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La Touche R.,University of San Pablo - CEU | Goddard G.,University of California at San Francisco | De-La-Hoz J.L.,University of San Pablo - CEU | Wang K.,Center for Sensory Motor Interaction | And 5 more authors.
Clinical Journal of Pain | Year: 2010

Objectives: The aim of this study is to perform a qualitative and quantitative analysis of the scientific literature regarding the use of acupuncture in the treatment of pain associated with temporomandibular disorders (TMDs). Methods: By using electronic databases, the goal was to search and evaluate all the randomized controlled trials (RCTs) in which acupuncture was used in the management of pain attributed to these clinical entities. For the meta-analysis, an adequate description of the results' statistical data was required along with a comparison of the treatment with a control group using a placebo or sham. Two independent reviewers evaluated the quality of the studies using the Jadad scale. Results: A total of 8 RCTs were selected, and the quality of only 4 was considered acceptable. These 4 studies showed positive results such as reducing pain, improving masticatory function, and increasing maximum interincisal opening. By combining the studies (n=96) and analyzing the results, it was concluded that acupuncture is more effective than placebo in reducing pain intensity in TMD (standardized mean difference 0.83; 95% confidence interval, 0.41-1.25; P=0.00012). Discussion: The results of this meta-analysis suggest that acupuncture is a reasonable adjunctive treatment for producing a short-term analgesic effect in patients with painful TMD symptoms. Although the results described are positive, the relevance of these results was limited by the fact that substantial bias was present. These findings must be confirmed by future RCTs that improve the methodologic deficiencies of the studies evaluated in this meta-analysis. © 2010 Lippincott Williams & Wilkins.

Sondergaard K.H.E.,Center for Sensory Motor Interaction | Olesen C.G.,Center for Sensory Motor Interaction | Olesen C.G.,University of Aalborg | Sondergaard E.K.,Center for Sensory Motor Interaction | And 2 more authors.
Journal of Biomechanics | Year: 2010

The present investigation examined the variability of sitting postural movement in relation to the development of perceived discomfort by means of linear and nonlinear analysis. Nine male subjects participated in this study. Discomfort ratings, kinetic and kinematics data were recorded during prolonged sitting. Body part discomfort index, displacement of the center of pressure (COP) in anterior-posterior and medial-lateral directions as well as lumbar curvature were calculated. Mean, standard deviation and sample entropy values were extracted from COP and lumbar curvature signals. Standard deviation and sample entropy were used to assess the degree of variability and complexity of sitting. A correlation analysis was performed to determine the correlation of each parameter with discomfort. There were no correlations between discomfort and any of the mean values. On the contrary, the standard deviations of the COP displacement in both directions and lumbar curvature were positively correlated to discomfort, whereas sample entropies were negatively correlated. The present study suggests that the increase in degree of variability and the decrease in complexity of sitting postural control are interrelated with the increase in perceived discomfort. Finally, the present study underlined the importance of quantifying motor variability for understanding the biomechanics of seated posture. © 2010 Elsevier Ltd.

Samani A.,Center for Sensory Motor Interaction | Kawczynski A.,University School of Physical Education in Wroclaw | Madeleine P.,Center for Sensory Motor Interaction
IFMBE Proceedings | Year: 2011

The design of an advanced biofeedback system was introduced using neuro-fuzzy concept. Eleven healthy volunteers took part in six sessions over two weeks in which computer work was performed for 10 min. The six sessions were divided into two identical parts where each part was taken place in two consecutive days. After the first session, the subjects underwent excessive eccentric exercises of shoulder elevation to induce muscle soreness. The second session was performed immediately after the exercises and third session 24 hours after the exercises. The second part was performed exactly one week after the first part. Surface electromyography (EMG) of descending and ascending trapezius, deltoideus anterior and serratus anterior was recorded. Linear and nonlinear indices of muscular load were calculated from EMG signals. The first session was utilized as the benchmark of normal muscle condition during computer work and all the rest as mal-functioning/altered condition. A neuro-fuzzy system was trained and tested to discriminate between the first session and all the rest. Using a greedy forward search strategy most discriminative features were found. A high sensitivity ~90% but a low specificity ∼60% was observed. It was concluded that apart from the trapezius, the deltoideus and serratus anterior should also benefit from a biofeedback design. Combining of such system with timing constraint on biofeedback alarming can render a viable biofeedback system aiming at preventing musculoskeletal disorders. © 2011 Springer-Verlag.

Samani A.,Center for Sensory Motor Interaction | Samani A.,Helmholtz Center Munich | Holtermann A.,Helmholtz Center Munich | Sogaard K.,University of Southern Denmark | Madeleine P.,Center for Sensory Motor Interaction
European Journal of Applied Physiology | Year: 2010

The aim of this study was to investigate the spatio-temporal effects of advanced biofeedback by inducing active and passive pauses on the trapezius activity pattern using high-density surface electromyography (HD-EMG). Thirteen healthy male subjects performed computer work with superimposed feedback either eliciting passive (rest) or active (approximately 30% MVC) pauses based on fuzzy logic design and a control session with no feedback. HD-EMG signals of upper trapezius were recorded using a 5 × 13 multichannel electrode grid. From the HD-EMG recordings, two-dimensional maps of root mean square (RMS), relative rest time (RRT) and permuted sample entropy (PeSaEn) were obtained. The centre of gravity (CoG) and entropy of maps were used to quantify changes in the spatial distribution of muscle activity. PeSaEn as a measure of temporal heterogeneity for each channel, decreased over the whole map in response to active pause (P < 0.05) underlining a more homogenous activation pattern. Concomitantly, the CoG of RRT maps moved in caudal direction and the entropy of RMS maps as a measure of spatial heterogeneity over the whole recording grid, increased in response to active pause session compared with control session (no feedback) (P < 0.05). Active pause compared with control resulted in more heterogeneous coordination of trapezius compared with no feedback implying a more uneven spatial distribution of the biomechanical load. The study introduced new aspects in relation to the potential benefit of superimposed muscle contraction in relation to the spatial organization of muscle activity during computer work. © 2010 Springer-Verlag.

Rueterbories J.,Center for Sensory Motor Interaction | Spaich E.G.,Center for Sensory Motor Interaction | Larsen B.,Neurodan A S | Andersen O.K.,Center for Sensory Motor Interaction
Medical Engineering and Physics | Year: 2010

After stroke, hemiparesis is a common problem resulting in very individual needs for walking assistance. Often patients suffer from foot drop, i.e. inability to lift the foot from the ground during the swing phase of walking. Functional electrical stimulation is commonly used to correct foot drop. For all supporting stimulation devices, it is vital to adequately detect the gait events, which is traditionally obtained by a foot switch placed under the heel. To investigate present methods of gait analysis and detection for use in ambulatory rehabilitation systems, we carried out a meta-analysis on research studies. We found various sensors and sensor combinations capable of analyzing gait in ambulatory settings, ranging form simple force based binary switches to complex setups involving multiple inertial sensors and advanced algorithms. However additional effort is needed to minimize donning/doffing efforts, to overcome cosmetical aspects, and to implement those systems into closed loop ambulatory devices. © 2010 IPEM.

Lontis E.R.,Center for Sensory Motor Interaction | Struijk L.N.S.A.,Center for Sensory Motor Interaction
Disability and Rehabilitation: Assistive Technology | Year: 2010

Purpose.The paper introduces a novel design of air-core inductive sensors in printed circuit board (PCB) technology for a tongue control system. The tongue control system provides a quadriplegic person with a keyboard and a joystick type of mouse for interaction with a computer or for control of an assistive device. Method.Activation of inductive sensors was performed with a cylindrical, soft ferromagnetic material (activation unit). Comparative analysis of inductive sensors in PCB technology with existing hand-made inductive sensors was performed with respect to inductance, resistance, and sensitivity to activation when the activation unit was placed in the center of the sensor. Optimisation of the activation unit was performed in a finite element model. Results.PCBs with air-core inductive sensors were manufactured in a 10 layers, 100μm and 120μm line width technology. These sensors provided quality signals that could drive the electronics of the hand-made sensors. Furthermore, changing the geometry of the sensors allowed generation of variable signals correlated with the 2D movement of the activation unit at the sensors' surface. Conclusion.PCB technology for inductive sensors allows flexibility in design, automation of production and ease of possible integration with supplying electronics. The basic switch function of the inductive sensor can be extended to two-dimensional movement detection for pointing devices. © 2010 Informa UK Ltd.

Kamavuako E.N.,Center for Sensory Motor Interaction | Rosenvang J.C.,Center for Sensory Motor Interaction
Muscle and Nerve | Year: 2012

Introduction:: In this study we analyzed the presence of hysteresis in the relationship between features of electromyography (EMG) and force. Methods:: Intramuscular EMG and surface EMG (sEMG) were recorded concurrently from the flexor digitorum profundus muscle from 0% to 100% maximum voluntary contraction (MVC) in 11 subjects. Two features, mean absolute value (MAV) and Wilson amplitude (WAMP), were computed using either the first-order (poly1) or third-order (poly3) polynomial. Results:: We detected hysteresis in the EMG-force relationship for both features in all subjects. In general, the hysteresis-based models performed better than the overall model (which does not take into account the hysteresis in the EMG-force relationship), with R2 values about 0.98 (averaged across subjects) and root mean square error around 5% of the MVC force. Conclusion:: These results imply the existence of a path-dependent model, which may improve the accuracy of force estimation. © 2012 Wiley Periodicals, Inc.

Salomoni S.E.,Center for Sensory Motor Interaction | Graven-Nielsen T.,Center for Sensory Motor Interaction
European Journal of Applied Physiology | Year: 2012

Pain elicits complex adaptations of motor strategy, leading to impairments in the generation and control of steady forces, which depend on muscle architecture. The present study used a cross-over design to assess the effects of muscle pain on the stability of multidirectional (taskrelated and tangential) forces during sustained dorsiflexions, elbow flexions, knee extensions, and plantarflexions. Fifteen healthy subjects performed series of isometric contractions (13-s duration, 2.5, 20, 50, 70% of maximal voluntary force) before, during, and after experimental muscle pain. Three-dimensional force magnitude, angle and variability were measured while the task-related force was provided as feedback to the subjects. Surface electromyography was recorded from agonist and antagonist muscles. Pain was induced in agonist muscles by intramuscular injections of hypertonic (6%) saline with isotonic (0.9%) saline injections as control. The pain intensity was assessed on an electronic visual analogue scale. Experimental muscle pain elicited larger ranges of force angle during knee extensions and plantarflexions (P < 0.03) and higher normalized fluctuations of task-related (P < 0.02) and tangential forces (P < 0.03) compared with control assessments across force levels, while the mean force magnitudes, mean force angle and the level of muscle activity were non-significantly affected by pain. Increased multidirectional force fluctuations probably resulted from multiple mechanisms that, acting together, balanced the mean surface electromyography. Although pain adaptations are believed to aim at the protection of the painful site, the current results show that they result in impairments in steadiness of force. © Springer-Verlag 2012.

Ge H.-Y.,Center for Sensory Motor Interaction | Wang Y.,Center for Sensory Motor Interaction | Danneskiold-Samsoe B.,Frederiksberg Hospital | Graven-Nielsen T.,Center for Sensory Motor Interaction | Arendt-Nielsen L.,Center for Sensory Motor Interaction
Journal of Pain | Year: 2010

The aim of this present study is to test the hypotheses that the 18 predetermined sites of examination for tender points (TP sites) in fibromyalgia syndrome (FMS) are myofascial trigger points (MTrPs), and that the induced pain from active MTrPs at TP sites may mimic fibromyalgia pain. Each TP site was evaluated with manual palpation followed by intramuscular electromyographic (EMG) registration of spontaneous electrical activity to confirm or refute the existence of an MTrP in 30 FMS patients. Overall spontaneous pain intensity and pain pattern were recorded before manual identification of MTrPs. Local and referred pain pattern from active MTrPs were drawn following manual palpation at TP sites. Results: Showed that most of the TP sites are MTrPs. Local and referred pain from active MTrPs reproduced partly the overall spontaneous pain pattern. The total number of active MTrPs (r = .78, P < .0001), but not latent MTrPs (r = -.001, P = .99), was positively correlated with spontaneous pain intensity in FMS. The current study provides first evidence that pain from active MTrPs at TP sites mimics fibromyalgia pain. MTrPs may relate to generalized increased sensitivity in FMS due to central sensitization. Perspective: This article underlies the importance of active MTrPs in FMS patients. Most of the TP sites in FMS are MTrPs. Active MTrPs may serve as a peripheral generator of fibromyalgia pain and inactivation of active MTrPs may thus be an alternative for the treatment of FMS. © 2010 American Pain Society.

Adnadjevic D.,Center for Sensory Motor Interaction | Graven-Nielsen T.,Center for Sensory Motor Interaction
Somatosensory and Motor Research | Year: 2015

Background: Pressure evoked temporal summation of pain has been described with slow repetitions (<0.5 Hz) relative to what is recommended originally for assessing temporal pain summation (>1 Hz). This study examined temporal summation of pain by repeated computer-controlled pressure stimulation at high repetition rates with and without simultaneous active probe rotations for potential better efficiency.Methods: In 15 healthy subjects, 15 pressure stimuli (300 and 500 ms durations) were delivered at the pressure pain threshold intensity with and without rotation of a rounded probe (1 cm2) at three repetition frequencies (1.5, 1, 0.5 Hz). The pressure pain intensity was continuously rated on a visual analogue scale (VAS) and scores after each stimulus were extracted and normalized to the first score.Results: The peak VAS score was larger for rotational (p < 0.001), longer stimulus duration (p < 0.02), and lower frequencies (p < 0.05) compared with non-rotational, shorter stimulus duration, and higher frequencies, respectively. VAS scores progressively increased from the first to the fifteenth stimulus (p < 0.01). The sum of VAS scores was higher after 1 Hz stimulation compared with 0.5 and 1.5 Hz stimulations (p < 0.01). Finally, the VAS sum was higher after rotational as well as longer stimulus duration compared with non-rotational and shorter stimulus duration paradigms (p < 0.01).Conclusions: An optimum of 500 ms repeated pressure stimulation at 1 Hz produced the most apparent temporal summation of pain sensation which further was enhanced during probe rotation. These findings suggest an optimized and novel method to improve the current procedures for assessing temporal summation of pressure-induced pain. © 2014 Informa UK Ltd. All rights reserved.

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