Influence of Mirror Therapy (Specular Face Software) on Electromyographic Behavior of the Facial Muscles for Facial Palsy

Introduction: Facial paralysis (FP) is a neuromuscular disorder caused by facial nerve injury. There are two main types of FP (which can be either primary or secondary): central and peripheral; Procedure of cases: This case series presents five patients with facial paralysis with different etiologies. In all cases, we assessed the facial disability index and a clinical test registering the electromyographic activity, with and without biofeedback generated by Specular Face, a new software program; Discussion: After performing the appropriate tests, we checked the patients’ ability to change certain expressions when the Specular Face program was added. We can confirm that the mirror visual feedback therapy changes the behavior of synkinesis and the muscle function in these patients; Conclusion: The use of mirror therapy using a computerized treatment system of facial images yields promising results in modulating the muscle activity of patients with FP.

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Effects of Functional Electrical Stimulation Cycling of Different Duration on Viscoelastic and Electromyographic Properties of the Knee in Patients with Spinal Cord Injury

Brain Sciences ◽

10.3390/brainsci11010007 ◽

2020 ◽

Vol 11 (1) ◽

pp. 7

Author(s):

Antonino Casabona ◽

Maria Stella Valle ◽

Claudio Dominante ◽

Luca Laudani ◽

Maria Pia Onesta ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Electrical Stimulation ◽

Functional Electrical Stimulation ◽

Muscle Activity ◽

Response Times ◽

Electromyographic Activity ◽

Functional Changes ◽

Pendulum Test ◽

Cord Injury

The benefits of functional electrical stimulation during cycling (FES-cycling) have been ascertained following spinal cord injury. The instrumented pendulum test was applied to chronic paraplegic patients to investigate the effects of FES-cycling of different duration (20-min vs. 40-min) on biomechanical and electromyographic characterization of knee mobility. Seven adults with post-traumatic paraplegia attended two FES-cycling sessions, a 20-min and a 40-min one, in a random order. Knee angular excursion, stiffness and viscosity were measured using the pendulum test before and after each session. Surface electromyographic activity was recorded from the rectus femoris (RF) and biceps femoris (BF) muscles. FES-cycling led to reduced excursion (p < 0.001) and increased stiffness (p = 0.005) of the knee, which was more evident after the 20-min than 40-min session. Noteworthy, biomechanical changes were associated with an increase of muscle activity and changes in latency of muscle activity only for 20-min, with anticipated response times for RF (p < 0.001) and delayed responses for BF (p = 0.033). These results indicate that significant functional changes in knee mobility can be achieved by FES-cycling for 20 min, as evaluated by the pendulum test in patients with chronic paraplegia. The observed muscle behaviour suggests modulatory effects of exercise on spinal network aimed to partially restore automatic neuronal processes.

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Oral Air Pressure and Nasal Air Flow Rate on Levator Veli Palatini Muscle Activity in Patients Wearing a Speech Appliance

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1995_032_0382_oapana_2.3.co_2 ◽

1995 ◽

Vol 32 (5) ◽

pp. 382-389 ◽

Cited By ~ 9

Author(s):

Takashi Tachimura ◽

Hisanaga Hara ◽

Takeshi Wada

Keyword(s):

Flow Rate ◽

Muscle Activity ◽

Neural Control ◽

Air Flow ◽

Air Pressure ◽

Electromyographic Activity ◽

Air Flow Rate ◽

Circular Area ◽

Pharyngeal Bulb ◽

Levator Veli Palatini

This study was designed to determine if levator veli palatini muscle activity can be elicited by simultaneous changes in oral air pressure and nasal air flow when a speech appliance is in place. The speech appliances routinely worn by 15 subjects were each modified experimentally by drilling a hole in the vertical center of the pharyngeal bulb. The air flow rate into the nasal cavity through the opening in the bulb was altered by changing the circular area of the opening in the bulb from the occluded condition (Condition I), to circular area of 12.6 mm2 (4 mm in diameter; Condition II), and then to 38.5 mm2 (7 mm in diameter; Condition III). Electromyographic activity was measured from the levator veli palatini muscle with changes in nasal air flow rate and oral air pressure. Levator veli palatini muscle activity was correlated with changes in nasal air flow and oral air pressure. Increases in levator veli palatini muscle activity were associated with increases in nasal air flow rate compared to oral air pressure changes. The results indicated that aerodynamic variables of nasal air flow and oral air pressure might be involved in the neural control of speech production in individuals wearing a speech appliance, even if the subjects exhibit velopharyngeal incompetence without using a speech appliance. Also, the stimulating effect of bulb reduction therapy on velopharyngeal function might be achieved through the change in aerodynamic variables in association with the bulb reduction.

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Electromyographic activity from human laryngeal, pharyngeal, and submental muscles during swallowing

Journal of Applied Physiology ◽

10.1152/jappl.1999.86.5.1663 ◽

1999 ◽

Vol 86 (5) ◽

pp. 1663-1669 ◽

Cited By ~ 92

Author(s):

A. L. Perlman ◽

P. M. Palmer ◽

T. M. McCulloch ◽

D. J. Vandaele

Keyword(s):

Muscle Activity ◽

Total Duration ◽

Normal Subjects ◽

Electromyographic Activity ◽

Surface Electrodes ◽

Submental Muscles ◽

Temporal Relationships ◽

Dependent Change ◽

Significant Difference ◽

High Level

The durations and temporal relationships of electromyographic activity from the submental complex, superior pharyngeal constrictor, cricopharyngeus, thyroarytenoid, and interarytenoid muscles were examined during swallowing of saliva and of 5- and 10-ml water boluses. Bipolar, hooked-wire electrodes were inserted into all muscles except for the submental complex, which was studied with bipolar surface electrodes. Eight healthy, normal, subjects produced five swallows of each of three bolus volumes for a total of 120 swallows. The total duration of electromyographic activity during the pharyngeal stage of the swallow did not alter with bolus condition; however, specific muscles did show a volume-dependent change in electromyograph duration and time of firing. Submental muscle activity was longest for saliva swallows. The interarytenoid muscle showed a significant difference in duration between the saliva and 10-ml water bolus. Finally, the interval between the onset of laryngeal muscle activity (thyroarytenoid, interarytenoid) and of pharyngeal muscle firing patterns (superior pharyngeal constrictor onset, cricopharyngeus offset) decreased as bolus volume increased. The pattern of muscle activity associated with the swallow showed a high level of intrasubject agreement; the presence of somewhat different patterns among subjects indicated a degree of population variance.

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Effect of posture, route of respiration, and negative pressure on palatal muscle activity in humans

Journal of Applied Physiology ◽

10.1152/jappl.1995.79.2.448 ◽

1995 ◽

Vol 79 (2) ◽

pp. 448-454 ◽

Cited By ~ 35

Author(s):

I. L. Mortimore ◽

R. Mathur ◽

N. J. Douglas

Keyword(s):

Negative Pressure ◽

Muscle Activity ◽

Respiratory Activity ◽

Maximum Activity ◽

Electromyographic Activity ◽

Airway Narrowing ◽

Pressure Application ◽

Supine Posture ◽

Inspiratory Activity ◽

Male Subjects

Sleep apnea is worse in the supine posture and is associated with retropalatal airway narrowing or occlusion. We have, therefore, examined the effects of posture, negative pressure, and route of respiration on palatal muscle activity in 13 nonsnoring awake male subjects by using electromyography. Electromyographic activity of the levator palatini and palatoglossus was expressed as a percentage of maximum activity. Both the levator palatini (P = 0.002) and palatoglossus (P = 0.002) exhibited phasic inspiratory activity. Overall, posture did not affect the levator palatini (F = 1.58; P = 0.23) or palatoglossus (F = 0.98; P = 0.34) activity, but analysis by route of respiration showed the palatoglossus to be more active when the subjects were nose breathing supine (F = 6.64; P = 0.02). Levator palatini activity was lower when nose breathing was compared with mouth breathing in both the erect and supine postures (F = 6.67; P < 0.02). Nose breathing with the mouth held open caused an increase in palatoglossal activity (P = 0.04). Negative-pressure application (0 to -12.5 cmH2O) caused significant increases in levator palatini (P < 0.001) and palatoglossus (P < 0.001) activity, 100 ms after pressure stimulus, irrespective of route. However, the palatoglossus required significantly greater negative pressures to cause activation when applied via the nose compared with the mouth (P < 0.05). These observations indicate that the levator palatini and palatglossus have respiratory activity and are reflexly activated by negative pressure.

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Spatiotemporal distribution of location and object effects in the electromyographic activity of upper extremity muscles during reach-to-grasp

Journal of Neurophysiology ◽

10.1152/jn.00008.2016 ◽

2016 ◽

Vol 115 (6) ◽

pp. 3238-3248 ◽

Cited By ~ 3

Author(s):

Adam G. Rouse ◽

Marc H. Schieber

Keyword(s):

Upper Extremity ◽

Muscle Activity ◽

Neural Control ◽

Emg Activity ◽

Electromyographic Activity ◽

Proximal Muscle ◽

Reach To Grasp ◽

Distal Muscle ◽

The Subject ◽

Later Phase

In reaching to grasp an object, proximal muscles that act on the shoulder and elbow classically have been viewed as transporting the hand to the intended location, while distal muscles that act on the fingers simultaneously shape the hand to grasp the object. Prior studies of electromyographic (EMG) activity in upper extremity muscles therefore have focused, by and large, either on proximal muscle activity during reaching to different locations or on distal muscle activity as the subject grasps various objects. Here, we examined the EMG activity of muscles from the shoulder to the hand, as monkeys reached and grasped in a task that dissociated location and object. We quantified the extent to which variation in the EMG activity of each muscle depended on location, on object, and on their interaction—all as a function of time. Although EMG variation depended on both location and object beginning early in the movement, an early phase of substantial location effects in muscles from proximal to distal was followed by a later phase in which object effects predominated throughout the extremity. Interaction effects remained relatively small. Our findings indicate that neural control of reach-to-grasp may occur largely in two sequential phases: the first, serving to project the entire upper extremity toward the intended location, and the second, acting predominantly to shape the entire extremity for grasping the object.

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Displaced femoral neck fractures in patients 60 years of age or younger: results of internal fixation with the dynamic locking blade plate

The Bone & Joint Journal ◽

10.1302/0301-620x.100b4.bjj-2016-1098.r3 ◽

2018 ◽

Vol 100-B (4) ◽

pp. 443-449 ◽

Cited By ~ 10

Author(s):

J. H. Kalsbeek ◽

A. D. P. van Walsum ◽

J. P. A. M. Vroemen ◽

H. M. J. Janzing ◽

J. T. Winkelhorst ◽

...

Keyword(s):

Femoral Neck ◽

Internal Fixation ◽

Fracture Healing ◽

Avascular Necrosis ◽

Young Patients ◽

Case Series ◽

Neuromuscular Disorder ◽

Femoral Neck Fractures ◽

Blade Plate ◽

Displaced Femoral Neck Fractures

AimsThe objective of this study was to investigate bone healing after internal fixation of displaced femoral neck fractures (FNFs) with the Dynamic Locking Blade Plate (DLBP) in a young patient population treated by various orthopaedic (trauma) surgeons.Patients and MethodsWe present a multicentre prospective case series with a follow-up of one year. All patients aged ≤ 60 years with a displaced FNF treated with the DLBP between 1st August 2010 and December 2014 were included. Patients with pathological fractures, concomitant fractures of the lower limb, symptomatic arthritis, local infection or inflammation, inadequate local tissue coverage, or any mental or neuromuscular disorder were excluded. Primary outcome measure was failure in fracture healing due to nonunion, avascular necrosis, or implant failure requiring revision surgery.ResultsIn total, 106 consecutive patients (mean age 52 years, range 23 to 60; 46% (49/106) female) were included. The failure rate was 14 of 106 patients (13.2%, 95% confidence interval (CI) 7.1 to 19.9). Avascular necrosis occurred in 11 patients (10.4%), nonunion in six (5.6%), and loss of fixation in two (1.9%).ConclusionThe rate of fracture healing after DLBP fixation of displaced femoral neck fracture in young patients is promising and warrants further investigation by a randomized trial to compare the performance against other contemporary methods of fixation. Cite this article: Bone Joint J 2018;100-B:443–9.

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Hip Muscle Activity During 3 Side-Lying Hip-Strengthening Exercises in Distance Runners

Journal of Athletic Training ◽

10.4085/1062-6050-47.1.15 ◽

2012 ◽

Vol 47 (1) ◽

pp. 15-23 ◽

Cited By ~ 28

Author(s):

Joseph M. McBeth ◽

Jennifer E. Earl-Boehm ◽

Stephen C. Cobb ◽

Wendy E. Huddleston

Keyword(s):

Muscle Activity ◽

Repeated Measures ◽

External Rotation ◽

Gluteus Maximus ◽

Gluteus Medius ◽

Electromyographic Activity ◽

Maximal Voluntary Isometric Contraction ◽

Strengthening Exercises ◽

Hip Abduction ◽

Hip Strengthening

Context: Lower extremity overuse injuries are associated with gluteus medius (GMed) weakness. Understanding the activation of muscles about the hip during strengthening exercises is important for rehabilitation. Objective: To compare the electromyographic activity produced by the gluteus medius (GMed), tensor fascia latae (TFL), anterior hip flexors (AHF), and gluteus maximus (GMax) during 3 hip-strengthening exercises: hip abduction (ABD), hip abduction with external rotation (ABD-ER), and clamshell (CLAM) exercises. Design: Controlled laboratory study. Setting: Laboratory. Patients or Other Participants: Twenty healthy runners (9 men, 11 women; age = 25.45 ± 5.80 years, height = 1.71 ± 0.07 m, mass = 64.43 ± 7.75 kg) participated. Intervention(s): A weight equal to 5% body mass was affixed to the ankle for the ABD and ABD-ER exercises, and an equivalent load was affixed for the CLAM exercise. A pressure biofeedback unit was placed beneath the trunk to provide positional feedback. Main Outcome Measure(s): Surface electromyography (root mean square normalized to maximal voluntary isometric contraction) was recorded over the GMed, TFL, AHF, and GMax. Results: Three 1-way, repeated-measures analyses of variance indicated differences for muscle activity among the ABD (F3,57 = 25.903, P<.001), ABD-ER (F3,57 = 10.458, P<.001), and CLAM (F3,57 = 4.640, P=.006) exercises. For the ABD exercise, the GMed (70.1 ± 29.9%), TFL (54.3 ± 19.1%), and AHF (28.2 ± 21.5%) differed in muscle activity. The GMax (25.3 ± 24.6%) was less active than the GMed and TFL but was not different from the AHF. For the ABD-ER exercise, the TFL (70.9 ± 17.2%) was more active than the AHF (54.3 ± 24.8%), GMed (53.03 ± 28.4%), and GMax (31.7 ± 24.1 %). For the CLAM exercise, the AHF (54.2 ± 25.2%) was more active than the TFL (34.4 ± 20.1%) and GMed (32.6 ± 16.9%) but was not different from the GMax (34.2 ± 24.8%). Conclusions: The ABD exercise is preferred if targeted activation of the GMed is a goal. Activation of the other muscles in the ABD-ER and CLAM exercises exceeded that of GMed, which might indicate the exercises are less appropriate when the primary goal is the GMed activation and strengthening.

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Levator recession and minimal lateral tarsorrhaphy for the management of lagophthalmos and corneal exposure in facial palsy

European Journal of Ophthalmology ◽

10.1177/1120672119881984 ◽

2019 ◽

pp. 112067211988198

Author(s):

Bahram Eshraghi ◽

Hadi Ghadimi ◽

Mojgan Nikdel

Keyword(s):

Facial Paralysis ◽

Facial Palsy ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Case Series ◽

Levator Muscle ◽

Vehicle Accident ◽

Parotid Surgery ◽

Common Etiology ◽

Additional Procedure

Purpose: Recession of levator muscle can potentially decrease the severity of corneal exposure by reducing margin-reflex distance 1. The purpose of this study is evaluation of effects of levator recession on lagophthalmos in facial palsy. Materials and methods: In a non-comparative case series of consecutive patients with exposure keratopathy due to facial paralysis between 2012 and 2017, levator recession was performed through lid crease incision. Small-size (⩽3 mm) lateral tarsorrhaphy was performed on a case-by-case basis for those with moderate-to-severe keratopathy. Preoperative and postoperative measurements of margin-reflex distance 1 and lagophthalmos were compared using paired t-test. Results: Thirty-four patients (14 men and 20 women) were enrolled with an average age of 52.3 years. Mean follow-up was 13.3 months (range, 6–36 months). The most common etiology of facial paralysis was Bell’s palsy (22 cases), followed by motor vehicle accident (8), parotid surgery (3), and brain tumor surgery (1). No additional procedure was performed for eight patients, while lateral tarsorrhaphy was performed in 26 cases. Mean margin-reflex distance 1 decreased from 5.0 ± 0.4 mm to 4.0 ± 0.5 mm ( p < 0.001) and mean lagophthalmos decreased from 3.3 ± 0.9 mm to 1.8 ± 0.9 mm ( p < 0.001). Subgroups of patients with additional lateral tarsorrhaphy and without tarsorrhaphy experienced the same amount of reduction in margin-reflex distance 1 and lagophthalmos. Conclusion: Recession of levator muscle was effective in reduction of margin-reflex distance 1 and lagophthalmos in facial palsy patients. This procedure can be added to the surgical armamentarium for management of patients with facial palsy and lagophthalmos.

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