Surface electromyography of jaw muscles and kinesiographic recordings: diagnostic accuracy for myofascial pain

Summary  The present investigations attempted to assess the diagnostic accuracy of commercially available surface electromyography (sEMG) and kinesiography (KG) devices for myofascial pain of jaw muscles. Thirty‐six (n = 36) consecutive patients with a research diagnostic criteria for temporomandibu...

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Published inJournal of oral rehabilitation Vol. 38; no. 11; pp. 791 - 799
Main Authors MANFREDINI, D., COCILOVO, F., FAVERO, L., FERRONATO, G., TONELLO, S., GUARDA-NARDINI, L.
Format Journal Article
LanguageEnglish
Published Oxford, UK Blackwell Publishing Ltd 01.11.2011
Subjects
Online AccessGet full text
ISSN0305-182X
1365-2842
1365-2842
DOI10.1111/j.1365-2842.2011.02218.x

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Abstract Summary  The present investigations attempted to assess the diagnostic accuracy of commercially available surface electromyography (sEMG) and kinesiography (KG) devices for myofascial pain of jaw muscles. Thirty‐six (n = 36) consecutive patients with a research diagnostic criteria for temporomandibular disorders (RDC/TMD) axis I diagnosis of myofascial pain and an age‐ and sex‐matched group of 36 TMD‐free asymptomatic subjects underwent sEMG and KG assessments to compare EMG parameters of the masseter and temporalis muscles as well as the jaw range of motion and the interarch freeway space. EMG data at rest were not significantly different between myofascial pain patients and asymptomatic subjects, while the latter achieved significantly higher levels of EMG activity during clenching tasks. Symmetry of muscle activity at rest and during clenching tasks, KG parameters of jaw range of motion and the measurement of the interarch vertical freeway did not differ between groups. Receiver operating characteristics curve analysis showed that, except EMG parameters during clenching tasks, all the other outcome sEMG and KG measures did not reach acceptable levels of sensitivity and specificity, with a 30·6–88·9% percentage of false‐positive results. Therefore, clinicians should not use sEMG and KG devices as diagnostic tools for individual patients who might have myofascial pain in the jaw muscles. Whether intended as a stand‐alone measurement or as an adjunct to making clinical decisions, such instruments do not meet the standard of reliability and validity required for such usage.
AbstractList The present investigations attempted to assess the diagnostic accuracy of commercially available surface electromyography (sEMG) and kinesiography (KG) devices for myofascial pain of jaw muscles. Thirty-six (n = 36) consecutive patients with a research diagnostic criteria for temporomandibular disorders (RDC/TMD) axis I diagnosis of myofascial pain and an age- and sex-matched group of 36 TMD-free asymptomatic subjects underwent sEMG and KG assessments to compare EMG parameters of the masseter and temporalis muscles as well as the jaw range of motion and the interarch freeway space. EMG data at rest were not significantly different between myofascial pain patients and asymptomatic subjects, while the latter achieved significantly higher levels of EMG activity during clenching tasks. Symmetry of muscle activity at rest and during clenching tasks, KG parameters of jaw range of motion and the measurement of the interarch vertical freeway did not differ between groups. Receiver operating characteristics curve analysis showed that, except EMG parameters during clenching tasks, all the other outcome sEMG and KG measures did not reach acceptable levels of sensitivity and specificity, with a 30·6-88·9% percentage of false-positive results. Therefore, clinicians should not use sEMG and KG devices as diagnostic tools for individual patients who might have myofascial pain in the jaw muscles. Whether intended as a stand-alone measurement or as an adjunct to making clinical decisions, such instruments do not meet the standard of reliability and validity required for such usage.
Summary  The present investigations attempted to assess the diagnostic accuracy of commercially available surface electromyography (sEMG) and kinesiography (KG) devices for myofascial pain of jaw muscles. Thirty‐six (n = 36) consecutive patients with a research diagnostic criteria for temporomandibular disorders (RDC/TMD) axis I diagnosis of myofascial pain and an age‐ and sex‐matched group of 36 TMD‐free asymptomatic subjects underwent sEMG and KG assessments to compare EMG parameters of the masseter and temporalis muscles as well as the jaw range of motion and the interarch freeway space. EMG data at rest were not significantly different between myofascial pain patients and asymptomatic subjects, while the latter achieved significantly higher levels of EMG activity during clenching tasks. Symmetry of muscle activity at rest and during clenching tasks, KG parameters of jaw range of motion and the measurement of the interarch vertical freeway did not differ between groups. Receiver operating characteristics curve analysis showed that, except EMG parameters during clenching tasks, all the other outcome sEMG and KG measures did not reach acceptable levels of sensitivity and specificity, with a 30·6–88·9% percentage of false‐positive results. Therefore, clinicians should not use sEMG and KG devices as diagnostic tools for individual patients who might have myofascial pain in the jaw muscles. Whether intended as a stand‐alone measurement or as an adjunct to making clinical decisions, such instruments do not meet the standard of reliability and validity required for such usage.
The present investigations attempted to assess the diagnostic accuracy of commercially available surface electromyography (sEMG) and kinesiography (KG) devices for myofascial pain of jaw muscles. Thirty-six (n = 36) consecutive patients with a research diagnostic criteria for temporomandibular disorders (RDC/TMD) axis I diagnosis of myofascial pain and an age- and sex-matched group of 36 TMD-free asymptomatic subjects underwent sEMG and KG assessments to compare EMG parameters of the masseter and temporalis muscles as well as the jaw range of motion and the interarch freeway space. EMG data at rest were not significantly different between myofascial pain patients and asymptomatic subjects, while the latter achieved significantly higher levels of EMG activity during clenching tasks. Symmetry of muscle activity at rest and during clenching tasks, KG parameters of jaw range of motion and the measurement of the interarch vertical freeway did not differ between groups. Receiver operating characteristics curve analysis showed that, except EMG parameters during clenching tasks, all the other outcome sEMG and KG measures did not reach acceptable levels of sensitivity and specificity, with a 30·6-88·9% percentage of false-positive results. Therefore, clinicians should not use sEMG and KG devices as diagnostic tools for individual patients who might have myofascial pain in the jaw muscles. Whether intended as a stand-alone measurement or as an adjunct to making clinical decisions, such instruments do not meet the standard of reliability and validity required for such usage.The present investigations attempted to assess the diagnostic accuracy of commercially available surface electromyography (sEMG) and kinesiography (KG) devices for myofascial pain of jaw muscles. Thirty-six (n = 36) consecutive patients with a research diagnostic criteria for temporomandibular disorders (RDC/TMD) axis I diagnosis of myofascial pain and an age- and sex-matched group of 36 TMD-free asymptomatic subjects underwent sEMG and KG assessments to compare EMG parameters of the masseter and temporalis muscles as well as the jaw range of motion and the interarch freeway space. EMG data at rest were not significantly different between myofascial pain patients and asymptomatic subjects, while the latter achieved significantly higher levels of EMG activity during clenching tasks. Symmetry of muscle activity at rest and during clenching tasks, KG parameters of jaw range of motion and the measurement of the interarch vertical freeway did not differ between groups. Receiver operating characteristics curve analysis showed that, except EMG parameters during clenching tasks, all the other outcome sEMG and KG measures did not reach acceptable levels of sensitivity and specificity, with a 30·6-88·9% percentage of false-positive results. Therefore, clinicians should not use sEMG and KG devices as diagnostic tools for individual patients who might have myofascial pain in the jaw muscles. Whether intended as a stand-alone measurement or as an adjunct to making clinical decisions, such instruments do not meet the standard of reliability and validity required for such usage.
Author MANFREDINI, D.
FERRONATO, G.
COCILOVO, F.
TONELLO, S.
GUARDA-NARDINI, L.
FAVERO, L.
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Cooper BC. Parameters of an optimal physiological state of the masticatory system: the results of a survey of practitioners using computerized measurement devices. Cranio. 2004;22:220-233.
Dworkin SF, Leresche L, DeRouen T, von Korff MR. Assessing clinical signs of temporomandibular disorders: reliability of clinical examiners. J Prosthet Dent. 1990;63:574-579.
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Steenks MH, de Wijer A. Validity of the research diagnostic criteria for temporomandibular disorders axis I in clinical and research settings. J Orofac Pain. 2009;23:9-16.
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Svensson P, Wang K, Sessle BJ, Arendt-Nielsen L. Associations between pain and neuromuscular activity in the human jaw and neck muscles. Pain. 2004;109:225-232.
Castroflorio T, Bracco P, Farina D. Surface electromyography in the assessment of jaw elevator muscles. J Oral Rehabil. 2008;35:638-645.
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2005; 116
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2008; 13
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References_xml – reference: Klasser GD, Okeson J. The clinical usefulness of surface electromyography in the diagnosis and treatment of temporomandibular disorders. J Am Dent Assoc. 2006;137:763-771.
– reference: Bodéré C, Téa SH, Giroux-Metges MA, Woda A. Activity of masticatory muscles in subjects with different orofacial pain conditions. Pain. 2005;116:33-41.
– reference: Suvinen TI, Malmberg J, Forster C, Kemppainen P. Postural and dynamic masseter and anterior temporalis muscle EMG repeatability in serial assessments. J Oral Rehabil. 2009;36:814-820.
– reference: Palla S, Farella M. External validity: a forgotten issue? Int J Prosthodont. 2010;23:293-294.
– reference: Manfredini D, Tognini F, Zampa V, Bosco M. Predictive value of clinical findings for temporomandibular joint effusion. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;96:521-526.
– reference: Leeflang MM, Deeks JJ, Gatsonis C, Bossuyt PM; Cochrane Diagnostic Test Accuracy Working Group. Systematic reviews of diagnostic test accuracy. Ann Intern Med. 2008;149:889-897.
– reference: Manfredini D, Guarda-Nardini L. Agreement between research diagnostic criteria for temporomandibular disorders and magnetic resonance diagnoses of temporomandibular disc displacement in a patient population. Int J Oral Maxillofac Surg. 2008;37:612-616.
– reference: Lund JP, Widmer CG, Feine JS. Validity of diagnostic and monitoring tests used for temporomandibular disorders. J Dent Res. 1995;74:1133-1143.
– reference: Jankelson B, Radke J. The myomonitor: its use and abuse. Quintessence Int Dent Digest. 1978;9:35-39, 47-52.
– reference: Manfredini D, Guarda-Nardini L. Ultrasonography of the temporomandibular joint: a literature review. Int J Oral Maxillofac Surg. 2009;38:1229-1236.
– reference: Petersson A. What you can and cannot see in TMJ imaging - an overview related to the RDC/TMD diagnostic system. J Oral Rehabil. 2010;37:771-778.
– reference: Ahmad M, Hollender L, Anderson Q, Kartha K, Ohrbach R, Truelove EL et al. Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107:844-860.
– reference: Dworkin SF, Leresche L, DeRouen T, von Korff MR. Assessing clinical signs of temporomandibular disorders: reliability of clinical examiners. J Prosthet Dent. 1990;63:574-579.
– reference: De Leeuw R. The American Academy of Orofacial Pain. Orofacial pain: guidelines for assessment, diagnosis, and management. Chicago: Quintessence Publishing, 2008.
– reference: Suvinen TI, Kemppainen P. Review of clinical EMG studies related to muscle and occlusal factors in healthy and TMD subjects. J Oral Rehabil. 2007;34:631-644.
– reference: Cooper BC. Parameters of an optimal physiological state of the masticatory system: the results of a survey of practitioners using computerized measurement devices. Cranio. 2004;22:220-233.
– reference: Metz CE. Basic principles of ROC analysis. Sem Nuc Med. 1978;8:283-298.
– reference: Cooper BC, Kleinberg I. Establishment of temporomandibular physiological state with neuromuscular orthosis treatment affects reduction of TMD symptoms in 313 patients. Cranio. 2008;26:104-117.
– reference: Svensson P, Wang K, Sessle BJ, Arendt-Nielsen L. Associations between pain and neuromuscular activity in the human jaw and neck muscles. Pain. 2004;109:225-232.
– reference: Dao TTT, Feine JS, Lund JP. Can electrical stimulation be used to establish a physiologic occlusal position? J Prosthet Dent. 1988;60:509-514.
– reference: Jankelson B. Neuromuscular aspects of occlusion: effects of occlusal position on the physiology and dysfunction of the mandibular musculature. Dent Clin North Am. 1979;23:157-168.
– reference: Dworkin SF, Leresche L. Research diagnostic criteria for temporomandibular disorders: review, criteria examinations and specifications, critique. J Craniomandib Disord Fac Oral Pain. 1992;6:301-355.
– reference: Mohl ND. Reliability and validity of diagnostic modalities for temporomandibular disorders. Adv Dent Res. 1993;7:113-119.
– reference: Castroflorio T, Bracco P, Farina D. Surface electromyography in the assessment of jaw elevator muscles. J Oral Rehabil. 2008;35:638-645.
– reference: Murray GM, Peck CC. Orofacial pain and jaw muscle activity: a new model. J Orofac Pain. 2007;21:263-278.
– reference: Tartaglia GM, Moreira Rodrigues da Silva MA, Bottini S, Sforza C, Ferrario VF. Masticatory muscle activity during maximum voluntary clench in different research diagnostic criteria for temporomandibular disorders (RDC/TMD) groups. Man Ther. 2008;13:434-440.
– reference: Steenks MH, de Wijer A. Validity of the research diagnostic criteria for temporomandibular disorders axis I in clinical and research settings. J Orofac Pain. 2009;23:9-16.
– reference: Koh KJ, List T, Petersson A, Rohlin M. Relationship between clinical and magnetic resonance imaging diagnoses and findings in degenerative and inflammatory temporomandibular joint diseases: a systematic literature review. J Orofac Pain. 2009;23:123-139.
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Snippet Summary  The present investigations attempted to assess the diagnostic accuracy of commercially available surface electromyography (sEMG) and kinesiography...
The present investigations attempted to assess the diagnostic accuracy of commercially available surface electromyography (sEMG) and kinesiography (KG) devices...
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StartPage 791
SubjectTerms Adult
Case-Control Studies
electromyography
Electromyography - methods
Facial Pain - diagnosis
Facial Pain - physiopathology
Female
Humans
kinesiography
Male
Masseter Muscle - physiopathology
Musculoskeletal Pain - diagnosis
Musculoskeletal Pain - physiopathology
myofascial pain
Range of Motion, Articular
Reproducibility of Results
research diagnostic criteria for temporomandibular disorders
surface electromyography
Temporal Muscle - physiopathology
temporomandibular disorders
Temporomandibular Joint Disorders - diagnosis
Temporomandibular Joint Disorders - physiopathology
Title Surface electromyography of jaw muscles and kinesiographic recordings: diagnostic accuracy for myofascial pain
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https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fj.1365-2842.2011.02218.x
https://www.ncbi.nlm.nih.gov/pubmed/21480942
https://www.proquest.com/docview/896825869
Volume 38
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