Medicine and Health Sciences Commons^™

Influences Of Athletic Trainers' Return-To-Activity Assessments For Patients With An Ankle Sprain, Ryan S. Mccann, Cailee E. Welch Bacon, Ashley M. B. Suttmiller, Phillip A. Gribble, Julie M. Cavallario

Rehabilitation Sciences Faculty Publications

Context: Athletic trainers (ATs) inconsistently apply rehabilitation-oriented assessments (ROASTs) when deciding return-to-activity readiness for patients with an ankle sprain. Facilitators and barriers that are most influential to ATs' assessment selection remain unknown.

Objective: To examine facilitators of and barriers to ATs' selection of outcome assessments when determining return-to-activity readiness for patients with an ankle sprain.

Design: Cross-sectional study.

Setting: Online survey.

Patients or other participants: We sent an online survey to 10 000 clinically practicing ATs. The survey was accessed by 676 individuals, of whom 574 submitted responses (85% completion rate), and 541 respondents met the inclusion criteria.

Main outcome …

Assessments Used By Athletic Trainers To Decide Return-To-Activity Readiness In Patients With An Ankle Sprain, Ryan S. Mccann, Cailee E. Welch Bacon, Ashley M. B. Suttmiller, Phillip A. Gribble, Julie M. Cavallario

Rehabilitation Sciences Faculty Publications

Context: Athletic trainers (ATs) often care for patients with ankle sprains. Expert consensus has been established for rehabilitation-oriented assessments (ROASTs) that should be included in ankle-sprain evaluations. However, the methods ATs use to determine return-to-activity readiness after an ankle sprain are unknown.

Objectives: To identify ATs' methods for determining patients' return-to-activity readiness after an ankle sprain and demographic characteristics of the ATs and their methods.

Setting: Online survey.

Design: Cross-sectional study.

Patients or Other Participants: We recruited 10 000 clinically practicing ATs. A total of 676 accessed the survey, 574 submitted responses (85% completion rate), and 541 respondents met the …

A Single-Cell Atlas Of Bovine Skeletal Muscle Reveals Mechanisms Regulating Intramuscular Adipogenesis And Fibrogenesis, Leshan Wang, Peidong Gao, Chaoyag Li, Qianglin Liu, Zeyang Yao, Yuxia Li, Xujia Zhang, Jiangwen Sun, Constantine Simintiras, Matthew Welborn, Kenneth Mcmillin, Stephanie Oprescu, Shihuan Kuang, Xing Fu

Computer Science Faculty Publications

Background: Intramuscular fat (IMF) and intramuscular connective tissue (IMC) are often seen in human myopathies and are central to beef quality. The mechanisms regulating their accumulation remain poorly understood. Here, we explored the possibility of using beef cattle as a novel model for mechanistic studies of intramuscular adipogenesis and fibrogenesis.

Methods: Skeletal muscle single-cell RNAseq was performed on three cattle breeds, including Wagyu (high IMF), Brahman (abundant IMC but scarce IMF), and Wagyu/Brahman cross. Sophisticated bioinformatics analyses, including clustering analysis, gene set enrichment analyses, gene regulatory network construction, RNA velocity, pseudotime analysis, and cell-cell communication analysis, were performed to elucidate …

Virtual Surgical Planning In Craniomaxillofacial Surgery: A Structured Review, Kaye Verlarde, Rentor Cafino, Armando Isla Jr., Karen Mae Ty, Xavier-Lewis Palmer, Lucas Potter, Larry Nadorra, Luchin Valrian Pueblos, Lemuel Clark Velasco

Electrical & Computer Engineering Faculty Publications

Craniomaxillofacial (CMF) surgery is a challenging and very demanding field that involves the treatment of congenital and acquired conditions of the face and head. Due to the complexity of the head and facial region, various tools and techniques were developed and utilized to aid surgical procedures and optimize results. Virtual Surgical Planning (VSP) has revolutionized the way craniomaxillofacial surgeries are planned and executed. It uses 3D imaging computer software to visualize and simulate a surgical procedure. Numerous studies were published on the usage of VSP in craniomaxillofacial surgery. However, the researchers found inconsistency in the previous literature which prompted the …

Pinch Force Generation During Scaling By Dental Professionals: A Systematic Review, Jessica R. Suedbeck, Emily A. Ludwig

Dental Hygiene Faculty Publications

Objective

The objective of this review was to examine the impact of instrument designs on pinch force generation during scaling by dental professionals.

Methods

Three databases were utilized from September 2019 to November 2021 in addition to hand-searching specific journals and reference lists. Research articles that examined pinch force generation in dental professionals during scaling with manual instruments only were included. Bias was assessed in the individual articles.

Results

Six research articles were included with sample populations that varied from 12 to 24 participants. Four articles evaluated instrument designs in relation to pinch force generation during scaling by dental professionals. …

Gene Expression Under Combined Hypoxia And Acidosis In Chondrosarcoma, Michael Stacey, Kostika Vangjeli, Christopher Osgood

Bioelectrics Publications

Chondrosarcomas are the second most common cause of bone cancer and are removed surgically with wide margins. On recurrence, they are resistant to chemo and radiation therapy and new treatment options are critically required. This tumor type produces hyaline cartilage, a cartilage normally formed under hypoxic and acidic environment due to lack of vasculature in cartilage. Paradoxically, chondrosarcomas arise in the well vascularized, oxygen rich environment of the bone. Hypoxia and acidosis are two stressors where the cellular effects are typically reported separately even though cells experience combined effects of hypoxia and acidosis. Given the mechanistic links between hypoxia and …

Corticospinal Activity During A Single-Leg Stance In People With Chronic Ankle Instability, Masafumi Terada, Kyle B. Kosik, Ryan S. Mccann, Colin Drinkard, Phillip A. Gribble

Rehabilitation Sciences Faculty Publications

Purpose: The aim of the study was to determine whether corticospinal excitability and inhibition of the tibialis anterior during single-leg standing differs among individuals with chronic ankle instability (CAI), lateral ankle sprain copers, and healthy controls.

Methods: Twenty-three participants with CAI, 23 lateral ankle sprain copers, and 24 healthy control participants volunteered. Active motor threshold (AMT), normalized motor-evoked potential (MEP), and cortical silent period (CSP) were evaluated by transcranial magnetic stimulation while participants performed a single-leg standing task.

Results: Participants with CAI had significantly longer CSP at 100% of AMT and lower normalized MEP at 120% of AMT compared to …

The Influence Of Shoe And Cleat Type On Lower Extremity Muscle Activation In Youth Baseball Pitchers, Jacob R. Gdovin, Chip Wade, Lauren A. Luginsland, Charles C. Williams, Riley Galloway, John C. Garner

Human Movement Sciences & Special Education Faculty Publications

Background: Baseball pitching is a dynamic movement where the lower extremities generate and sequentially transfer energy to the upper extremities to maximize ball velocity. The need for lower body muscular strength to produce adequate push-off and landing forces has been documented; however, the influence footwear and surface inclination has on muscle activation remains unknown.

Objectives: Determine how pitching in molded cleats and turf shoes from a pitching mound and flat ground affects stride-leg muscle activation in youth baseball pitchers while determining percent activation during each pitching phase.

Methods: Cross – sectional study analyzing mean muscle activity and percent activation of …

Perceived Instability, Pain, And Psychological Factors Predict Function And Disability In Individuals With Chronic Ankle Instability, Ashley M.B. Suttmiller, Julie M. Cavallario, Shelby E. Baez, Jessica C. Martinez, Ryan S. Mccann

Rehabilitation Sciences Faculty Publications

Context:

Chronic ankle instability (CAI) is associated with residual instability, pain, decreased function, and increased disablement. Injury-related fear has been associated with CAI, although its relationship to other impairments is unclear. The Fear-Avoidance Model is a theoretical framework hypothesizing a relationship between injury-related fear, chronic pain, pain catastrophizing, and disability. It has been useful in understanding fear's influence in other musculoskeletal conditions but has yet to be studied in those with CAI.

Objective:

To explore relationships between instability, pain catastrophizing, injury-related fear, pain, ankle function, and global disability in individuals with CAI.

Design:

Cross-Sectional Study

Setting:

Anonymous online survey

Patients …

The Effect Of Concussion History On Lower Extremity Injury Risk In College Athletes: A Systematic Review And Meta Analysis, Vanessa Ramirez, Ryan Mccann, Eric Schussler, Jessica Martinez

Rehabilitation Sciences Faculty Publications

INTRODUCTION: Collegiate athletes who suffer a concussion may possess prolonged impairments even after clearance for return-to-participation, which may place them at an increased risk of lower extremity injury.

OBJECTIVE: To conduct a systematic review and meta-analysis of studies examining risk of lower extremity musculoskeletal injury following a concussion in collegiate athletes.

METHODS: A literature search was performed using the following databases: PubMed, CINAHL, SPORTDiscus. The following search terms were used to identify relevant articles, ["concussion" OR "brain injury" OR "mild traumatic brain injury" OR "mTBI"] AND ["lower extremity injury" OR "musculoskeletal injury"]. Articles were included if they were published between …

Gene Electrotransfer Of Fgf2 Enhances Collagen Scaffold Biocompatibility, Carly Boye, Kyle Cristensen, Kamal Asadipour, Scott Declemente, Michael Francis, Anna Bulysheva

Electrical & Computer Engineering Faculty Publications

Tendon injuries are a common athletic injury that have been increasing in prevalence. While there are current clinical treatments for tendon injuries, they have relatively long recovery times and often do not restore native function of the tendon. In the current study, gene electrotransfer (GET) parameters for delivery to the skin were optimized with monophasic and biphasic pulses with reporter and effector genes towards optimizing underlying tendon healing. Tissue twitching and damage, as well as gene expression and distribution were evaluated. Bioprinted collagen scaffolds, mimicking healthy tendon structure were then implanted subcutaneously for biocompatibility and angiogenesis analyses when combined with …

Automatic Generation And Novel Validation Of Patient-Specific, Anatomically Inclusive Scoliosis Models For Biomechanics-Informed Surgical Planning, Austin Tapp, Michel Audette, James Bennett

College of Engineering & Technology (Batten) Posters

Scoliosis is an abnormal spinal curvature of greater than 10 degrees. Severe scoliotic deformities are addressed with highly invasive procedures: anterior or posterior spinal fusion approaches. This invasiveness is due, in part, to the constraints of current surgical planning, which utilizes computed tomography (CT) scans unable to discern spinal ligaments that are dissected to make the spine sufficiently compliant for correction. If localization of ligaments and soft tissues were achieved pre-operatively, corrective procedures could become safer and more efficient by using finite element (FE) biomechanical simulations to determine decreased incidences of ligament releases. This research aims to achieve ligament localization …

Musculoskeletal Modeling Of The Pelvis And Lumbar Spine During Running, Ruth Higgins, Maryam Moeini, Hunter Bennett, Stacie Ringleb

College of Engineering & Technology (Batten) Posters

Musculoskeletal modeling provides an alternative to in-vivo characteristics that are difficult to directly measure for movements such as running, especially for trunk muscles and joints. The full-body-lumbar-spine (FBLS) model by Raabe and Chaudhari, 2016 is an OpenSim model created for simulations of jogging. The lifting full-body (LFB) model by Beaucage-Gauvreau et al., 2018 is an adaptation of the FBLS created for estimating spinal loads during lifting. PURPOSE: Determine validity of the FBLS and LFB models in simulating pelvis and lumbar spine kinematics during running. METHODS: Inverse Kinematics were executed using experimental data for the FBLS and LFB models. To …

Comprehensive Collagen Crosslinking Comparison Of Microfluidic Wet-Extruded Microfibers For Bioactive Surgical Suture Development, Amrita Dasgupta, Nardos Sori, Stella Petrova, Yas Maghdouri-White, Nick Thayer, Nathan Kemper, Seth Polk, Delaney Leathers, Kelly Coughenour, Jake Dascoli, Riya Palikonda, Connor Donahue, Anna A. Bulysheva, Michael P. Francis

Bioelectrics Publications

Collagen microfiber-based constructs have garnered considerable attention for ligament, tendon, and other soft tissue repairs, yet with limited clinical translation due to strength, biocompatibility, scalable manufacturing, and other challenges. Crosslinking collagen fibers improves mechanical properties; however, questions remain regarding optimal crosslinking chemistries, biocompatibility, biodegradation, long-term stability, and potential for biotextile assemble at scale, limiting their clinical usefulness. Here, we assessed over 50 different crosslinking chemistries on microfluidic wet-extruded collagen microfibers made with clinically relevant collagen to optimize collagen fibers as a biotextile yarn for suture or other medical device manufacture. The endogenous collagen crosslinker, glyoxal, provides extraordinary fiber ultimate tensile …

The Influence Of Sonographer Experience On Skeletal Muscle Image Acquisition And Analysis, Joshua C. Carr, Gena R. Gerstner, Caleb C. Voskuil, Joel E. Harden, Dustin Dunnick, Kristin M. Badillo, Jason I. Pagan, Kylie K. Harmon, Ryan M. Girts, Jonathan P. Beausejour, Matt S. Stock

Human Movement Sciences & Special Education Faculty Publications

The amount of experience with ultrasonography may influence measurement outcomes while images are acquired or analyzed. The purpose of this study was to identify the interrater reliability of ultrasound image acquisition and image analysis between experienced and novice sonographers and image analysts, respectively. Following a brief hands-on training session (2 h), the experienced and novice sonographers and analysts independently performed image acquisition and analyses on the biceps brachii, vastus lateralis, and medial gastrocnemius in a sample of healthy participants (n = 17). Test–retest reliability statistics were computed for muscle thickness (transverse and sagittal planes), muscle cross-sectional area, echo intensity and …

Lumbopelvic Stability And Trunk Muscle Contractility Of Individuals With Chronic Ankle Instability, Ryan S. Mccann, Kelly Johnson, Ashley M.B. Suttmiller

Rehabilitation Sciences Faculty Publications

BACKGROUND: Chronic ankle instability (CAI) results in hip neuromuscular impairments that can perpetuate dysfunction through reduced lumbopelvic stability and subsequent malpositioning of the lower body during functional movement. Lumbopelvic stability might be further impaired through changes in trunk muscular contractility. However, lumbopelvic stability and trunk muscle morphology have not been compared between individuals with and without CAI.

PURPOSE: To compare lumbopelvic stability and trunk muscle contractility between individuals with and without chronic ankle instability (CAI) and determine if lumbopelvic stability and trunk muscle contractility are associated with self-reported function.

STUDY DESIGN: Case-control study.

METHODS: Ten individuals with CAI, 10 …

Wearing Knee Sleeves During Back Squats Does Not Improve Mass Lifted Or Affect Knee Biomechanics, Hunter J. Bennett, Alexandria Trypuc, Kevin A. Valenzuela, Zachary A. Sievert

Human Movement Sciences & Special Education Faculty Publications

Purpose:
Knee sleeves have become widely popular in the exercise realm, especially for knee support during back squats. Knee sleeves are successful in providing frontal plane knee support during functional tasks, but have not been investigated in back squats. Knee wraps, a somewhat similar elastic material, provide elastic energy that increases weight lifted during back squats. Thus, it is possible the thick neoprene knee sleeves could prove advantageous for back squats. The purpose of this study was to examine the effects of knee sleeves on weight lifted, knee biomechanics, and muscle activations during back squats.

Methods:
Fifteen resistance trained men …

Promote Ergonomic Health, Amber W. Hunt, Kimberly B. Lintag-Nguyen

Dental Hygiene Faculty Publications

A wide array of interventions and therapies is available to help dental hygienists stay healthy and reduce pain.

Surgical Gps Proof Of Concept For Scoliosis Surgery, Austin Tapp, Michel Audette

Computational Modeling & Simulation Engineering Faculty Publications

Scoliotic deformities may be addressed with either anterior or posterior approaches for scoliosis correction procedures. While typically quite invasive, the impact of these operations may be reduced through the use of computer-assisted surgery. A combination of physician-designated anatomical landmarks and surgical ontologies allows for real-time intraoperative guidance during computer-assisted surgical interventions. Predetermined landmarks are labeled on an identical patient model, which seeks to encompass vertebrae, intervertebral disks, ligaments, and other soft tissues. The inclusion of this anatomy permits the consideration of hypothetical forces that are previously not well characterized in a patient-specific manner. Updated ontologies then suggest procedural directions throughout …

Deformable Multisurface Segmentation Of The Spine For Orthopedic Surgery Planning And Simulation, Rabia Haq, Jérôme Schmid, Roderick Borgie, Joshua Cates, Michel Audette

Computational Modeling & Simulation Engineering Faculty Publications

Purpose: We describe a shape-aware multisurface simplex deformable model for the segmentation of healthy as well as pathological lumbar spine in medical image data.

Approach: This model provides an accurate and robust segmentation scheme for the identification of intervertebral disc pathologies to enable the minimally supervised planning and patient-specific simulation of spine surgery, in a manner that combines multisurface and shape statistics-based variants of the deformable simplex model. Statistical shape variation within the dataset has been captured by application of principal component analysis and incorporated during the segmentation process to refine results. In the case where shape statistics hinder detection …

Quality Of Life Of Adults With Chronic Spinal Cord Injury In Mainland China: A Cross-Sectional Study, Fengshui Chang, Haixia Xie, Qi Zhang, Mei Sun, Yuhui Yang, Gang Chen, Huifang Wang, Chengyue Li, Jun Lu

Community & Environmental Health Faculty Publications

Objective: To evaluate the quality of life of patients with chronic spinal cord injury in mainland China.

Design: Cross-sectional study. Subjects: A total of 247 adults ≥ 1 year post-SCI in mainland China.

Methods: The World Health Organization (WHO) Quality of Life Scale Brief Version (WHOQOL-BREF) and the add-on modules on disability-related QoL (WHOQOL-DIS) were used to assess quality of life. Anxiety/depression was measured using the Zung Self-Rating Anxiety/Depression Scale. Quality of life was compared with that of reference populations from China, Korea, the international field trial (23 countries). Multivariate linear regression was conducted to determine the factors that might …

The Additive Effects Of Cell Phone Use And Dental Hygiene Practice On Finger Muscle Strength: A Pilot Study, Jessica R. Suedbeck, Cortney N. Armitano-Lago, Emily A. Ludwig

Dental Hygiene Faculty Publications

Purpose: The purpose of this study was to determine strength of muscles involved with instrumentation (scaling) by dental hygienists and the additive effects of cellular (mobile) phone usage, as indicated by measurements of muscular force generation.

Methods: A convenience sample of licensed dental hygienists currently in clinical practice (n=16) and an equal number of individuals not currently using devices/tools repetitively for work (n=16), agreed to participate in this pilot study. All participants completed a modified cell phone usage questionnaire to determine their use pattern and frequency. Upon completion of the questionnaire, participants' force production in six muscle groups was measured …

Abnormal Response Of Costal Chondrocytes To Acidosis In Patients With Chest Wall Deformity, A. Asmar, Iurii Semenov, R. Kelly Jr., Michael Stacey

Bioelectrics Publications

Costal cartilage is much understudied compared to the load bearing cartilages. Abnormally grown costal cartilages are associated with the inherited chest wall deformities pectus excavatum and pectus carinatum resulting in sunken or pigeon chest respectively. A lack of understanding of the ultrastructural and molecular biology properties of costal cartilage is a major confounder in predicting causes and outcomes of these disorders. Due to the avascular nature of cartilage, chondrocytes metabolize glycolytically, producing an acidic environment. During physical activity hydrogen ions move within cartilage driven by compressive forces, thus at any one time, chondrocytes experience transient changes in pH. A variety …

The Role Of Neck Musculature In Traumatic Brain Injuries In Older Adults: Implications From Sports Medicine, Tyler A. Wood, Steven Morrison, Jacob J. Sosnoff

Rehabilitation Sciences Faculty Publications

Traumatic brain injuries (TBIs) are common and serious injuries to older adults. The majority of TBIs in older adults are sustained when the head impacts the ground or other surface during a fall. While several non-modifiable risk factors have been identified for fall-related TBIs in older adults, there still remains a dearth of knowledge surrounding modifiable risk factors. Thus, this significant knowledge gap warrants an investigation into research across disciplines. The sports medicine literature has examined several modifiable risk factors to prevent a mild form of TBI known as concussion. While this research has identified several risk factors, one particular …

Walking Biomechanics And Energetics Of Individuals With A Visual Impairment: A Preliminary Report, Hunter J. Bennett, Kevin A. Valenzuela, Kristina Fleenor, Steven Morrison, Justin A. Haegele

Human Movement Sciences & Special Education Faculty Publications

Purpose.

Although walking gait in sighted populations is well researched, few studies have investigated persons with visual impairments (VIs). Given the lack of physical activity in people with VIs, it is possible that reduced efficiency in walking could adversely affect activity. The purposes of this preliminary study were to (1) examine the biomechanics and energetics utilized during independent and guided walking in subjects with VIs, and (2) compare gait biomechanics between people with VIs and sighted controls.

Methods.

Three-dimensional motion capture and force platforms were used during independent and guided walking at self-selected speeds. Joint angles, moments, external work, and …

Prevalence Of Low Back Pain Among Adolescents In Relation To The Weight Of School Bags, Fatemah Akbar, Muneera Albesharah, Jumana Al-Baghli, Farah Bulbul, Dana Mohammad, Bann Qadoura, Abdullah Al-Taiar

Community & Environmental Health Faculty Publications

Background

The association between the weight of school bag and Low Back Pain (LBP) amongst students remains under intense debate worldwide. This study aimed to estimate the prevalence of LBP amongst public high school students (14 to 19 years) in Kuwait and to investigate the association between LBP and the weight of school bags.

Methods

An analytical cross-sectional study using multistage cluster random sampling with probability proportional to size was conducted on a total of 950 public high school students from all governorates. Data on LBP were collected through face-to-face interviews using a structured questionnaire. A 0–10 Numeric Pain Rating …

Use Of An Optical Scanning Device To Monitor The Progress Of Noninvasive Treatments For Chest Wall Deformity: A Pilot Study, Robert E. Kelly Jr., Robert J. Obermeyer, Ann Kuhn, Frazier W. Frantz, Mohammad F. Obeid, Nahom Kidane, Frederic D. Mckenzie

Computational Modeling & Simulation Engineering Faculty Publications

Background: The nonsurgical treatment of chest wall deformity by a vacuum bell or external brace is gradual, with correction taking place over months. Monitoring the progress of nonsurgical treatment of chest wall deformity has relied on the ancient methods of measuring the depth of the excavatum and the protrusion of the carinatum. Patients, who are often adolescent, may become discouraged and abandon treatment. Methods: Optical scanning was utilized before and after the intervention to assess the effectiveness of treatment. The device measured the change in chest shape at each visit. In this pilot study, patients were included if they were …

Effects Of Gait Speed Of Femoroacetabular Joint Forces, Joshua T. Weinhandl, Bobbie S. Irmisher, Zachary A. Sievert

Human Movement Sciences & Special Education Faculty Publications

Alterations in hip joint loading have been associated with diseases such as arthritis and osteoporosis. Understanding the relationship between gait speed and hip joint loading in healthy hips may illuminate changes in gait mechanics as walking speed deviates from preferred. The purpose of this study was to quantify hip joint loading during the gait cycle and identify differences with varying speed using musculo skeletal modeling. Ten, healthy, physically active individuals performed walking trials at their preferred speed, 10% faster, and 10% slower. Kinematic, kinetic, and electromyographic data were collected and used to estimate hip joint force via a musculoskeletal model. …

Enhanced Osseous Integration Of Human Trabecular Allografts Following Surface Modification With Bioactive Lipids, Tiffany Wang, Jack Krieger, Cynthia Huang, Anusuya Das, Michael P. Francis, Roy Ogle, Edward Botchwey

School of Medical Diagnostics & Translational Sciences Faculty Publications

In this study, we used extracellular matrix (ECM) gels and human bone allograft as matrix vehicles to deliver the sphingolipid growth factor FTY720 to rodent models of tibial fracture and a critical-sized cranial defect. We show that FTY720 released from injectable ECM gels may accelerate callous formation and resolution and bone volume in a mouse tibial fracture model. We then show that FTY720 binds directly to human trabecular allograft bone and releases over 1 week in vitro. Rat critical-sized cranial defects treated with FTY720-coated grafts show increases in vascularization and bone deposition, with histological and micro-computed topography (microCT) evidence of …

Comparison Of Corded And Cordless Handpieces On Forearm Muscle Activity, Procedure Time And Ease Of Use During Simulated Tooth Polishing, Gayle Mccombs, Daniel M. Russell

Dental Hygiene Faculty Publications

Purpose: Dental professionals suffer from a high prevalence of work-related musculoskeletal disorders (MSD). Dental hygienists in particular have a high prevalence of pain in the forearms and hands. The objective of this study was to compare 1 cordless handpiece to 2 corded handpieces during simulated tooth polishing in terms of the muscle loads (recorded as electromyography (EMG) activity), duration of polishing procedure, and dental hygienist opinion about ease of use. Methods: EMG was used to quantify muscle electrical activity of 4 forearm muscles during simulated dental polishing with 2 corded handpieces (HP-A and HP-B) and 1 cordless handpiece (HP-C). A …