Characteristics of muscle fatigue in patients with myofascial pain-dysfunction syndrome.

The purpose of this study was to compare the properties of muscle fatigue in the masseter and temporalis muscles of normal individuals and those with myofascial pain-dysfunction syndrome (MPD). The MPD muscle is presumed to have different characteristics of fatigue than its healthy counterpart; these characteristics can be quantitated using standard electromyogram (EMG) signal-processing techniques. A total of 18 patients diagnosed as having MPD comprised the experimental group and 15 adults with no history or present symptoms of temporomandibular joint pain and dysfunction served as controls. Surface EMG recordings were made for both the masseter and anterior temporalis muscles while the subject held an incisal bite force level of 10 N for as long as possible. The EMG data were transferred to a microcomputer where the power-density spectrum of the signals were calculated for 2-s samples at 10-s intervals. The mean power frequency (MPF) and power (root mean square, r.m.s.) of the signals were calculated from the power-density spectra. Results showed: (1) the endurance times were significantly shorter for the MPD patients; (2) the masseter was not active in three of 17 MPD patients; (3) decreases in MPF over time were significantly greater for the MPD patients than normal subjects; (4) increases in r.m.s. power were significantly greater over time for the MPD patients; (5) bandwidths of the power-density spectra were similar for the two groups. The implication of these results is the MPD muscle is not in a state of constant fatigue, as is currently believed, but rather demonstrates accelerated fatigue.