title: Electromyographic biofeedback training for reducing muscle pain and tension on masseter and temporal muscles: A pilot study.
abstract: BACKGROUND
  Due to the absence of agreement about an effective unified treatment for temporomandibular disorders, non-invasive therapies such as EMG-biofeedback generate a greater interest. Furthermore, most studies to the present show methodological deficiencies that must be solved in the future, which makes important to emphasize this line of studies.
  
  
  METHODS
  Fourteen patients were selected for this case series study, and replied to a questionnaire concerning awareness of bruxism, painful muscles, and muscle tension. They also practiced an intraoral exploration (occlusal analysis and mandibular dynamics), and an extraoral exploration of the head and neck muscles and the temporomandibular joint. Before each session, patients responded to a questionnaire about the subjective perceived improvement. In each session, a period of three minutes of pre-biofeedback EMG activity of right masseter and temporal muscles was registered, then patients performed 30 iterations of visual EMG-biofeedback training and finally, a period of three minutes of post-EMG activity was also registered for those muscles. Patients performed four sessions.
  
  
  RESULTS
  A decrease in painful symptoms was found for all patients since the first session. EMG activity decreases (p<0,05) in both muscles during the biofeedback training stage, in the four sessions. It is also observed a decrease (p<0,05) in EMG activity in the masseter muscle at the post-biofeedback stage, in the second and third sessions. There is likewise a decrease in EMG post-biofeedback activity of the temporal muscle (p<0,05) in sessions two, three, and four.
  
  
  CONCLUSIONS
  EMG-biofeedback training produces a decrease in EMG activity in both masseter and temporal muscles during the session. This decrease persists during the post-biofeedback period since the second session. Also there is a decrease in painful symptoms for all patients.Key words:Muscle tension, muscle pain, EMG-biofeedback, masseter muscle, temporal muscle.
authors.affiliation: PhD, Student. Universidad de Salamanca. Dep. Cirugía. Facultad de Medicina. Avenida Alfonso X el Sabio s/n. 37007. Salamanca. Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Criado
authors.affiliation: PhD, MD. Associate Professor. Universidad de Salamanca. Dep. Fisiología y Farmacología. Facultad de Medicina. Avenida Alfonso X el Sabio s/n. 37007. Salamanca. Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: de La Fuente
authors.affiliation: PhD. Senior Lecturer. Universidad de Salamanca. Dep. Fisiología y Farmacología. Facultad de Medicina. Avenida Alfonso X el Sabio s/n. 37007. Salamanca. Spain.
authors.forename: Margarita
authors.initials: M
authors.lastname: Heredia
authors.affiliation: PhD. Associate Professor. Universidad de Salamanca. Dep. Cirugía. Facultad de Medicina. Avenida Alfonso X el Sabio s/n. 37007. Salamanca. Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Montero
authors.affiliation: PhD. Associate Professor. Universidad de Salamanca. Dep. Cirugía. Facultad de Medicina. Avenida Alfonso X el Sabio s/n. 37007. Salamanca. Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Albaladejo
authors.affiliation: PhD, MD. Senior Lecturer. Universidad de Salamanca. Dep. Fisiología y Farmacología. Facultad de Medicina. Avenida Alfonso X el Sabio s/n. 37007. Salamanca. Spain.
authors.forename: José-María
authors.initials: JM
authors.lastname: Criado