Activity recognition in long-term electromyograms

The development of the Standardised Tool for the Assessment of Bruxism (STAB): An international road map

This paper summarises the background reasoning and work that led to the selection of the items included in the Standardised Tool for the Assessment of Bruxism (STAB), also introducing the list of items. The instrument is currently being tested for face validity and on-field comprehension. The underlying premise is that the different motor activities included in the bruxism spectrum (e.g. clenching vs. grinding, with or without teeth contact) potentially need to be discriminated from each other, based on their purportedly different aetiology, comorbidities and potential consequences. Focus should be on a valid impression of the activities' frequency, intensity and duration. The methods that can be used for the above purposes can be grouped into strategies that collect information from the patient's history (subject-based), from the clinical assessment performed by an examiner (clinically based) or from the use of instruments to measure certain outcomes (instrumentally based). The three strategies can apply to all aspects of bruxism (i.e. status, comorbid conditions, aetiology and consequences). The STAB will help gathering information on many aspects, factors and conditions that are currently poorly investigated in the field of bruxism. To this purpose, it is divided into two axes. Axis A includes the self-reported information on bruxism status and potential consequences (subject-based report) together with the clinical (examiner report) and instrumental assessment (technology report). Axis B includes the self-reported information (subject-based report) on factors and conditions that may have an etiological or comorbid role for bruxism. This comprehensive multidimensional assessment system will allow building predictive model for clinical and research purposes.

Quantitative Laughter Detection, Measurement, and Classification-A Critical Survey

The study of human nonverbal social behaviors has taken a more quantitative and computational approach in recent years due to the development of smart interfaces and virtual agents or robots able to interact socially. One of the most interesting nonverbal social behaviors, producing a characteristic vocal signal, is laughing. Laughter is produced in several different situations: in response to external physical, cognitive, or emotional stimuli; to negotiate social interactions; and also, pathologically, as a consequence of neural damage. For this reason, laughter has attracted researchers from many disciplines. A consequence of this multidisciplinarity is the absence of a holistic vision of this complex behavior: the methods of analysis and classification of laughter, as well as the terminology used, are heterogeneous; the findings sometimes contradictory and poorly documented. This survey aims at collecting and presenting objective measurement methods and results from a variety of different studies in different fields, to contribute to build a unified model and taxonomy of laughter. This could be successfully used for advances in several fields, from artificial intelligence and human-robot interaction to medicine and psychiatry.

The Design of Non-Occlusal Intraoral Appliances on Hard Palate and Their Effect on Masseter Muscle Activity During Sleep

This study aimed to reveal whether masseter muscle activity during sleep is affected by the difference in design of non-occlusal intraoral appliances on hard palate. Eight healthy Japanese participants were selected and wore each of the four types of appliances (horse shoe, thin, thick and medium thick) during sleep for one week with a one week interval without appliance during sleep. A masseter muscle electromyograph (EMG) was recorded during sleep. The EMG activities were analyzed by calculating the number of bursts per hour, episodes per hour, and bursts per episode. The EMG parameters with the thick type appliance were significantly lower than the baseline condition without appliance. In this study, it is suggested that a thick type appliance has an active effect on suppression of masseter muscle activity.

Bruxism physiology and pathology: an overview for clinicians

Awake bruxism is defined as the awareness of jaw clenching. Its prevalence is reported to be 20% among the adult population. Awake bruxism is mainly associated with nervous tic and reactions to stress. The physiology and pathology of awake bruxism is unknown, although stress and anxiety are considered to be risk factors. During sleep, awareness of tooth grinding (as noted by sleep partner or family members) is reported by 8% of the population. Sleep bruxism is a behaviour that was recently classified as a 'sleep-related movement disorder'. There is limited evidence to support the role of occlusal factors in the aetiology of sleep bruxism. Recent publications suggest that sleep bruxism is secondary to sleep-related micro-arousals (defined by a rise in autonomic cardiac and respiratory activity that tends to be repeated 8-14 times per hour of sleep). The putative roles of hereditary (genetic) factors and of upper airway resistance in the genesis of rhythmic masticatory muscle activity and of sleep bruxism are under investigation. Moreover, rhythmic masticatory muscle activity in sleep bruxism peaks in the minutes before rapid eye movement sleep, which suggests that some mechanism related to sleep stage transitions exerts an influence on the motor neurons that facilitate the onset of sleep bruxism. Finally, it remains to be clarified when bruxism, as a behaviour found in an otherwise healthy population, becomes a disorder, i.e. associated with consequences (e.g. tooth damage, pain and social/marital conflict) requires intervention by a clinician.

Assessment of bruxism in the clinic

Bruxism is a much-discussed clinical issue in dentistry. Although bruxism is not a life-threatening disorder, it can influence the quality of human life, especially through dental problems, such as tooth wear, frequent fractures of dental restorations and pain in the oro-facial region. Therefore, various clinical methods have been devised to assess bruxism over the last 70 years. This paper reviews the assessment of bruxism, provides information on various assessment methods which are available in clinical situations and discusses their effectiveness and usefulness. Currently, there is no definitive method for assessing bruxism clinically that has reasonable diagnostic and technical validity, affects therapeutic decisions and is cost effective. One future direction is to refine questionnaire items and clinical examination because they are the easiest to apply in everyday practice. Another possible direction is to establish a method that can measure actual bruxism activity directly using a device that can be applied to patients routinely. More clinical studies should examine the clinical impact of bruxism on oral structures, treatment success and the factors influencing the decision-making process in dental treatment.

Masticatory muscle activity during deliberately performed oral tasks

The aim of this study was to investigate masticatory muscle activity during deliberately performed functional and non-functional oral tasks. Electromyographic (EMG) surface activity was recorded unilaterally from the masseter, anterior temporalis and suprahyoid muscles in 11 subjects (5 men, 6 women; age = 34.6 +/- 10.8 years), who were accurately instructed to perform 30 different oral tasks under computer guidance using task markers. Data were analyzed by descriptive statistics, repeated measurements analysis of variance (ANOVA) and hierarchical cluster analysis. The maximum EMG amplitude of the masseter and anterior temporalis muscles was more often found during hard chewing tasks than during maximum clenching tasks. The relative contribution of masseter and anterior temporalis changed across the tasks examined (F 5.2; p < or = 0.001). The masseter muscle was significantly (p < or = 0.05) more active than the anterior temporalis muscle during tasks involving incisal biting, jaw protrusion, laterotrusion and jaw cupping, the difference being statistically significant (p < or = 0.05). The anterior temporalis muscle was significantly (p < or = 0.01) more active than the masseter muscle during tasks performed in intercuspal position, during tooth grinding, and during hard chewing on the working side. Based upon the relative contribution of the masseter, anterior temporalis, and suprahyoid muscles, the investigated oral tasks could be grouped into six separate clusters. The findings provided further insight into muscle- and task-specific EMG patterns during functional and non-functional oral behaviors.

Habitual daily masseter activity of subjects with different vertical craniofacial morphology

Little is known about the habitual daily masticatory activity of subjects with different vertical craniofacial morphology. The purpose of the present study was to compare the daily long-term muscle activity of short-face subjects with that of long-face subjects as assessed in their natural environment. Digital photographs of the facial profile were obtained from a sample of 300 subjects and the ratio between anterior total and anterior lower facial height was assessed (Vertical Facial Index: VFI). Fourteen long-face and 16 short-face subjects were selected from the opposite tails of the frequency distribution of VFI. Long-term masseter activity was monitored for 8 h d(-1) in the natural environment by means of portable one-channel electromyograph recorders over three working days. Assessments included calculation of the number of activity periods (APs) per h (N/h), their mean amplitude (Amean), and their mean duration (Dur). The maximal electromyogram activity did not differ significantly between the short-face and the long-face subjects. There was no significant difference between the two groups investigated in N/h, in Amean and Dur. The findings suggest that habitual activity of masseter muscle in the natural environment was not influenced by the vertical craniofacial morphology as assessed in the present study.

Predicting masticatory jaw movements from chin movements using multivariate linear methods

Previously, we have used bivariate correlations of maximum and minimum displacement, velocity and acceleration variables to compare masticatory chin and jaw movements (J. Prosthet. Dent. 81 (1999) 179). This previous study represented a first step in exploring the hypothesis that the chin contained useful information regarding jaw kinematics. The current study extends our understanding of the relationship between masticatory chin and jaw movements by: (1) reconstructing and evaluating a more continuous trajectory of chin and jaw movements, and (2) performing multivariate correlations comparing chin and jaw movements at discrete points along the trajectory in order to gain insight into the coupling of chin and jaw movements during a chewing cycle. Results indicated that chin and jaw movement trajectories were visually similar in the lateral, vertical, and anteroposterior axes. The adjusted R(2) results in the lateral, vertical, and anteroposterior dimensions averaged 0.74, 0.78, and 0.89, respectively. Within chewing cycles, the lowest correlations between chin and jaw movements in the lateral and vertical dimensions occurred when the jaw was relatively closed, whereas the lowest correlations between chin and jaw movements in the anteroposterior dimension occurred while the jaw was opening from a closed position. The results indicated that jaw and chin movements were qualitatively similar and that at least 74% of the variation in jaw movements could be accounted for by multivariate linear models of chin movement.

Effect of occlusal interference on habitual activity of human masseter

It has been suggested that occlusal interference may increase habitual activity in the jaw muscles and may lead to temporomandibular disorders (TMD). We tested these hypotheses by means of a double-blind randomized crossover experiment carried out on 11 young healthy females. Strips of gold foil were glued either on a selected occlusal contact area (active interference) or on the vestibular surface of the same tooth (dummy interference) and left for 8 days each. Electromyographic masseter activity was recorded in the natural environment by portable recorders under interference-free, dummy-interference, and active-interference conditions. The active occlusal interference caused a significant reduction in the number of activity periods per hour and in their mean amplitude. The EMG activity did not change significantly during the dummy-interference condition. None of the subjects developed signs and/or symptoms of TMD throughout the whole study, and most of them adapted fairly well to the occlusal disturbance.

Mandibular positions and jaw-closing muscle activity during sleep

The aim of this study was to clarify the relationship between the mandibular position with tooth contacts and jaw-closing muscle activity during sleep using electromyography and newly devised equipment for detecting tooth contacts and also to confirm the validity of this system. Five males volunteered for this study and three of them reported their bruxing during sleep. Occurrences of tooth contacts at eccentric mandibular positions in addition to the intercuspal position during sleep were detected using micro photo sensors and sensor targets prepared for the individuals. Electromyographic activities (EMG) from right and left masseter and anterior temporal muscles were also recorded. Results of the polygraphic recordings demonstrated that the mandibular positions during bruxism could be distinguished clearly whether it's in the right or left position, or has no lateral deviation, and further, that bruxing events could be categorized based on mandibular position pattern. The relationship between the mandibular position and muscle activity could be evaluated using this system. The study suggested the validity of the system for measuring nocturnal bruxing events.

Nocturnal masseter EMG activity of healthy subjects in a natural environment

Facial pain of patients with craniomandibular disorders might be caused by muscle overload. However, the activity of masticatory muscles of healthy individuals is still unknown. The aim of this study was therefore a first attempt to clarify this question by recording the masseter muscle activity of healthy subjects during sleep by means of portable recorders. The study was performed on 21 healthy subjects selected after telephone and questionnaire screenings and clinical examination from among randomly selected inhabitants of Zürich. The masseter EMG was recorded during seven nights in each subject's natural environment with the electrodes in reproducible position. The signal was analyzed for number, amplitude, and duration of contraction periods defined as signal portions above a threshold which could contain sub-threshold signal portions shorter than the standby time of 5 sec. The signal amplitude was expressed in percent of the amplitude recorded during maximum voluntary clenches (%MVC). An average of 71.9 +/- 28.7 contraction episodes per night (men, 74.7 +/- 30.1; women, 65.0 +/- 23.8; p = 0.043), i.e., of 10.5 +/- 3.8 per hour (men, 11.0 +/- 4.0; women, 9.3 +/- 3.0; p = 0.005), was found. The average mean amplitude was 26.2 +/- 6.4% MVC (men, 27.0 +/- 6.8; women, 24.4 +/- 4.5; p = 0.009). The duration of the episodes had a mode of 0.5 sec, and the group mean of the integral of the amplitude over time was 123.7 +/- 157.9% MVC (men, 138.9 +/- 184.0; women, 85.9 +/- 28.2; p = 0.005). Healthy subjects showed intermittent periods of masseter activity during sleep which, on average, were of rather low intensity and short duration.

Automatic on-line one-channel recognition of masseter activity

The etiology of myoarthropathies of the masticatory system (MAP) is not fully understood. For the hypothetical association between the myogenous pain of MAP patients and masticatory muscle overuse to be proved, functional and parafunctional behavior of the masticatory muscles should be analyzed in normal and diseased subjects. The aim of this study was to test on-line the validity and reliability of an algorithm, applied to the electromyographic signal, to recognize various oral activities. The surface electromyogram of the masseter muscle was recorded in 12 subjects (seven females and five males, from 18 to 32 years old) who performed a series of functional and parafunctional activities (chewing soft food, chewing hard food, swallowing, laughing, speaking, and tooth grinding and clenching), as well as no activity. During the computer training phase, intra-individual classification functions of a multivariate discriminant analysis were calculated while each subject performed the described activities. During the test phase, each subject repeated the same activities, and the computer continuously classified them on-line. The percentage of correctly recognized activities was calculated for each activity and for each subject. No activity, chewing hard food, swallowing, laughing, grinding, and clenching were recognized correctly > 99% of the time. Chewing soft food was recognized correctly 97% and speaking 86% of the time. The sensitivity values for the recognition rates of the complete oral activities were, with one exception, > 0.82; the specificity values were > 0.95, and the kappa-values > 0.80. These results show that the algorithm had high sensitivity, specificity, and reliability in the classification of different oral activities under laboratory conditions.

Reliability of scoring EMG orofacial events: polysomnography compared with ambulatory recordings

The study of sleep bruxism is usually based on clinical history, signs and symptoms. The recording of electromyographic signals with either ambulatory portable home recorders or with polysomnographic techniques in the laboratory environment allows collection of objective data. The present study showed a 100% agreement with clinical evaluation in the recognition of bruxism episodes from the masseter electromyogram recorded with portable recorders and using the polysomnographic technique. On the contrary, scorers had difficulties in discriminating between different types of episodes (phasic, tonic and mixed), the between-scorers agreement varied between 62% and 63% and the kappa-values between 0.43 and 0.33. The ideal time base at which electromyographic signals should be integrated to allow for a good discrimination of bruxism patterns is 0.06 s. The results indicate that portable electromyography recorders are a valuable complement to polysomnographic recordings of orofacial motor activities as they provide a very good recognition rate with adequate time base data collection.

A randomized double-blind clinical trial of the effect of amitriptyline on nocturnal masseteric motor activity (sleep bruxism)

Using a double-blind and randomized experimental design, ten adult subjects with sleep bruxism were administered amitriptyline (25 mg/night) and placebo (25 mg/night), each compound over a period of one week. Neither the intensities and locations of pains nor the nocturnal masseteric electromyographic activities were significantly affected by the tricyclic antidepressant. In fact, intake of amitriptyline was unpredictably associated with either an increase or a decrease in masseteric electromyographic activity (microV.s/min of sleep). On the basis of this study, small doses of amitriptyline cannot be recommended for the control of sleep bruxism and associated discomforts.