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Nota A, Pittari L, Lannes AC, Vaghi C, Calugi Benvenuti C, Tecco S. Analysis of Cervical Range of Motion in Subjects Affected by Temporomandibular Disorders: A Controlled Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:37. [PMID: 38256297 PMCID: PMC10819167 DOI: 10.3390/medicina60010037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024]
Abstract
Background and Objectives: The aim of this study were to compare the cervical ROM data obtained from accelerometer exams between patients suffering from TMDs (study group) and healthy patients (control group). Material and Methods: A sample of 43 young adult subjects (23 control subjects and 20 TMD patients) were included in this study and analyzed with the accelerometer (Baiobit™, BTS, Garbagnate Milanese, Milan, Italy) to assess cervical ROM using a standardized protocol, including the following occlusal conditions: mandibular rest position, clenching, clenching with cotton rolls, maximal intercuspation, and mandibular position with cotton rolls. The cervical ROM was measured in degrees and expressed as the mean and standard deviation. Results: TMD patients showed a reduced cervical extension compared to control subjects in all the conditions, with statistically significant relevance. Regarding the other movements, the differences were not statistically or clinically significant. Conclusions: Based on the results of the present study, it can be observed that temporomandibular disorders are associated with a decreased cervical extension range, while the remaining components of ROM do not seem to be significantly associated. The use of accelerometers in ROM analysis could be helpful in improving interdisciplinary communication between dentists and physiotherapists.
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Affiliation(s)
- Alessandro Nota
- Dental School, Vita-Salute San Raffaele University and Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy; (L.P.); (A.C.L.); (C.V.); (C.C.B.); (S.T.)
| | - Laura Pittari
- Dental School, Vita-Salute San Raffaele University and Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy; (L.P.); (A.C.L.); (C.V.); (C.C.B.); (S.T.)
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences (MeSVA), University of L’Aquila, 24100 L’Aquila, Italy
| | - Alessia Claudia Lannes
- Dental School, Vita-Salute San Raffaele University and Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy; (L.P.); (A.C.L.); (C.V.); (C.C.B.); (S.T.)
| | - Chiara Vaghi
- Dental School, Vita-Salute San Raffaele University and Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy; (L.P.); (A.C.L.); (C.V.); (C.C.B.); (S.T.)
| | - Clarissa Calugi Benvenuti
- Dental School, Vita-Salute San Raffaele University and Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy; (L.P.); (A.C.L.); (C.V.); (C.C.B.); (S.T.)
| | - Simona Tecco
- Dental School, Vita-Salute San Raffaele University and Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy; (L.P.); (A.C.L.); (C.V.); (C.C.B.); (S.T.)
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Nota A, Pittari L, Gamba L, Monticciolo FM, Lannes A, Carta C, Beraldi A, Baldini A, Marzo G, Tecco S. Cervical Range of Motion Analysis Performed with an Accelerometer: A Study of Intersession Reliability for Dental Practice. Healthcare (Basel) 2023; 11:healthcare11101428. [PMID: 37239714 DOI: 10.3390/healthcare11101428] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/09/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
During the clinical examination of subjects with temporomandibular disorders (TMDs), the dentist sometimes must evaluate the cervical spine, due to the anatomical and functional connections between the cervical portion of the spine and the stomatognathic apparatus. The accelerometer is a device that evaluates the Range of Motion (ROM) of the main movements of the head on the neck. To date, only a few studies have investigated the repeatability of the use of the accelerometer in the assessment of cervical ROM. Therefore, the present longitudinal observational study analyzed the repeatability of acquired cervical movements on a sample of volunteer subjects who underwent accelerometer testing. A sample of 32 subjects was tested twice within 14 days to assess cervical ROM using a standardized protocol based on a review of existing literature. The results show that the examination is reliable for all the positions of the jaw, except for the parameters regarding the asymmetries of rotation and bending. In conclusion, the accelerometer can be considered a reliable tool for evaluating the active cervical ROM. However, further studies will be necessary to make better evaluations.
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Affiliation(s)
- Alessandro Nota
- Dental School, Vita-Salute San Raffaele University and Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
| | - Laura Pittari
- Dental School, Vita-Salute San Raffaele University and Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences (MeSVA), University of L'Aquila, 24100 L'Aquila, Italy
| | - Laura Gamba
- Dental School, Vita-Salute San Raffaele University and Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
| | - Francesco Manfredi Monticciolo
- Dental School, Vita-Salute San Raffaele University and Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
| | - Alessia Lannes
- Dental School, Vita-Salute San Raffaele University and Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
| | - Carlotta Carta
- Dental School, Vita-Salute San Raffaele University and Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
| | | | | | - Giuseppe Marzo
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences (MeSVA), University of L'Aquila, 24100 L'Aquila, Italy
| | - Simona Tecco
- Dental School, Vita-Salute San Raffaele University and Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
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Ioniță C, Petre AE, Cononov RS, Covaleov A, Mitoiu BI, Nica AS. Methods of postural analysis in connection with the stomatognathic system. A systematic review. J Med Life 2023; 16:507-514. [PMID: 37305821 PMCID: PMC10251373 DOI: 10.25122/jml-2022-0327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/22/2023] [Indexed: 06/13/2023] Open
Abstract
This systematic review aimed to identify the main tools used to analyze the relationship between the postural and stomatognathic systems. The study followed the PRISMA guidelines, and data were collected from Science Direct and PubMed databases to identify articles published until December 2022. After applying inclusion and exclusion criteria, 26 articles were selected from the initial 903 articles. The selected articles were full-text studies in English or Romanian, examining the relationship between dental occlusion and posture, measuring postural parameters using various tools, implementing occlusal changes, evaluating patients with permanent dentition, or analyzing the connection between occlusion and posture in a unidirectional manner. The findings indicate that orthognathic surgery and orthodontic mouthguards can significantly enhance postural balance and athletic performance. In addition, 63% of the studies concluded that varying modifications and occlusal conditions impact posture. Notable differences exist concerning posture and Angle dental occlusion classes, and different occlusal devices used to simulate malocclusion can affect patients' postural systems in response to external stimuli. The stabilometry platform is the predominant method for measuring postural parameters; however, other researchers have employed raster stereography, photogrammetry, mobile phone apps, and the Fukuda-Unterberger test. Consequently, interventions targeting the stomatognathic system should consider potential variations in the postural system.
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Affiliation(s)
- Cezar Ioniță
- Department of Occlusion and Fixed Prosthodontics, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - Alexandru Eugen Petre
- Department of Occlusion and Fixed Prosthodontics, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - Roxana-Simina Cononov
- Department of Restorative Odontotherapy, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - Anatoli Covaleov
- Department of Rehabilitation, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - Brindusa Ilinca Mitoiu
- Department of Rehabilitation, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - Adriana Sarah Nica
- Department of Rehabilitation, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
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Zárate-Tejero C, Hidalgo-García C, Lucha-López O, Hernández-Secorún M, Krauss J, Rodríguez-Rubio P. Association between age, sex and cervical and upper cervical rotation tests. Descriptive and correlational study in healthy volunteers. Ther Adv Chronic Dis 2023; 14:20406223231170158. [PMID: 37152351 PMCID: PMC10155033 DOI: 10.1177/20406223231170158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/29/2023] [Indexed: 05/09/2023] Open
Abstract
Background Active cervical spine rotation (ACROM Rot) shows cervical rotation and flexion rotation test (FRT); side-bending rotation test (SBRT) and upper cervical axial rotation test (C0-C2ART) are described to measure upper cervical rotation. The objectives of this study are (1) to describe the normal range of motion (ROM) of ACROM Rot, and the ROM in FRT, SBRT and C0-C2ART tests; (2) to explore the correlation among the four tests and (3) to investigate the influence of age and sex in their ROM. Methods A cross-sectional study was carried out with healthy volunteers from 18 to 75 years of age. Tests were measured using a CROM device and a bubble inclinometer. Descriptive analysis was performed to establish normative data for the ROM tests. Correlation analysis was conducted to understand the relation between upper and global cervical rotation ROM and among the three upper cervical rotation tests. Linear regression models were developed to understand the influence of age and sex in the ROM of all tests. Results Normative values were obtained from 122 healthy volunteers (50% male), by sex and age strata. The degree of correlation ranged between 0.582 (p < 0.01) for FRT and ACROM Rot left and 0.217 (p < 0.05) for SBRT and C0-C2ART left. Linear regression models showed the influence of sex for ACROM Rot right (men -4.64° less than women), SBRT (men -4.1° less than women) left and C0-C2ART right and left (men -2.24° and -1.78° less than women). The age influenced rotation ROM with a decrease for every 10 years of -2.11° and -1.96° for ACROM Rot right and left, of -1.72° and -1.26° for FRT right and left and -0.58° and -0.41° for C0-C2ART right and left in the linear regression models. No association was found between age and SBRT (p = 0.63 for right SBRT and p = 0.49 for left SBRT). Conclusion Weak-to-moderate correlation was found between the upper cervical spine rotation tests and with the ACROM. Women had a larger ROM in ACROM Rot right, SBRT left and C0-C2ART. Decreases in ROM related with age were observed for ACROM Rot, FRT and C0-C2ART but not for SBRT.
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Affiliation(s)
- Carlos Zárate-Tejero
- Physiotherapy Department, Faculty of Medicine
and Health Sciences, Universitat Internacional de Catalunya, Barcelona,
Spain
| | | | | | - Mar Hernández-Secorún
- Unidad de Investigación en Fisioterapia,
Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza,
Spain
| | - John Krauss
- School of Health Sciences, Oakland University,
Rochester, MI, USA
| | - Pere Rodríguez-Rubio
- Physiotherapy Department, Faculty of Medicine
and Health Sciences, Universitat Internacional de Catalunya, Barcelona,
Spain
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Satpute KH, Parekh K, Hall TM. The C0-C2 axial rotation test - Reliability and correlation with the flexion rotation test in people with cervicogenic headache and migraine. Musculoskelet Sci Pract 2021; 51:102286. [PMID: 33187891 DOI: 10.1016/j.msksp.2020.102286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/28/2020] [Accepted: 11/01/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The C0-C2 axial rotation test is a measure of upper cervical range of motion (UCROM), reported to be reliable in a headache free population. The objective was to determine the intra- and inter-rater reliability of the C0-C2 axial rotation test in people with a diagnosis of cervicogenic headache (CGH) or episodic migraine. METHODS Two therapists independently evaluated UCROM during the C0-C2 axial rotation test and flexion-rotation test (FRT) with an iPhone in 70 subjects (mean age 37.7 SD 11.6 years) with a diagnosis of CGH (35 subjects) or episodic migraine (35 subjects) on two occasions. Measurement procedures were standardized; and the order of testing randomized. RESULTS Reliability of the C0-C2 axial rotation test was moderate to high (ICC > 0.70). The standard error of measurement and minimum detectable change for this test were at most 2°. In subjects with CGH mean UCROM to the most restricted side was 9.3° (1.9) and 8.8° (2.1) for rater 1 and 2 respectively. While in patients with episodic migraine mean UCROM to the restricted side was 13.7° (1.6) and 13.6° (2.0) for rater 1 and 2 respectively. DISCUSSION The C0-C2 axial rotation test has at least moderate levels of reliability and correlates well with mobility determined by the FRT.
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Affiliation(s)
- Kiran H Satpute
- Department of Musculoskeletal Physiotherapy, Smt. Kashibai Navale College of Physiotherapy, Pune, Maharashatra, India.
| | - Krisha Parekh
- Department of Musculoskeletal Physiotherapy, Smt. Kashibai Navale College of Physiotherapy, Pune, Maharashatra, India.
| | - Toby M Hall
- School of Physiotherapy and Exercise Science, Curtin University, P.O. Box U1987, Perth, WA, 6845, Australia.
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The effect of tongue and suprahyoid muscles release in the treatment of chronic non-specific neck pain: Study protocol for a randomized controlled trial. INT J OSTEOPATH MED 2020. [DOI: 10.1016/j.ijosm.2020.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Keogh JWL, Cox A, Anderson S, Liew B, Olsen A, Schram B, Furness J. Reliability and validity of clinically accessible smartphone applications to measure joint range of motion: A systematic review. PLoS One 2019; 14:e0215806. [PMID: 31067247 PMCID: PMC6505893 DOI: 10.1371/journal.pone.0215806] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 04/09/2019] [Indexed: 12/01/2022] Open
Abstract
Measuring joint range of motion is an important skill for many allied health professionals. While the Universal Goniometer is the most commonly utilised clinical tool for measuring joint range of motion, the evolution of smartphone technology and applications (apps) provides the clinician with more measurement options. However, the reliability and validity of these smartphones and apps is still somewhat uncertain. The aim of this study was to systematically review the literature regarding the intra- and inter-rater reliability and validity of smartphones and apps to measure joint range of motion. Eligible studies were published in English peer-reviewed journals with full text available, involving the assessment of reliability and/or validity of a non-videographic smartphone app to measure joint range of motion in participants >18 years old. An electronic search using PubMed, Medline via Ovid, EMBASE, CINAHL, and SPORTSDiscus was performed. The risk of bias was assessed using a standardised appraisal tool. Twenty-three of the eligible 25 studies exceeded the minimum 60% score to be classified as a low risk of bias, although 3 of the 13 criteria were not achieved in >50% of the studies. Most of the studies demonstrated adequate intra-rater or inter-rater reliability and/or validity for >50% of the range of motion tests across all joints assessed. However, this level of evidence appeared weaker for absolute (e.g. mean difference ± limit of agreement, minimal detectable change) than relative (e.g. intraclass correlation, correlation) measures; and for spinal rotation than spinal extension, flexion and lateral flexion. Our results provide clinicians with sufficient evidence to support the use of smartphones and apps in place of goniometers to measure joint motion. Future research should address some methodological limitations of the literature, especially including the inclusion of absolute and not just relative reliability and validity statistics.
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Affiliation(s)
- Justin W. L. Keogh
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- Sports Performance Research Institute New Zealand (SPRINZ), AUT University, Auckland, New Zealand
- Cluster for Health improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
- * E-mail:
| | - Alistair Cox
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Sarah Anderson
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Bernard Liew
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Alicia Olsen
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Ben Schram
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
- Water Based Research Unit, Bond Institute of Health and Sport, Bond University, Gold Coast, QLD, Australia
| | - James Furness
- Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
- Water Based Research Unit, Bond Institute of Health and Sport, Bond University, Gold Coast, QLD, Australia
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Satpute K, Nalband S, Hall T. The C0-C2 axial rotation test: normal values, intra- and inter-rater reliability and correlation with the flexion rotation test in normal subjects. J Man Manip Ther 2018; 27:92-98. [PMID: 30935342 DOI: 10.1080/10669817.2018.1533195] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVES Impairment in upper cervical spine mobility is associated with cervicogenic headache severity and disability. Measures of such mobility include the flexion-rotation test (FRT), which requires full cervical flexion and may be influenced by lower cervical spine dysfunction. The C0-C2 axial rotation test also evaluates upper cervical mobility but normal values and reliability have not been reported. Our objective is to determine normal values, and intra-rater and inter-rater reliability of the C0-C2 axial rotation test. METHODS Two therapists independently evaluated the FRT and C0-C2 axial rotation test with an iPhone compass application on 32 asymptomatic subjects with mean age 40.53 (SD 11.64) years on two occasions. Measurement procedures were standardized; and order of testing randomized. RESULTS For the FRT and C0-C2 axial rotation test reliability was high (ICC > 0.88). For rater one, Mean range to the left during the FRT and C0-C2 axial rotation test was 45.0° (6.04) and 14.43° (2.94), respectively, while range to the right was 44.6° (6.57) and 15.44° (2.68). For the FRT and C0-C2 axial rotation test the standard error of measurement was at most 2°, while the minimum detectable change was at most 4°. A strong positive correlation exists between the FRT and C0-C2 axial rotation test (r = 0.84, P < 0.01). DISCUSSION The range recorded during the C0-C2 axial rotation test and FRT have high levels of reliability when evaluated using an iPhone. The strong correlation between the FRT and C0-C2 axial rotation test indicate that both may be measuring similar constructs, but each test needs to be referenced to normal values.
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Affiliation(s)
- Kiran Satpute
- a Department of Kinesiotherapy and Physical Diagnosis, Department of Musculoskeletal Physiotherapy , Smt. Kashibai Navale College of Physiotherapy , Pune , India
| | - Sadaf Nalband
- b Smt. Kashibai Navale College of Physiotherapy , Pune , India
| | - Toby Hall
- c School of Physiotherapy and Exercise Science , Curtin University , Perth , Australia.,d Faculty of Health & Medical Sciences , The University Of Western Australia , Perth , Australia
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Grondin F, Hall T. Changes in cervical movement impairment and pain following orofacial treatment in patients with chronic arthralgic temporomandibular disorder with pain: A prospective case series. Physiother Theory Pract 2016; 33:52-61. [PMID: 27911133 DOI: 10.1080/09593985.2016.1247934] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to investigate the influence of isolated temporomandibular joint (TMJ) manual therapy on pain and range of motion (ROM) of the TMJ and cervical spine including flexion-rotation test (FRT) in people suffering chronic pain arising from chronic arthralgic temporomandibular disorder (TMD). An experienced clinician managed a case series of 12 patients with TMD (mean duration 28.6 months +/- 26.9). The intervention comprised four-weekly sessions of transverse medial accessory TMJ mobilization and advice. Patients were examined prior to and one-week following the intervention period. Outcome measures included jaw disability (JFLS-20), jaw pain measured by Visual Analogue Scale (VAS), maximal mouth opening ROM, cervical ROM including FRT, and pain during cervical movement. A paired t-test revealed significant improvement following the intervention in disability (p < 0.001), VAS pain score at rest (p < 0.001) and at maximum mouth opening (p < 0.001), jaw opening ROM (p < 0.001), FRT ROM to the left (p = 0.024) and right (p = 0.001). In contrast, no significant change was identified for total cervical ROM (p = 0.905). After the intervention, five patients (41.66%) had no pain at rest or at maximal mouth opening, and all had a negative FRT. The effect sizes indicate a moderate to strong, clinically significant effect for all variables apart from total cervical ROM. While a case series cannot identify a cause and effect relationship, these results provide preliminary evidence for the influence of TMJ manual therapy on measures of TMD including pain, as well as upper but not whole cervical movement and associated pain in patients with a diagnosis of TMJ arthralgia.
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Affiliation(s)
- Francis Grondin
- a Laboratory of Anatomy , Bordeaux University , Bordeaux Cedex, France
| | - Toby Hall
- b School of Physiotherapy and Exercise Science , Curtin University of Technology , Perth , WA , Australia
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