces generated by elastics. Five partially edentulous patients, three with mandibular fractures and two with orthognathic problems, were treated with these implants. All patients healed without any complications and with the best possible occlusal relationships.     

Design, construction and evaluation of systems to predict risk in obstetrics

We present a systematic, practical approach to developing risk prediction systems, suitable for use with large databases of medical information. An important part of this approach is a novel feature selection algorithm which uses the area under the receiver operating characteristic (ROC) curve to measure the expected discriminative power of different sets of predictor variables. We describe this algorithm and use it to select variables to predict risk of a specific adverse pregnancy outcome: failure to progress in labour. Neural network, logistic regression and hierarchical Bayesian risk prediction models are constructed, all of which achieve close to the limit of performance attainable on this prediction task. We show that better prediction performance requires more discriminative clinical information rather than improved modelling techniques. It is also shown that better diagnostic criteria in clinical records would greatly assist the development of systems to predict risk in pregnancy.     

Thermal comfort in offices:comfort values and optimization of indoor control variables

In order to search for reasonable air-conditioned indoor control variables and save energy consumption and meet tO need of personal thermal comfort,a method which is based on numerical simulation is employed to optimize indoor control variables.Computational fluid dynamics(CFD)is used to describe thermal state of office.An optimal method is proposed in this paper,dual neural network model is firstly used to acquire reliable information,data from CFD model are pre-processed,and the remaining data are used to train artificial neural networks(ANN),then CFD model is replaced by ANN model to reduce computational cost when is optimized,indoor control variables are optimized by genetic algorithm.Simulation results show that indoor thermal comfort is improved obviously,and the energy cost is decreased accordingly.     

Use of demographic and clinical characteristics in predicting length of psychiatric hospital stay: A final evaluation.

The literature on patient demographic and clinical characteristics as predictors of length of psychiatric hospital stay suggests that investigators have been unsuccessful in producing a prediction model using this information to account for any substantial criterion variance. The present study maximized predictions of length of hospital stay by using a more powerful statistical procedure and an expanded number of predictor variables. Data were obtained on 877 patients who were discharged from psychiatric hospitals in 1980. Results show that despite these improvements, the resulting proportion of variance was moderate at best. It is concluded that increases in similar information are unlikely to improve predictions. The use of untapped variables (e.g., management philosophies and politically based information) is discussed. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Medical therapy of chronic heart failure. Role of ACE inhibitors and beta-blockers

Heart failure has long been considered to have a progressive downhill course leading inexorably to an early demise. This course often occurs silently, in the absence of any obvious cardiac insults. The reason for this is a combination of cell loss, myocyte dysfunction, impaired energetics, and pathologic remodeling of the chamber. Improved clinical outcome should result from strategies that reduce the biologic signals responsible for myocyte growth, dysfunction, and loss and chamber remodeling. Clinicians should no longer attempt to treat chronic heart failure with pharmacologic growth and remodeling process. In time, it may be possible for the clinician to view the treatment of heart failure largely as a matter of improving the biologic function of the myocardium.     

The influence of dietary iron on zinc in rat

Cortical bone remodeling rates for rib samples from three archaeological populations and a modern autopsy sample were determined using an algorithm developed by Frost (Frost [1987a] Calcif. Tissue Res. 3:211-237). When plotted against the relative antiquities for population samples, histomorphometric variables; i.e., activation frequency (mu rc), net bone formation (netVf,r,t), and mean annual bone formation rate (Vf,r,t), exhibit a concordant trend of increased cortical bone remodeling activity levels over time. Two intensive foraging populations, Windover and Gibson, are similar for all bone remodeling parameters and have the lowest remodeling activity levels among the samples. The more recent Ledders sample, which is reported to practice agricultural subsistence, is consistently intermediate between these and a modern autopsy sample. Although there appear to be differences in bone formation rates among the populations it is concluded that these differences cannot be attributed to differences in bone remodeling rates among the populations, but rather are reflecting different effective ages of adult compacta for their ribs. These findings suggest that the earlier populations, particularly Windsor and Gibson, appear to have reached skeletal maturity at an older age than observed for modern.     

Readability of self-report depression inventories.

Reading grade levels were obtained for 10 depression scales (e.g., Beck Depression Inventory) using 2 empirically based readability formulae, one by R. Gunning (1952) and the other by R. F. Flesch (1949). Results suggest that most of the scales are appropriate for use with both adolescents and adult patients who have attained 9th-grade-level reading skills. The limitations of empirical estimates of readability are discussed, and it is noted that comprehension could be influenced by contextual variables such as scale format. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

New paradigms for anterior tooth preparation. Rationale and technique

A biologic and esthetic rationale has been presented along with a simplified controlled technique to achieve predictable results (Figures 13A and 13B). The clinician is constantly faced with the challenge of developing room for esthetic material while preserving the biologic objectives. Using the three essential anterior tooth preparation keys (incisal edge, reduction requirements, and the biologic zone) enhances predictability. Developing the incisal edge relative to the dynamics of facial esthetics provides the initial starting point of tooth preparation. The reduction requirements are designed to satisfy the mechanical principles, address the pulpal concerns, and preserve the structural requirements of the tooth. The biologic zone can be developed by using the total dentogingival complex measurements and will clinically aid in the determination of cervical limitations to providing intracrevicular margin location.     

Living stories, telling stories, changing stories: Experiential use of the relationship in narrative therapy.

In narrative therapy, the therapeutic relationship is seen as facilitative, although constructionist thinking emphasizes the relational nature of meaning, suggesting that the client-therapist relationship is central to developing the client's story. By contrast, humanistic/existential theories stress the mutative nature of the therapeutic relationship. This article integrates these perspectives by developing a rationale for using the story both as lived in relation to the therapist and as verbalized. The implications of this rationale for the therapist's use of his or her own experience in treatment, the active use of the relationship, and the use of reflexive procedures that draw upon the I (subject/author) versus me (object/protagonist) distinction in the client's narrative are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A case of dystrophic epidermolysis bullosa: surgical treatment for hand contracture using abdominal skin flap

OBJECTIVE: To describe a new method for measuring lateral neck flexion range of motion (ROM), document the reliability of the method and present estimates of normal. SUBJECTS: One hundred thirty-five subjects ranging in age from 14-95 yr. Two physical therapists with 13 and 2 yr of experience, respectively, served as testers. INTERVENTION: Measurement of active lateral neck flexion ROM using a universal goniometer modified by the placement of a portion of a small paper clip through the axis. The goniometer arms were aligned with the subject's nose, and the free-swinging paper clip (pendulum) was used as a marker. The more experienced therapist measured lateral flexion of 100 subjects to establish intratester reliability and estimates of normal. Both therapists measured 35 subjects to determine intertester reliability. MAIN OUTCOME MEASURE: Degrees of lateral neck flexion. RESULTS: Intraclass correlation coefficients for intratester reliability exceeded 0.90. Coefficients for intertester reliability were 0.86 and 0.65. ROM decreased with increasing age. CONCLUSION: The modified goniometer is inexpensive, easy to use and can yield high intratester reliability and satisfactory intertester reliability. The estimates of normal provide preliminary values with which a patient's lateral neck flexion ROM can be compared.     

Evaluation of acupuncture and occlusal splint therapy in the treatment of temporomandibular joint disorders

One hundred patients showed signs and symptoms of temporomandibular joint disorder, were participated in a one year follow up study. The patients were randomly divided into four groups: Acuhealth treatment (group A), occlusal splint therapy (group B), Acuhealth and occlusal splint therapy (group C), and control (group D). Each group comprised 25 patients. The patients were examined before and 3, 6, and 12 months after treatment. At the three month evaluation, the patients who were not satisfied with the treatment outcome were offered additional treatment. The result showed that 87% of the patients treated by Acuhealth unit, 77.3% of the patients treated with occlusal splint therapy, and 91.3% of the patients received Acuhealth and occlusal splint therapy were improved subjectively and clinically after 3 months follow-up. The patients who responded well to treatment initially also responded well in the long run. The study showed that the Acuhealth unit proved to be an ideal early therapy for TMD, and complemented later with occlusal splint.     

Reoperations on the spine--outcome studies

Rheumatoid arthritis is described by Swanson (1995) as 'the greatest crippler from the standpoint of severity and prolonged disability' (p. 1307). One key factor in keeping persons with rheumatoid arthritis independent in their activities of daily living is maintaining functional use of their hands. In rural areas, where a move to assisted accommodation may require a person to leave the locality, this splint may help older citizens to remain functional and at home. The deformity and instability caused in rheumatoid arthritic hands by radial deviation of the wrist and subsequent ulnar deviation of the metacarpophalangeal (MCP) joints can greatly affect functional use of the hands. In this article, design and fabrication instructions for a lycra working splint which is suitable for the rheumatoid arthritic hand with MCP ulnar deviation are presented. Health professionals working in rural areas will find this splint inexpensive and easy to design, either alone or, ideally, with the assistance of regional occupational therapists.