Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3

TMD Related Abstracts

3 Vibration control of Bridge Super structure using Tuned Mass Damper (TMD)

Authors: Tauhidur Rahman, Dhrubajyoti Thakuria

Abstract:

In this article, vibration caused by earthquake excitation, wind load and the high-speed vehicle in the superstructure has been studied. An attempt has been made to control these vibrations using passive Tuned Mass Dampers (TMD). Tuned mass damper consists of a mass, spring, and viscous damper which dissipates the vibration energy of the primary structure at the damper of the TMD. In the present paper, the concrete box girder bridge superstructure is considered and is modeled using MIDAS software. The bridge is modeled as Euler-Bernoulli beam to study the responses imposed by high-speed vehicle, earthquake excitation and wind load. In the present study, comparative study for the responses has been done considering different velocities of the train. The results obtained in this study are based on Indian standard loadings specified in Indian Railways Board (Bridge Rules). A comparative study has been done for the responses of the high-speed vehicle with and without Tuned Mass Dampers. The results indicate that there is a significant reduction in displacement and acceleration in the bridge superstructure when Tuned Mass Damper is used.

Keywords: Vibration Control, bridge superstructure, high speed vehicle, tuned mass damper, TMD

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2 Impact of Kinesio Taping on Masseter Muscle: An Electromyographic Study

Authors: Joanna E. Owczarek, Izabela Zielinska

Abstract:

The incidence of temporomandibular disorders is 50% up to 80%. Kinesio taping (KT) is treatment method for musculoskeletal disorders. The aim of our study was to assess the impact of KT on masseter muscles’ tone evaluated by electromyography. 30 adults (aged 22±2.1) were examined. The tone of masseters before and after 4 days KT application on sternocleidomastoideus muscle was measured during resting mandibular position and clenching. Noraxon DTS device was used. Masseter muscles’ tone during clenching after KT application was relevently lower in comparison to its tone before the KT.

Keywords: electromyography, TMD, Kinesio taping, masseter muscle

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1 Management of Myofascial Temporomandibular Disorder in Secondary Care: A Quality Improvement Project

Authors: Rishana Bilimoria, Selina Tang, Sajni Shah, Marianne Henien, Christopher Sproat

Abstract:

Temporomandibular disorders (TMD) may affect up to a third of the general population, and there is evidence demonstrating the majority of Myofascial TMD cases improve after education and conservative measures. In 2015 our department implemented a modified care pathway for myofascial TMD patients in an attempt to improve the patient journey. This involved the use of an interactive group therapy approach to deliver education, reinforce conservative measures and promote self-management. Patient reported experience measures from the new group clinic revealed 71% patient satisfaction. This service is efficient in improving aspects of health status while reducing health-care costs and redistributing clinical time. Since its’ establishment, 52 hours of clinical time, resources and funding have been redirected effectively. This Quality Improvement Project was initiated because it was felt that this new service was being underutilised by our surgical teams. The ‘Plan-Do-Study-Act cycle’ (PDSA) framework was employed to analyse utilisation of the service: The ‘plan’ stage involved outlining our aims: to raise awareness amongst clinicians of the unified care pathway and to increase referral to this clinic. The ‘do’ stage involved collecting data from a sample of 96 patients over 4 month period to ascertain the proportion of Myofascial TMD patients who were correctly referred to the designated clinic. ‘Suitable’ patients who weren’t referred were identified. The ‘Study’ phase involved analysis of results, which revealed that 77% of suitable patients weren’t referred to the designated clinic. They were reviewed on other clinics, which are often overbooked, or managed by junior staff members. This correlated with our original prediction. Barriers to referral included: lack of awareness of the clinic, individual consultant treatment preferences and patient, reluctance to be referred to a ‘group’ clinic. The ‘Act’ stage involved presenting our findings to the team at a clinical governance meeting. This included demonstration of the clinical effectiveness of the care-pathway and explaining the referral route and criteria. In light of the evaluation results, it was decided to keep the group clinic and maximize utilisation. The second cycle of data collection following these changes revealed that of 66 Myofascial TMD patients over a 4 month period, only 9% of suitable patients were not seen via the designated pathway; therefore this QIP was successful in meeting the set objectives. Overall, employing the PDSA cycle in this QIP resulted in appropriate utilisation of the modified care pathway for patients with myofascial TMD in Guy’s Oral Surgery Department. In turn, this leads to high patient satisfaction with the service and effectively redirected 52 hours of clinical time. It permitted adoption of a collaborative working style with oral surgery colleagues to investigate problems, identify solutions, and collectively raise standards of clinical care to ensure we adopt a unified care pathway in secondary care management of Myofascial TMD patients.

Keywords: Quality improvement, TMD, myofascial, PDSA

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