Impact of benefit limits and managed care on discharge plans and outcome: a research design and preliminary results.
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Biomedical subjects
Publications and source records attributed to F J Parente.
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In this pilot report, four of the five patients in the myofascial pain dysfunction group reported subjective improvement after 6 weeks of therapy, concomitant with a statistically significant decrease in integrated EMG Hz values in the clenched jaw position. Our results agree with those of other investigators who demonstrated a positive contribution by masticatory EMG data to confirm and quantify objectively the subjective symptoms.
This study was designed to determine the feasibility of using electromyography (EMG) to quantify muscle pain in patients suffering from chronic myofacial pain dysfunction (MPD). Ten patients were carefully selected to include those having mild to severe pain, but not any major psychological or other physiological dysfunction. Measurements of perceived pain and EMG frequency and amplitude were recorded before and after standard analgesic therapy. EMG recordings were collected bilaterally from the masseter and anterior temporalis muscles during the resting, swallowing, clenching and chewing modes of activity. Multiple regression (R) analysis indicated that changes in perceived pain are correlated with changes in the EMG and can be determined by using the following formula: delta P = (delta F) (0.405) + C where P = perceived pain level, F = EMG frequency, and C = 1.533. By computing the Phi coefficients, the highest correlation between EMG recordings and subjective pain ratings was demonstrated in the resting mode. In this mode, 64% (multiple R = 0.80) of the variance in perceived pain difference scores from pre- to post-therapy tests could be determined. A significant relationship exists between the change in perceived pain and the EMG (t = 2.525, p less than 0.05), whether pain levels increase or decrease. The implementation of this method to quantify expected changes in pain due to muscle spasm in uncomplicated individuals is discussed.
The study concerned the nature of the alterations, if any, in muscle activity demonstrable when the mandible shifts from maximum intercuspation into its most retruded physiological relation (i.e. centric relation). An integrator-averager was used to determine micro V average amplitude from masseter and temporal muscles in two maxillo-mandibular positions, centric relation and maximum intercuspation, and three modes, first contact occlusion, chewing and swallowing. Vertical reference marks on the cuspids were used to quantitate horizontal deviation from maximum intercuspation to centric relation. Data were obtained from twelve subjects and analysed for variance. Results demonstrated a significant increase in micro V in all centric relation positions. Statistics yielded an F value of 5.88258 with a probability of 0.005. Results suggest critical limitations in reliance on centric relation as a reference position during clinical therapy.
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