Tongue Position Variability During Sustained Notes in Healthy vs Dystonic Horn Players Using Real-Time MRI

2019 ◽  
Vol 34 (1) ◽  
pp. 33-38
Author(s):  
Peter W Iltis ◽  
Jens Frahm ◽  
Eckart Altenmüller ◽  
Dirk Voit ◽  
Arun Joseph ◽  
...  

OBJECTIVE: Embouchure dystonia (EmD) is a variant of focal task-specific dystonia in musicians characterized by the loss of control in facial and oral muscles while controlling airflow into the mouthpiece of a wind or brass instrument. We compared tongue position variability (TPV) during sustained notes between healthy, elite horn players and horn players affected by EmD. METHODS: Real-time MRI films at 33.3 ms resolution were obtained from 8 healthy elite and 5 EmD horn players as they performed on a non-ferromagnetic horn at each of three different dynamic levels: pianissimo, mezzo forte, and fortissimo. Nine profile lines (3 from anterior, 3 from middle, and 3 from posterior oral cavity regions) were overlaid on each image using a customized MATLAB toolkit, and the variability of the dorsal tongue edge position was examined at each dynamic from temporal intensity profiles produced by MATLAB. RESULTS: Despite trends for more pronounced TPV (larger standard deviations) in the elite musicians (p=0.062), 2-way repeated measures ANOVA revealed no significant differences between groups. However, dynamic level significantly influenced TPV for all subjects, combined (p=0.048) and different regions of the oral cavity showed differing TPV (p<0.001). When only the most active region (anterior oral cavity) was included in the model, differences between groups reached statistical significance (elite > EmD, p<0.048), particularly at the fortissimo dynamic. We postulate that these differences may be due, in part, to a greater degree of generalized orofacial muscle tension in the EmD subjects that includes the tongue.

2019 ◽  
Vol 44 (5) ◽  
pp. 452-458 ◽  
Author(s):  
R Arif ◽  
JB Dennison ◽  
D Garcia ◽  
P Yaman

SUMMARY Statement of Problem: The long-term effect of the presence of porcelain laminate veneers (PLVs) on the health of the surrounding gingival issues is not available in the restorative literature. Purpose: To assess the long-term effect of PLVs on the health of the surrounding gingival tissues. A secondary aim was to correlate gingival crevicular fluid (GCF) scores with clinical parameters used for gingival health assessment in teeth treated with PLVs. Methods and Materials: Patients who received PLVs placed at the Graduate Restorative Clinic within a seven- to 14-year period were recalled for clinical evaluations. Periodontal measurements including gingival index (GI), periodontal pocket depth (PPD), gingival recession (GR), and clinical attachment level (CAL) were measured using a standard probe and indices. Gingival Crevicular Fluid (GCF) was measured with a Periotron machine (Periotron 8000, Oraflow Inc), using Periopaper (Periopaper Gingival Fluid Collection Strip, Oraflow Inc.) for fluid collection. Photographs of any observed clinical defect were taken. Data were tabulated using Excel 2010 (Microsoft Corp). Statistical analysis for all descriptive statistics was performed using SPSS 21 (SPSS Software, IBM Corp.) and Stata SE 13 (Stata Software, StataCorp). Repeated-measures analysis of variance (ANOVA) was done to test for statistical significance of the mean pocket depths between the restored and unrestored surfaces of the veneered teeth. The significance level for all tests was p&lt;0.05. Pearson's correlation coefficient was performed for testing statistical significance between GCF and GI and between GCF and PPD. Results: The frequency distribution of the GI included 47 PLVs (43%) with normal gingiva, 16 (15%) with mild inflammation, and 46 (42%) with moderate inflammation and bleeding on probing. The average PPD on the facial surface of the maxillary and mandibular PLVs was 2.17 mm and 2.16 mm, respectively. On the lingual surface, the average PPD was 2.10 mm for maxillary and 2.22 mm for mandibular PLVs. Gingival recession was seen in 27% of the evaluated PLVs. The repeated-measures ANOVA revealed p≥0.136, showing no statistical difference in the mean pocket depths between restored facial and unrestored lingual surfaces of the veneered teeth. A moderate correlation (r=0.407) was found between GCF and GI, which was significant at p&lt;0.001. No correlation (r=0.124) was found between GCF and PPD, which was not significant at p=0.197. Conclusions: Gingival response to the evaluated PLVs was in the satisfactory range, with overall GI scores ranging between normal and moderate inflammation, pocket depths ranging from 1 to 2 mm, and recession present in 27% of the evaluated PLVs. No statistically significant difference was found between the mean pocket depths of the restored and unrestored surfaces of veneered teeth (p≥0.136). A moderate correlation was found between GCF and GI.


Author(s):  
Brendan L Pinto ◽  
Clark R Dickerson

Employing an arched back posture during the bench press exercise is increasingly popular. Vertical displacement of the barbell is commonly believed to be the key difference influencing strength performance between an arched and flat back bench press technique. However, comparisons between these back postures using a free weight barbell are lacking. Directly comparing performance between each posture is confounded by many variables such as proficiency and fatigue. This investigation aimed to investigate whether changing back posture alone can influence barbell kinematics, to indirectly assess potential performance differences. Twenty males performed one repetition of the bench press exercise using either an arched or flat back posture, at 25%, 50% and 75% of their one repetition maximum, in a repeated measures study design. Statistical significance was considered at p < 0.05. Changing back posture alone, reduced vertical displacement (approximately 11% average difference across all load conditions) and barbell to glenohumeral joint moment arm (approximately 20% difference) in the arched posture compared to the flat posture. These changes occurred without any specific cueing of the barbell motion and may increase the potential for lifting higher loads and decrease cumulative joint exposure. Additional cueing and training may be required to maximize the mechanical advantage available with each back posture. The arched posture appears to have an increased potential for further improvements in vertical displacement and moment arm through specific cueing. Future comparisons should consider if each back posture’s potential mechanical advantage has been maximized when assessing differences between techniques.


2021 ◽  
Vol 8 (4) ◽  
pp. 54
Author(s):  
Daniele Serrani ◽  
Antonella Volta ◽  
Franco Cingolani ◽  
Luca Pennasilico ◽  
Caterina Di Bella ◽  
...  

Real-time elastosonography (RTE) is a recently described, non-invasive, ultrasonographic technique developed to assess tissue elasticity. The main aim of this study was to investigate the ultrasonographic and elastosonographic appearance of the common calcaneal tendon (CCT) in an ovine model, and to monitor the progression of tendon healing after an experimentally-induced tendinopathy. Sound tendons were initially evaluated (T0) with a caliper and by a single operator with ultrasound. Ultrasonographic and elastosonographic images were then acquired. Subsequently, ultrasound-guided tendon lesions were induced by injecting 500 IU of Type IA collagenases proximally to the calcaneal tuberosity. Caliper measurement, ultrasonography and elastosonography were then repeated at 15 (T1), 30 (T2) and 60 (T3) days. Clinically measured width of the tendon, ultrasonographic thickness and width and percentage of hard (Elx-t%hrd) and soft (Elx-t%sft) tissue were recorded. Statistical analysis was performed on the data collected; statistical significance was set at p < 0.05. Intra-class correlation coefficient (ICC) revealed good (0.68) repeatability of elastosonographic evaluation of the CCT. The tendon width was significantly increased when comparing T0 with T1–2 and decreased when comparing T1–2 with T3. Ultrasound-assessed thickness was significantly increased between T0–T1 and decreased between T1-T2–3. Elx-t%hrd was significantly decreased at T1–2–3 and Elx-t%sft was significantly increased at T1–2–3. In conclusion, the ovine CCT is a highly stiff structure that undergoes a severe loss of stiffness during the healing process. Thickness and width of the tendon increased during the first 30 days and then reduced progressively along the subsequent 30 days. Ultrasonographic appearance of the tendon remained severely abnormal and the tendon showed severely reduced elastic proprieties 60 days after lesion induction.


2021 ◽  
Vol 9 (7_suppl4) ◽  
pp. 2325967121S0024
Author(s):  
Manuel Schubert ◽  
Tariq Awan ◽  
Aaron Sciascia ◽  
Emily Pacheco ◽  
Jennifer DeMink ◽  
...  

Objectives: There has been a rise in elbow ulnar collateral ligament (UCL) injuries in youth pitchers over recent years. With forearm flexor-pronator mass fatigue, the dynamic stability provided could be diminished placing greater stress on the UCL. Pitch count limits have been instituted in an attempt to help curtail this rise in throwing injuries, especially in youth athletes. In order to provide more objective data regarding current pitch count limits for youth pitchers, the purpose of this pilot study was to evaluate for potential fatigue of the flexor-pronator mass by assessing changes in medial elbow laxity, noninvasively characterizing changes in muscle glycogen storage within the forearm flexor-pronator mass, and evaluating changes in subjective fatigue, strength, range of motion (ROM), pitching velocity, and accuracy with increasing number of pitches thrown by 10-year-old pitchers up to their recommended 75 pitch count limit. Methods: After appropriate power analysis, male pitchers 10 years of age were recruited for the study (n=22). Pitchers threw a total of 75 pitches divided into sets of 25 pitches, with standardized periods of rest in between throws and sets to best simulate a game. Bilateral medial elbow laxity was measured by applying 10 decanewtons of valgus force with a standardized stress device and utilizing ultrasound imaging (Figures 1A-B) prior to pitching and after each pitching set. The change in medial ulnohumeral joint distance (Figure 1C) after stress was applied was calculated from baseline without stress. Relative changes in muscle glycogen storage, detected as changes in echogenicity, within the flexor carpi radialis (FCR) and the flexor digitorum superficialis (FDS)/flexor carpi ulnaris (FCU) muscles were measured non-invasively with ultrasound-based software (Figures 1D-E) and recorded as fuel percentile. Repeated measures analysis of variance and post-hoc testing were used to determine statistical significance (alpha=0.05). Results: There were no significant differences in medial elbow laxity between arms or time points. There was a trend for similar decline in FCR fuel percentile values between each arm, indicating relative decreases in glycogen storage bilaterally. However, only the throwing arm demonstrated a statistically significant decline in fuel percentile from baseline to after 75 pitches (p=0.05). There were no statistically significant differences across time points for FDS/FCU fuel percentile values. Fatigue measurements for both arms were significantly higher at all time points compared to baseline (p≤0.03). Grip strength of the dominant arm after 75 pitches was significantly decreased compared to after 25 pitches (p=0.02). There were no statistically significant changes in other strength measurements, ROM, velocity, or accuracy between all time points. Conclusions: By the recommended 75 pitch count limit in 10-year-olds, subjective fatigue and a decrease in grip strength had occurred. Furthermore, relative glycogen storage of the flexor-pronator mass of the throwing arm decreased between pitching 50 to 75 pitches, but without an increase in medial elbow gapping. This study provides a foundation and raises questions for further objective testing of physiologic changes that occur throughout increasing pitching to better guide pitch count limits and ensure the safety of young athletes


Author(s):  
Christian M. Puttlitz ◽  
Robert P. Melcher ◽  
Vedat Deviren ◽  
Dezsoe Jeszenszky ◽  
Ju¨rgen Harms

Reconstruction of C2 after tumor destruction and resection remains a significant challenge. Most constructs utilize a strutgraft with plate or screw fixation. A novel C2 prosthesis combining a titanium mesh cage with bilateral C1 shelves and a T-plate has been used successfully in 18 patients. Supplemental posterior instrumentation includes C0-C3 or C1-C3. Biomechanical comparisons of this C2 prosthesis with traditional fixation options have not been reported. Five fresh-frozen human cadaveric cervical spines (C0-C5) were tested intact. Next, the C2 prosthesis, and strut graft and anterior plate constructs were tested with occiput-C3 and C1-C3 posterior fixation. Pure moment loads (up to 1.5 N-m) were applied in flexion and extension, lateral bending, and axial rotation. C1-C3 motion was evaluated using 3 camera motion analysis. Statistical significance was evaluated using one-way repeated measures ANOVA with Student-Newman-Keuls post hoc pairwise comparisons. All constructs provided a statistically significant decrease in motion in this C2 corpectomy model as compared to the intact condition. There was no significant difference in C1-C3 motion between the 4 constructs, regardless of whether the occiput was included in the fixation. Under these loading conditions, both the C2 prostheisis and strut-graft-plate constructs provided initial C1-C3 stability beyond that of the intact specimen. The occiput does not need to be included in the posterior instrumentation.


2015 ◽  
Vol 33 (10) ◽  
pp. 1171-1179 ◽  
Author(s):  
Lari Wenzel ◽  
Kathryn Osann ◽  
Susie Hsieh ◽  
Jo A. Tucker ◽  
Bradley J. Monk ◽  
...  

Purpose Survivors of cervical cancer experience quality-of-life (QOL) disruptions that persist years after treatment. This study examines the effect of a psychosocial telephone counseling (PTC) intervention on QOL domains and associations with biomarkers. Patients and Methods We conducted a randomized clinical trial in survivors of cervical cancer, who were ≥ 9 and less than 30 months from diagnosis (n = 204), to compare PTC to usual care (UC). PTC included five weekly sessions and a 1-month booster. Patient-reported outcomes (PROs) and biospecimens were collected at baseline and 4 and 9 months after enrollment. Changes in PROs over time and associations with longitudinal change in cytokines as categorical variables were analyzed using multivariable analysis of variance for repeated measures. Results Participant mean age was 43 years; 40% of women were Hispanic, and 51% were non-Hispanic white. Adjusting for age and baseline scores, participants receiving PTC had significantly improved depression and improved gynecologic and cancer-specific concerns at 4 months compared with UC participants (all P < .05); significant differences in gynecologic and cancer-specific concerns (P < .05) were sustained at 9 months. Longitudinal change in overall QOL and anxiety did not reach statistical significance. Participants with decreasing interleukin (IL) -4, IL-5, IL-10, and IL-13 had significantly greater improvement in QOL than those with increasing cytokine levels. Conclusion This trial confirms that PTC benefits mood and QOL cancer-specific and gynecologic concerns for a multiethnic underserved population of survivors of cancer. The improvement in PROs with decreases in T-helper type 2 and counter-regulatory cytokines supports a potential biobehavioral pathway relevant to cancer survivorship.


Author(s):  
Leonice Fumiko Sato Kurebayashi ◽  
Ruth Natalia Teresa Turrini ◽  
Talita Pavarini Borges de Souza ◽  
Carolina Felicio Marques ◽  
Renata Tavares Franco Rodrigues ◽  
...  

RESUMEN Objectives: to evaluate the effectiveness of the auricular protocol (APPA) in reducing pain and anxiety and improving the quality of life of the nursing staff of a hospital. Method: randomized clinical trial with an initial sample of 180 professionals divided into 4 groups Control (G1), Seed (G2), Needle (G3) and Tape (G4). The evaluation instruments were the State-Trait Anxiety Inventory, Pain Visual Analog Scale and Quality of Life instrument, applied at the start and after five and 10 sessions (five weeks). Descriptive statistics, analysis of variance (ANOVA) and Cohen's d Index were used in the analysis. Results: there was a statistical difference (p < 0.05) for anxiety according to the repeated measures ANOVA, with better results for the G3 in the final assessment (Cohen's d index 1.08/17% reduction). There was a reduction of pain of 36% in G3 and 24% in G2 and a 13% increase in the mental aspect of quality of life for the G3, although without statistical significance. Conclusion: the APPA protocol reduced the anxiety levels of nursing staff after 10 sessions. Further studies are, however, suggested with new populations and in different contexts so that the results can be confirmed. RBR-5pc43m.


2014 ◽  
Vol 99 (6) ◽  
pp. 729-733 ◽  
Author(s):  
Tasiopoulos Konstantinos ◽  
Komnos Apostolos ◽  
Paraforos Georgios ◽  
Tepetes Konstantinos

Abstract Studies on surgical patients provide some evidence of prompt detection of enteric ischemia with microdialysis. The purpose of the study was to measure intraperitoneal microdialysis values (glucose, glycerol, pyruvate, and lactate) in patients hospitalized in an intensive care unit (ICU) with an underlying abdominal surgical condition and to correlate these values with patients' outcomes. Twenty-one patients, 10 female, were enrolled in the study. The intraperitoneal metabolite values were measured for 3 consecutive days, starting from the first day of ICU hospitalization. Descriptive and inferential statistics were performed. The t-test, repeated measures analysis, Holm's test, and a logistic regression model were applied. Level of statistical significance was set at P = 0.05. Mean age of participants was 68.10 ± 8.02 years old. Survivors exhibited statistically significantly higher glucose values on day 3 (6.61 ± 2.01 against 3.67 ± 1.62; P = 0.002). Mean lactate/ pyruvate (L/P) values were above 20 (35.35 ± 27.11). All non-survivors had a mean three day L/P values greater than 25.94. Low L/P values were related to increased survival possibilities. High microdialysis glucose concentration, high L/P ratio and low glucose concentration were the major findings during the first three ICU hospitalization days in non-survivors. Intraperitoneal microdialysis may serve as a useful tool in understanding enteric ischemia pathophysiology.


Author(s):  
Barry Gerber ◽  
Anita E. Pienaar ◽  
Ankebe Kruger

Puberty and the onset of menarche influences the motor performance of girls. However, the magnitude of these influences during varying maturity status, is not clear. This longitudinal study over two years aimed to investigate differences in motor fitness between early and late developing girls based on pre- and post-menarche status. A convenience sample (n = 58) of girls aged 13.51 ± 3.51, divided by means of the Status Quo method into pre (n = 13) and post-menarche (n = 45) groups, was used. Motor fitness was tested once annually by standardized protocols. Basic statistics, independent t-testing and a repeated measures ANOVA with a post hoc Bonferonni correction were used (p < 0.05 = statistical significance). Effect sizes were determined by Cohen’s d-values. Only explosive upper body strength differed significantly between groups during baseline, favoring post-menarche girls. Initially, post-menarche girls showed advantages in hand-eye coordination and speed (p > 0.05) with pre-menarche girls performing better in agility and explosive leg strength (p > 0.05). At 15.51 years, no significant, between-group differences were found. Pre-menarche girls surpassed post-menarche girls in hand-eye coordination and 0–40 m speed and post-menarche girls displayed higher explosive leg and upper body strength scores (p > 0.05). Our data show that the potential to excel in sport based on motor capabilities can only be accurately estimated 1–2 years after reaching menarche.


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