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Bednarczyk V, Proulx F, Paez A. The effectiveness of cervical rehabilitation interventions for pain in adults with myogenic temporomandibular disorders: A systematic review and meta-analysis. J Oral Rehabil 2024; 51:1091-1107. [PMID: 38454576 DOI: 10.1111/joor.13671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 12/14/2023] [Accepted: 02/22/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE Little evidence exists for the most effective conservative treatment approach for adults with myogenic temporomandibular disorders (MTMD). We aim to assess the effectiveness of cervical rehabilitation interventions on pain intensity and sensitivity in adults with MTMD compared to comparison intervention such as placebo, sham treatment, education or no intervention. METHODS For this systematic review and meta-analysis, we searched PubMed, EMBASE, Medline, PEDro databases, forward and backward citations and grey literature studies through PROSPERO, clinical trials and data registries without language or date restrictions between inception and 1 December 2021. We selected randomised controlled trials (RCTs) based on adult populations with MTMD who had a cervical rehabilitation intervention which was defined as any conservative intervention targeting the anatomical structures of the cervical spine. The primary outcome measures for pain were self-reported pain intensity and pain sensitivity through the pressure pain threshold (PPT) of the masseter and temporalis muscles. Secondary outcome measures of maximal mouth opening (on MMO) were included. Included studies were assessed for bias with the Cochrane risk of bias tool for randomised trials. Evidence from RCTs was synthesised to determine treatment effect size as differences between standardised mean difference (SMD) for changes in pain intensity, PPT and MMO comparing adults with MTMD who were treated with cervical rehabilitation interventions compared to a control group. This study is registered on Prospero, number CRD 42021289299. RESULTS Our general search yielded 2647 studies where seven RCTs met eligibility criteria with low to some concerns in their risk of bias. Pain intensity (five studies, n = 223, SMD -0.98, 95% CI -1.67 to -0.28, I2 = 79%), PPT of the masseter muscle (six studies, n = 395, SMD 0.64, 95% CI 0.43 to 0.86, I2 = 90%) and the temporalis muscles (five studies, n = 295, SMD 0.76, 95% CI 0.07 to 1.45, I2 = 84%) showed large treatment effect estimates favouring cervical rehabilitation interventions compared to no treatment, sham cervical treatment, patient education or non-cervical neuromuscular techniques. Compared to control interventions, one type of cervical rehabilitation intervention, cervical manual therapy alone or in combination with a neck exercise program was associated with statistically significant, large treatment effect estimates on pain intensity (four studies, n = 203, SMD -1.52, 95% CI -2.50 to -0.55). CONCLUSIONS This review found that in the short-term, cervical rehabilitation interventions especially upper cervical MT alone or in combination with a neck exercise program are effective in improving multiple pain outcomes in adults with MTMD. However, further research is needed to measure the long-term effects of this type of intervention.
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Affiliation(s)
- Victoria Bednarczyk
- College of Professional Studies, Northeastern University, Boston, Massachusetts, USA
| | - François Proulx
- Oral and Maxillofacial Surgery Division, University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
| | - Arsenio Paez
- Bouvé College of Health Professions, Northeastern University, Boston, Massachusetts, USA
- Nuffield Department for Primary Care Health Sciences, University of Oxford, Oxford, UK
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Gençosmanoğlu H, Ünlüer NÖ, Akın ME, Demir P, Aydın G. An investigation of biomechanics, muscle performance, and disability level of craniocervical region of individuals with temporomandibular disorder. Cranio 2024; 42:232-242. [PMID: 34128775 DOI: 10.1080/08869634.2021.1938854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate biomechanics, muscle performance, and disability of the craniocervical region in temporomandibular disorder (TMD) patients and compare them with controls. METHODS Craniocervical posture was evaluated using lateral photography and radiography. Range of motion, muscle performance, disability, and TMD severity were assessed using an inclinometer, Functional Strength Testing of Cervical Spine, Neck Disability Index, and Fonseca Anamnestic Index, respectively. RESULTS Compared to the control group, the TMD group demonstrated higher cervical flexion angle (p=0.005) and neck disability (p<0.001) as well as lower cervical extension (p=0.040), right cervical rotation (p=0.005), left cervical rotation (p<0.001), and tragus-C7-horizontal (p=0.048) angles, and reduced muscle performances (p≤0.001). Most patients had higher than normal craniocervical angle (p<0.001). Muscle performance in each cervical motion (p<0.005) and disability (p<0.001) were associated with TMD severity in the TMD group. CONCLUSION Biomechanics, muscle performance, and disability of craniocervical region were altered in the TMD group.
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Affiliation(s)
- Harun Gençosmanoğlu
- Department of Physiotherapy & Rehabilitation, Faculty of Health Sciences, Avrasya University, Trabzon, Turkey
| | - Nezehat Özgül Ünlüer
- Department of Physiotherapy & Rehabilitation, Faculty of Health Sciences, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Mustafa Emre Akın
- Department of Radiology, Yenimahalle Training & Research Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Pervin Demir
- Department of Biostatistics & Medical Informatics, Ankara Yildirim Beyazit University Medical School, Ankara, Turkey
| | - Gülümser Aydın
- Department of Physical Medicine & Rehabilitation, Ankara Yildirim Beyazit University Medical School, Ankara, Turkey
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Didier HA, Cappellari AM, Sessa F, Giannì AB, Didier AH, Pavesi MM, Caria MP, Curone M, Tullo V, Di Berardino F, Iacona E, Lilli G, Barozzi S, Aldè M, De Bortoli G, Zanetti D, Arnone F, Bussone G. Somatosensory tinnitus and temporomandibular disorders: A common association. J Oral Rehabil 2023; 50:1181-1184. [PMID: 37335244 DOI: 10.1111/joor.13541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/16/2023] [Accepted: 06/11/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Although the association between tinnitus and temporo-mandibular disorders (TMD) has been frequently reported, their rate of association in the literature shows a great variability. OBJECTIVE We aimed to investigate the prevalence of TMD in patients with somatosensory tinnitus and, vice versa, the occurrence of somatosensory tinnitus in patients with TMD. METHODS The study included patients with somatosensory tinnitus (audiological group) and patients with TMD (stomatological group), evaluated at the audiologic and stomatologic clinics of the Policlinic Hospital of Milan, Italy. Common causes of tinnitus, such as hearing and neurological disorders, were excluded. A cervicogenic somatic tinnitus was also ruled out. Different TMD symptoms, including joint noise and joint pain, were considered. The collected data were analysed using descriptive statistical methods, and the Pearson's Chi-squared test was performed to study the prevalence of the different symptoms by clinical groups. RESULTS Audiological group included 47 patients with somatosensory tinnitus. Overall, TMD was diagnosed in 46 patients (97.8%), including TMJ noise in 37 (78.7%), clenching in 41 (87.2%) and pain in 7 (14.8%) patients. Stomatological group included 50 patients with TMD, including joint noise in 32 (64.0%), clenching in 28 (56.0%) and TMJ pain in 42 (84.0%) patients. A somatosensory tinnitus was diagnosed in 12 (24.0%) patients. CONCLUSION Our study showed a high prevalence of TMD in patients with tinnitus, as well as a not uncommon occurrence of tinnitus in patients presenting with TMD. The distribution of TMD symptoms, such as joint noise, and joint pain was different between the two groups.
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Affiliation(s)
- H A Didier
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico, Milan, Italy
- Department of Neuroscience, Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico, Milan, Italy
- UOC Hospital Pharmacy, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Istituto Stomatologico Italiano, Milan, Italy
| | - A M Cappellari
- Department of Neuroscience, Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico, Milan, Italy
| | - F Sessa
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico, Milan, Italy
| | - A B Giannì
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico, Milan, Italy
| | - A H Didier
- UOC Hospital Pharmacy, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M M Pavesi
- Istituto Stomatologico Italiano, Milan, Italy
| | - M P Caria
- CERISMAS (Research Centre in Health Care Management), Catholic University Milan, Milan, Italy
| | - M Curone
- Casa di Cura del Policlinico Igea Headache Center, Milan, Italy
| | - V Tullo
- Casa di Cura del Policlinico Igea Headache Center, Milan, Italy
| | - F Di Berardino
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - E Iacona
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - G Lilli
- Casa di Cura del Policlinico Igea Headache Center, Milan, Italy
| | - S Barozzi
- Casa di Cura del Policlinico Igea Headache Center, Milan, Italy
| | - M Aldè
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - G De Bortoli
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - D Zanetti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - F Arnone
- Azienda Ospedaliera Santi Paolo e Carlo, Milan, Italy
| | - G Bussone
- Casa di Cura del Policlinico Igea Headache Center, Milan, Italy
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İnal Ö. Investigation of the predictors of temporomandibular disorders in engineers across different variables: sociodemographic characteristics, neck pain and neck awareness. Somatosens Mot Res 2023:1-7. [PMID: 36939816 DOI: 10.1080/08990220.2023.2188931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
PURPOSE/AIM This study aimed to investigate the predictors of temporomandibular disorders (TMD) in desk-bound engineers. MATERIALS AND METHODS The Fonseca Anamnestic Index (FAI), The Visual Analogue Scale (VAS), The Neck Pain and Disability Scale (NPDS), Neck Bournemouth Questionnaire (NBQ) and The Fremantle Neck Awareness Questionnaire-Turkish (FreNAQ-T) were used for TMD severity, pain, disability, neck awareness. RESULTS The study was conducted with 208 desk-bound engineers. Mild-to-severe TMD was detected in 78.9% of the subjects. Intensity of pain at rest and during activity was higher in female engineers compared to male engineers (p = 0.002 and <0.01, respectively) and mean FAI, NBQ, NPDS and FreNAQ-T scores were also higher than that of male engineers (p = 0.005, 0.005, 0.006 and 0.016, respectively). FAI, VAS, NPDS, NBQ and FreNAQ-T were found to be correlated with each other (p < 0.05). A statistically significant contribution to the regression model was observed for the variables gender, daily duration of computer use, neck pain at rest, and NBQ (p = 0.043, p = 0.043, p = 0.031 and p = 0.003, respectively). NBQ was identified as the most influential variable in this model, followed by neck pain at rest. CONCLUSIONS Temporomandibular disorders are common among desk-bound engineers and are associated with neck pain, disability, and neck awareness. For this reason, it is important to take preventive and protective ergonomic approaches at the personal and institutional levels in desk-bound engineers.
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Affiliation(s)
- Özgü İnal
- University of Health Sciences Turkey, Faculty of Gülhane Physiotherapy and Rehabilitation, Department of Neurological Physiotherapy-Rehabilitation, Ankara, Turkey
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Budd AS, Huynh TKT, Seres P, Beaulieu C, Armijo-Olivo S, Cummine J. White Matter Diffusion Properties in Chronic Temporomandibular Disorders: An Exploratory Analysis. FRONTIERS IN PAIN RESEARCH 2022; 3:880831. [PMID: 35800990 PMCID: PMC9254396 DOI: 10.3389/fpain.2022.880831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/16/2022] [Indexed: 11/22/2022] Open
Abstract
Objective To determine differences in diffusion metrics in key white matter (WM) tracts between women with chronic temporomandibular disorders (TMDs) and age- and sex-matched healthy controls. Design Cross sectional study compared diffusion metrics between groups and explored their associations with clinical variables in subjects with TMDs. Methods In a total of 33 subjects with TMDs and 33 healthy controls, we performed tractography to obtain diffusion metrics (fractional anisotropy [FA], mean diffusivity [MD], radial diffusivity [RD], and axial diffusivity [AD]) from the cingulum near the cingulate gyrus (CGC), the cingulum near the hippocampus (CGH), the fornix, the anterior limb of the internal capsule (ALIC), the posterior limb of the internal capsule (PLIC), and the uncinate fasciculus (UF). We compared diffusion metrics across groups and explored the relationships between diffusion metrics and clinical measures (pain chronicity and intensity, central sensitization, somatization, depression, orofacial behavior severity, jaw function limitations, disability, and interference due to pain) in subjects with TMDs. Results We observed differences in diffusion metrics between groups, primarily in the right side of the brain, with the right CGC having lower FA and the right UF having lower FA and higher MD and RD in subjects with TMDs compared to healthy controls. No clinical measures were consistently associated with diffusion metrics in subjects with TMDs. Conclusion The UF showed potential microstructural damage in subjects with TMDs, but further studies are needed to confirm any associations between diffusion changes and clinical measures.
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Affiliation(s)
- Alexandra S. Budd
- Neuroscience and Mental Health Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Thi K. T. Huynh
- Faculty of Science, University of Alberta, Edmonton, AB, Canada
| | - Peter Seres
- Department of Biomedical Engineering, University of Alberta, Edmonton, AB, Canada
| | - Christian Beaulieu
- Department of Biomedical Engineering, University of Alberta, Edmonton, AB, Canada
| | - Susan Armijo-Olivo
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Faculty of Business and Social Sciences, University of Applied Sciences Osnabrück, Osnabrück, Germany
- Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- *Correspondence: Susan Armijo-Olivo
| | - Jacqueline Cummine
- Neuroscience and Mental Health Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
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Böthun A, Häggman-Henrikson B, Wiesinger B, Wänman A, Hellström F, Österlund C. Jaw-neck motor strategy during jaw-opening with resistance load. J Oral Rehabil 2021; 49:514-521. [PMID: 34878690 DOI: 10.1111/joor.13291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/23/2021] [Accepted: 12/03/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The jaw and neck motor systems have a close functional integration but the effect of resistance load to the mandible during jaw opening on the jaw-neck integration is not known. OBJECTIVES To evaluate the effect of resistance load compared to no load on integrated jaw and neck motor function in individuals free from pain and dysfunction in the jaw and neck regions. METHODS Jaw and head movements during continuous jaw opening were recorded with an optoelectronic system (MacReflex® ) in 26 pain-free individuals (14 women, 12 men, mean age 22 years). Jaw opening was performed with and without resistance load (1600 g) to the mandible. The relationship between jaw movement amplitude, head movement amplitude, head/jaw ratio (quotient of head and jaw movement amplitude) and resistance load were modelled using linear mixed-model analysis. A p-value <.05 was considered statistically significant. RESULTS The expected head/jaw ratio mean was increased by 0.05 (95% CI: 0.03, 0.08, p < .001) with resistance load as compared to no load. This corresponds to an increase in expected mean by 55.6%. With resistance load, expected mean head movement amplitude increased by 1.4 mm (95% CI: 0.2, 2.5, p = .018), and expected mean jaw movement amplitude decreased by 3.7 mm (95% CI: -7.0, -0.5, p = .025). CONCLUSION There is a compensation and adaptation of integrated jaw-neck motor function with an altered jaw-neck motor strategy during jaw opening with resistance load compared to no load. The head/jaw ratio demonstrates increased proportional involvement of the neck during increased load on the jaw system.
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Affiliation(s)
- Alicia Böthun
- Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Birgitta Häggman-Henrikson
- Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden.,Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Birgitta Wiesinger
- Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden.,Department of Research and Development, Umeå University, Sundsvall, Sweden
| | - Anders Wänman
- Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Fredrik Hellström
- Department of Occupational Health Science and Psychology, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
| | - Catharina Österlund
- Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden
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The influence of cervical spine rehabilitation on bioelectrical activity (sEMG) of cervical and masticatory system muscles. PLoS One 2021; 16:e0250746. [PMID: 33901247 PMCID: PMC8075221 DOI: 10.1371/journal.pone.0250746] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/09/2021] [Indexed: 01/13/2023] Open
Abstract
Background Coexistence of temporomandibular joint discomfort along with cervical spine disorders is quite common, and is associated with many limitations and adverse symptoms for the patient. Both diagnostics and treatment of these ailments are difficult, and in many cases, the effects of therapy are not satisfactory. This study assessed the impact of a 3-week neck-only rehabilitation programme without direct intervention in the craniofacial area on the bioelectric activity of both the cervical spine and muscles in the craniofacial area among patients with idiopathic neck pain who do not report TMJ pain. Design A parallel group trial with follow-up; Setting: Rehabilitation Clinic. Methods Twenty five patients experiencing idiopathic neck pain underwent the 3-week rehabilitation programme. Thirty five age-matched subjects with no cervical spine and temporomandibular joint (TMJ) dysfunctions were control group. At baseline and after 3 weeks the cervical and craniofacial area muscles’ bioelectrical activity (sEMG) was evaluated. Results In the experimental group during cervical flexion, a significant decrease of sEMG amplitude was noted in the right (mean 25.1 μV; 95% CI: 21.5–28.6 vs mean 16.8 μV; 95% CI: 13.8–19.7) and left (mean 25.9 μV; 95% CI: 21.7–30.0 vs mean 17.2 μV; 95% CI: 13.6–20.7) Sternocleidomastoid as well as a significant increase in sEMG amplitude of the right (mean 11.1 μV; 95% CI: 7.9–14.2 vs mean 15.7 μV; 95% CI: 12.1–19.2) and left (mean 15.3 μV; 95% CI: 11.9–18.6 vs mean 20.2 μV; 95% CI: 15.7–24.2) Upper Trapezius muscles. In the experimental group, after therapy right and left Sternocleidomastoid, Temporalis Anterior and Masseter muscles presented lower fatigue levels. Conclusions Three weeks of rehabilitation without any therapeutic intervention in temporomandibular joint significantly decreased the bioelectrical activity of the neck and craniofacial muscles while improving the muscle pattern of coactivation in participants with idiopathic neck pain who do not report temporomandibular joint pain. These observations could be helpful in the physiotherapeutic treatment of neck and craniofacial area dysfunctions. Trial registration ID ISRCTN14511735—retrospectively registered.
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The association between specific temporomandibular disorders and cervicogenic headache. Musculoskelet Sci Pract 2021; 52:102321. [PMID: 33482538 DOI: 10.1016/j.msksp.2021.102321] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 12/19/2020] [Accepted: 01/08/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS Upper neck signs, symptoms and hypomobility have been shown to present with a higher prevalence in patients with temporomandibular disorders (TMDs). However, there is currently no evidence of an association between specific TMDs and cervicogenic headache (CGH). Therefore, the aim of this study was to evaluate the odds ratio and the relative risk of CGH in patients with specific TMDs. METHOD 116 participants, including 74 patients with TMD (pain-related/intraarticular/mixed TMD) and 42 healthy controls took part in this study. The TMD diagnosis was made by senior faculty members of the Dental School according to the Diagnostic Criteria for TMD, while the cervical diagnosis was made by a qualified senior physical therapist. The analysis comprised the evaluation of the odds ratio of CGH among patients with TMD and the relative risk (RR) for CGH during 14-24 months of follow-up. RESULTS Significantly higher odds ratios of cervicogenic headache were found among pain-related and mixed TMD (12.17 and 10.76, respectively) versus healthy controls. During the 14-24 months of follow-up, there was no significant difference of relative risk for CGH among patients with TMD versus healthy controls. SUMMARY AND CONCLUSIONS The results support a clear clinical association between painful TMD (pain-related and mixed TMD) and cervicogenic headache.
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Paço M, Duarte JA, Pinho T. Orthodontic Treatment and Craniocervical Posture in Patients with Temporomandibular Disorders: An Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063295. [PMID: 33806739 PMCID: PMC8004626 DOI: 10.3390/ijerph18063295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 03/18/2021] [Indexed: 12/15/2022]
Abstract
Orthodontic treatment acts through the application of forces and/or by stimulating and redirecting the functional forces within the craniofacial complex. Considering the interrelationship between craniomandibular and craniocervical systems, this intervention may alter craniocervical posture. Thus, our aim is to (a) compare craniocervical posture, hyoid bone position, and craniofacial morphology before, after, and also in the contention phase at least one year after the orthodontic treatment, in patients with temporomandibular disorders and (b) to verify whether the presence of condylar displacement, the skeletal class, or the facial biotype interferes with the abovementioned outcomes. To do so an observational, analytical, longitudinal, and retrospective design study was carried out. A non-probabilistic convenience sampling method was applied. The sample consisted of clinical records of patients diagnosed with temporomandibular disorders in order to compare pre-orthodontic treatment with post-orthodontic treatment (n = 42) and contention phase data (n = 26). A cephalometric analysis of several variables was performed. The p-value was set as 0.05. When the pre- and post-orthodontic treatment data were analyzed, there were statistically significant changes in variables concerning craniocervical posture (CV angle, C0-C1, and AA-PNS) and also concerning hyoid bone position (C3-Rgn). When pre- and post-orthodontic treatment and contention phase data were analyzed the variables concerning craniocervical posture (C0-C1, CVT/Ver, NSL/OPT, NSL/CVT, NSL/Ver; OPT/CVT, OPT/Ver) and facial biotype had statistically significant changes. This allowed us to conclude that in the sample studied, there were significant differences regarding hyoid bone position (pre- versus post-orthodontic treatment) and craniocervical posture (pre- versus post-orthodontic versus contention), with the craniocervical posture being prone to return to basal values. The presence of condylar displacement was found to significantly increase the H-H1 distance in the three moments of evaluation. Facial biotype was found to significantly increase the NSL/Ver angle on hypodivergent compared to hyperdivergent in the contention phase.
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Affiliation(s)
- Maria Paço
- CESPU, Instituto de Investigacão e Formação Avançada em Ciências e Tecnologias da Saúde, 4585-116 Gandra-Paredes, Portugal;
| | - José Alberto Duarte
- CIAFEL, Faculdade de Desporto da Universidade do Porto, 4200-450 Porto, Portugal;
| | - Teresa Pinho
- CESPU, Instituto de Investigacão e Formação Avançada em Ciências e Tecnologias da Saúde, 4585-116 Gandra-Paredes, Portugal;
- IBMC—Inst. Biologia Molecular e Celular, i3S—Inst. Inovação e Investigação em Saúde, Universidade do Porto, 4585-116 Porto, Portugal
- Correspondence:
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Cervical musculoskeletal disorders in patients with temporomandibular dysfunction: A systematic review and meta-analysis. J Bodyw Mov Ther 2020; 24:84-101. [PMID: 33218570 DOI: 10.1016/j.jbmt.2020.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 03/18/2020] [Accepted: 05/01/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To verify which are the neck musculoskeletal disorders presented by individuals with temporomandibular disorders (TMD). METHODS It is a systematic review and meta-analysis that were included cohort, case-control and cross-section studies that analyzed the presence of cervical musculoskeletal disorders in individuals with TMD, with age between 18 and 55 years. The searches were carried out in the databases: Medline/PubMed, Cinahl, Web of Science, Cochrane, Lilacs and Scopus; and there was no linguistic or temporal restriction. The evidence quality was evaluated by GRADE system and methodological quality by Newcastle-Ottawa Quality Assessment Scale (NOS) and the risk of publication bias assessed by the funnel plot graph. The data was quantitatively analyzed by the meta-analysis using the mean differences (MD) as an effect measure. RESULTS There were included 21 manuscripts in the synthesis, of theses 16 were evaluated by meta-analysis with methodological quality ranging from poor to excellent by NOS scale. Individuals with TMD present lower endurance of extensor neck muscle compared to TMD-free (MD = -194.66s [95%CI: 212.44;-176.88]), with moderate to excellent quality. As, upper neck hymobility on the right (MD = -8.59° (95%CI: -10.43°;-6.75°) and left (MD = -7.99° (95%CI: -9.63°;-6.35°), and in all global neck movements. Also, individuals with TMD presented worse self-reported neck disability (MD = 7.91 (95%CI: 7.39; 8.43)) compared to free-TMD. CONCLUSION There is moderate and strong evidence that patients with TMD present lower endurance of extensor neck muscle, global and upper neck hypomobility, worse self-reported neck disability, however, their cranio-cervical posture is similar to individuals without TMD, based on a moderate to excellent methodological quality. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42018103918.
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Cuenca-Martínez F, Herranz-Gómez A, Madroñero-Miguel B, Reina-Varona Á, La Touche R, Angulo-Díaz-Parreño S, Pardo-Montero J, del Corral T, López-de-Uralde-Villanueva I. Craniocervical and Cervical Spine Features of Patients with Temporomandibular Disorders: A Systematic Review and Meta-Analysis of Observational Studies. J Clin Med 2020; 9:jcm9092806. [PMID: 32872670 PMCID: PMC7565821 DOI: 10.3390/jcm9092806] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/26/2020] [Accepted: 08/29/2020] [Indexed: 01/22/2023] Open
Abstract
To assess neck disability with respect to jaw disability, craniocervical position, cervical alignment, and sensorimotor impairments in patients with temporomandibular disorders (TMD), a systematic review and meta-analysis of observational studies trials were conducted. The meta-analysis showed statistically significant differences in the association between neck disability and jaw disability (standardized mean difference (SMD), 0.72 (0.56–0.82)). However, results showed no significant differences for cervical alignment (SMD, 0.02 (−0.31–0.36)) or for the craniocervical position (SMD, −0.09 (−0.27–0.09)). There was moderate evidence for lower pressure pain thresholds (PPT) and for limited cervical range of motion (ROM). There was limited evidence for equal values for maximal strength between the patients with TMD and controls. There was also limited evidence for reduced cervical endurance and conflicting evidence for abnormal electromyographic (EMG) activity and motor control in TMD patients. Results showed a clinically relevant association between cervical and mandibular disability in patients with TMD. Regarding sensory-motor alterations, the most conclusive findings were observed in the reduction of PPT and cervical ROM, with moderate evidence of their presence in the patients with TMD. Lastly, the evidence on impaired motor control and cervical EMG activity in patients with TMD was conflicting.
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Affiliation(s)
- Ferran Cuenca-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (F.C.-M.); (A.H.-G.); (B.M.-M.); (Á.R.-V.); (J.P.-M.); (T.d.C.)
- Motion in Brains Research Group, Institute of Neurosciences and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (S.A.-D.-P.); (I.L.-d.-U.-V.)
| | - Aida Herranz-Gómez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (F.C.-M.); (A.H.-G.); (B.M.-M.); (Á.R.-V.); (J.P.-M.); (T.d.C.)
| | - Beatriz Madroñero-Miguel
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (F.C.-M.); (A.H.-G.); (B.M.-M.); (Á.R.-V.); (J.P.-M.); (T.d.C.)
| | - Álvaro Reina-Varona
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (F.C.-M.); (A.H.-G.); (B.M.-M.); (Á.R.-V.); (J.P.-M.); (T.d.C.)
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (F.C.-M.); (A.H.-G.); (B.M.-M.); (Á.R.-V.); (J.P.-M.); (T.d.C.)
- Motion in Brains Research Group, Institute of Neurosciences and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (S.A.-D.-P.); (I.L.-d.-U.-V.)
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), 28008 Madrid, Spain
- Correspondence: ; Tel.: +34-917-401-980
| | - Santiago Angulo-Díaz-Parreño
- Motion in Brains Research Group, Institute of Neurosciences and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (S.A.-D.-P.); (I.L.-d.-U.-V.)
- Facultad de Medicina, Universidad CEU San Pablo, 28003 Madrid, Spain
| | - Joaquín Pardo-Montero
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (F.C.-M.); (A.H.-G.); (B.M.-M.); (Á.R.-V.); (J.P.-M.); (T.d.C.)
- Motion in Brains Research Group, Institute of Neurosciences and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (S.A.-D.-P.); (I.L.-d.-U.-V.)
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), 28008 Madrid, Spain
| | - Tamara del Corral
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (F.C.-M.); (A.H.-G.); (B.M.-M.); (Á.R.-V.); (J.P.-M.); (T.d.C.)
- Motion in Brains Research Group, Institute of Neurosciences and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (S.A.-D.-P.); (I.L.-d.-U.-V.)
| | - Ibai López-de-Uralde-Villanueva
- Motion in Brains Research Group, Institute of Neurosciences and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain; (S.A.-D.-P.); (I.L.-d.-U.-V.)
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
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12
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Espí-López GV, Arnal-Gómez A, Cuerda del Pino A, Benavent-Corai J, Serra-Añó P, Inglés M. Effect of Manual Therapy and Splint Therapy in People with Temporomandibular Disorders: A Preliminary Study. J Clin Med 2020; 9:jcm9082411. [PMID: 32731453 PMCID: PMC7463644 DOI: 10.3390/jcm9082411] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/24/2020] [Accepted: 07/25/2020] [Indexed: 12/13/2022] Open
Abstract
Background: Isolated manual therapy techniques (MT) have shown beneficial effects in patients with temporomandibular disorders (TMD) but the effect of the combination of such techniques, together with the well-stablished splint therapy (ST) remains to be elucidated. Objective: This study was conducted to ascertain whether a combined program of MT techniques, including intraoral treatment, plus traditional ST improves pain and clinical dysfunction in subjects with TMD. Methods: A preliminary trial was conducted. 16 participants were assigned to either the MT plus ST-Experimental Group (EG, n = 8) or the ST alone—Control Group (CG, n = 8). Forty-five minute sessions of combined MT techniques were performed, once a week for four weeks. Three evaluations were conducted: baseline, post-treatment, and one-month follow-up. Outcome measures were pain perception, pain pressure threshold (PPT), TMD dysfunction, and perception of change after treatment. Results: EG showed significant reduction on pain, higher PPT, significant improvement of dysfunction and significantly positive perception of change after treatment (p < 0.05 all). Additionally, such positive effects were maintained at follow-up with a high treatment effect (R2 explaining 26.6–33.2% of all variables). Conclusion: MT plus ST showed reduction on perceived pain (3 points decrease), higher PPT (of at least 1.0 kg/cm2), improvement of disability caused by pain (4.4 points decrease), and positive perception of change (EG: 50% felt “much improvement”), compared to ST alone.
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Affiliation(s)
- Gemma Victoria Espí-López
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag Street nº 5, 46010 Valencia, Spain; (G.V.E.-L.); (A.C.d.P.); (P.S.-A.); (M.I.)
- Research Unit in Clinical Biomechanics (UBIC), University of Valencia, 46010 Valencia, Spain
| | - Anna Arnal-Gómez
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag Street nº 5, 46010 Valencia, Spain; (G.V.E.-L.); (A.C.d.P.); (P.S.-A.); (M.I.)
- Research Unit in Clinical Biomechanics (UBIC), University of Valencia, 46010 Valencia, Spain
- Correspondence: ; Tel.: +34-963983853 (ext. 51227)
| | - Alba Cuerda del Pino
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag Street nº 5, 46010 Valencia, Spain; (G.V.E.-L.); (A.C.d.P.); (P.S.-A.); (M.I.)
| | - José Benavent-Corai
- Cavanilles Institute for Biodiversity and Evolutionary Biology, University of Valencia, 46980 Paterna, Spain;
| | - Pilar Serra-Añó
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag Street nº 5, 46010 Valencia, Spain; (G.V.E.-L.); (A.C.d.P.); (P.S.-A.); (M.I.)
- Research Unit in Clinical Biomechanics (UBIC), University of Valencia, 46010 Valencia, Spain
| | - Marta Inglés
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag Street nº 5, 46010 Valencia, Spain; (G.V.E.-L.); (A.C.d.P.); (P.S.-A.); (M.I.)
- Research Unit in Clinical Biomechanics (UBIC), University of Valencia, 46010 Valencia, Spain
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13
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Greenbaum T, Dvir Z, Emodi-Perelmam A, Reiter S, Rubin P, Winocur E. Relationship between specific temporomandibular disorders and impaired upper neck performance. Eur J Oral Sci 2020; 128:292-298. [PMID: 32627243 DOI: 10.1111/eos.12718] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2020] [Indexed: 11/26/2022]
Abstract
Upper neck impairments are more prevalent in patients with temporomandibular disorders (TMDs) but the differences between specific types of TMDs are unclear. This study evaluated the distribution of such impairments among different forms of TMD. In total, 116 participants (86 women and 30 men, age range 21-75 yr) were investigated. Forty-two individuals had no TMDs and were assigned to the control group. The remaining 74 patients were assigned to one of three groups based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) findings: pain-related (n = 37); intra-articular (n = 17); or mixed (combined pain-related and intra-articular) (n = 20). Analyses of impairments included between-group comparisons of key parameters of upper neck performance (active/passive mobility and muscular capabilities) and pain (subjective neck disability and pain sensitivity). Patients in the pain-related and mixed TMD groups were found to have decreased upper neck mobility in the cervical flexion-rotation test compared with patients in intra-articular and control groups, as well as poorer capabilities of the deep neck flexor muscles in the cranio-cervical flexion test compared to the control group. It was concluded that patients with pain-related TMD diagnoses are more likely to experience significant upper-neck hypomobility and poor muscular capabilities than patients with intra-articular diagnoses of TMD.
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Affiliation(s)
- Tzvika Greenbaum
- The Department of Physical Therapy, Tel Aviv University, Tel Aviv, Israel
| | - Zeevi Dvir
- The Department of Physical Therapy, Tel Aviv University, Tel Aviv, Israel
| | - Alona Emodi-Perelmam
- The School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shoshana Reiter
- The School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Pessia Rubin
- The School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ephraim Winocur
- The School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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14
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Dağ F, Taş S, Kaynak BA, Bölgen Çimen O. Temporomandibular dysfunction affects aerobic capacity in females: A preliminary study. Cranio 2020; 40:113-118. [PMID: 32155115 DOI: 10.1080/08869634.2020.1739190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: The purpose of this study was to investigate the aerobic capacity in patients with temporomandibular dysfunction (TMD) and to compare the results with those of the asymptomatic individuals.Methods: The TMD group included a total of 31 females between the ages of 18 and 25 years. The control group consisted of 31 asymptomatic females with an age range of 18 to 27 years. A graded exercise test was performed using an electronically braked arm crank ergometer. An indirect calorimeter system was used to calculate the peak oxygen consumption (VO2peak). In addition, peak heart rate (HRpeak) and respiratory quotient were calculated for each participant.Results: The TMD group had lower VO2peak (p = 0.017) and HRpeak (p = 0.012) in aerobic capacity tests; however, respiratory quotient was similar in both groups (p = 0.446).Discussion: The TMD group had lower aerobic capacity compared to the asymptomatic individuals.
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Affiliation(s)
- Figen Dağ
- School of Medicine, Department of Physical Medicine and Rehabilitation, Mersin University, Mersin, Turkey
| | - Serkan Taş
- School of Health Science, Department of Physiotherapy and Rehabilitation, Toros University, Mersin, Turkey
| | - Besime Ahu Kaynak
- School of Health Science, Department of Health Management, Toros University, Mersin, Turkey
| | - Ozlem Bölgen Çimen
- School of Medicine, Department of Physical Medicine and Rehabilitation, Mersin University, Mersin, Turkey
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15
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Monticone M, Rocca B, Abelli P, Tecco S, Geri T, Gherlone EF, Luzzi D, Testa M. Cross-cultural adaptation, reliability and validity of the Italian version of the craniofacial pain and disability inventory in patients with chronic temporomandibular joint disorders. BMC Oral Health 2019; 19:244. [PMID: 31718686 PMCID: PMC6852744 DOI: 10.1186/s12903-019-0927-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 10/15/2019] [Indexed: 12/23/2022] Open
Abstract
Background To develop an Italian version of the Craniofacial Pain Disability Inventory (CFPDI-I) and investigate its psychometric abilities in patients with temporomandibular disorders (TMD). Methods The CFPDI was translated following international standards. The psychometric analyses included reliability by internal consistency (Cronbach’s alpha) and test/retest stability (intraclass correlation coefficient, ICC); construct validity was investigated by matching (a priori hypotheses) the CFPDI-I with the Italian Neck Disability Index (NDI-I), a pain intensity numerical rating scale (NRS), the Italian Pain Catastrophising Scale (PCS-I), the Italian Tampa Scale of Kinesiophobia (TSK-I), and the Italian Migraine Disability Assessment Score Questionnaire (MIDAS) (Pearson’s correlation). Alpha was set at 0.05. Results Two hundred and twelve patients with chronic TMD completed the tool. The questionnaire was internally consistent (α = 0.95) and its stability was good (ICCs = 0.91). As hypothesised, validity figures showed CFPDI-I strongly correlated with the NDI-I (r = 0.66, p < 0.05) and moderately correlated with the NRS (r = 0.48, p < 0.05), PCS (r = 0.37, p < 0.05), TSKI (r = 0.35, p < 0.05) and MIDAS (r = 0.47, p < 0.05). Similar estimates were shown by CFPDI-I subscales. Conclusions The cross-culturally adapted version of the Craniofacial Pain and Disability Inventory (CFPDI-I) showed satisfactory psychometric properties that replicate those of the original version and, therefore, can be implemented in the clinical assessment of Italian people affected by TMD.
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Affiliation(s)
- Marco Monticone
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Department of Neuroscience and Rehabilitation, Neurorehabilitation Unit, G. Brotzu Hospital, Cagliari, Italy
| | - Barbara Rocca
- Istituti Clinici Scientifici Maugeri, IRCCS, PRM Unit of Lissone, Lissone, Italy
| | - Paola Abelli
- Istituti Clinici Scientifici Maugeri, IRCCS, PRM Unit of Montescano, Montescano, Italy
| | - Simona Tecco
- Vita-Salute San Raffaele University, Dental Clinic, Milan, Italy
| | - Tommaso Geri
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova - Campus of Savona, Savona, Italy
| | | | - Deborah Luzzi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova - Campus of Savona, Savona, Italy
| | - Marco Testa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova - Campus of Savona, Savona, Italy.
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16
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Zafar H, Alghadir AH, Iqbal ZA. Effect of jaw functional status on neck muscle endurance. Arch Oral Biol 2019; 101:30-33. [PMID: 30875591 DOI: 10.1016/j.archoralbio.2019.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 02/19/2019] [Accepted: 03/01/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To investigate the effect of resting jaw and maximum voluntary clenching on neck flexor and extensor muscle endurance. DESIGN Neck flexor and extensor endurance was measured in a college health clinic in 85 male college students in two test positions: resting jaw (control) and maximum voluntary clenching. RESULTS Mean neck flexor muscle endurance values during resting jaw and maximum voluntary clenching were 70.06 SD 28.24, and 60.03 SD 16.5, seconds respectively. Mean neck extensor muscle endurance values during resting jaw and maximum voluntary clenching were 105.54 SD 29.9, and 98.32 SD 24.54, respectively. Both values were significantly lower while maximum voluntary clenching as compared to resting jaw position (p < 0.05). CONCLUSION Modification of jaw position can affect neck muscle endurance. Results of this study further supports sensory-motor relation between jaw and neck region.
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Affiliation(s)
- Hamayun Zafar
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umea University, Umea, Sweden
| | - Ahmad H Alghadir
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Zaheen A Iqbal
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
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17
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Tolentino GDA, Bevilaqua-Grossi D, Carvalho GF, Carnevalli APDO, Dach F, Florencio LL. Relationship Between Headaches and Neck Pain Characteristics With Neck Muscle Strength. J Manipulative Physiol Ther 2018; 41:650-657. [PMID: 30573197 DOI: 10.1016/j.jmpt.2018.04.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 04/05/2018] [Accepted: 04/05/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the correlations between neck muscle strength and pain features, such as neck-related disability, neck pain frequency and intensity, and headache frequency in women with headache. METHODS Seventy women with migraine between 18 and 55 years of age diagnosed according to International Headache Society criteria were assessed. Participants provided clinical information regarding neck pain and headache. The Neck Disability Index was used to assess neck-related disability, and neck muscle strength was assessed via maximum voluntary contraction during flexion, extension, and lateral flexion with a handheld dynamometer. The correlation was verified with Spearman's correlation coefficient (ρ). Multiple linear regression was performed to verify whether the clinical variables could predict the strength of neck muscles. All calculations were performed adopting a level of significance of 0.05. RESULTS Neck extensor strength was negatively correlated with all clinical variables (ρrange = -.24 to -.32, p < .05); lateral flexor strength was negatively correlated with headache frequency, neck pain intensity, and neck-related disability (ρrange = -.27 to -.39, p < .05); and flexor strength also correlated negatively with neck pain intensity and related disability (ρr = -.26 to -.29, p < .05). Headache frequency and neck pain intensity were identified as significant predictors of the strength variability in extension (R2 = 0.16, p < .05) and in lateral flexion (R2 = 0.18, p < .05). CONCLUSIONS For the women with migraine in this study, correlations of headache and neck pain with neck muscle strength features were weakly to moderately negative. Headache frequency and neck pain intensity may influence a small proportion of the strength variability in extension and lateral flexion.
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Affiliation(s)
- Gabriella de Almeida Tolentino
- Department of Biomechanics, Medicine and Locomotor Apparatus Rehabilitation, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Débora Bevilaqua-Grossi
- Department of Biomechanics, Medicine and Locomotor Apparatus Rehabilitation, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Gabriela Ferreira Carvalho
- Department of Biomechanics, Medicine and Locomotor Apparatus Rehabilitation, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Ana Paula de Oliveira Carnevalli
- Department of Biomechanics, Medicine and Locomotor Apparatus Rehabilitation, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Fabíola Dach
- Department of Neurosciences and Behavioral Science, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Lidiane Lima Florencio
- Department of Biomechanics, Medicine and Locomotor Apparatus Rehabilitation, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil; Department of Physiotherapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Madrid, Spain.
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18
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Abtahi SMA, Jamshidi N, Ghaziasgar A. The effect of Knee-Ankle-Foot orthosis stiffness on the parameters of walking. Comput Methods Biomech Biomed Engin 2018; 21:201-207. [PMID: 29465260 DOI: 10.1080/10255842.2018.1438417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The purpose of this simulation study was to analyze the effect of variation in Knee-Ankle-Foot-Orthosis stiffness on the joint power and the energy cost of walking. The effect of contractile tissue was simulated using linear elastic spring and viscous dampers in knee and ankle joints. Then, joint angles, ground reaction force, were collected from Twenty chronic hemiparesis subjects (15 males and 5 females) and twenty control subjects (14 males and 6 females), and spring stiffness were considered as the inputs. In this new study, the generated muscle torques were optimized by changing the stiffness as the desired output in the mathematical model attained by the MATLAB SimMechanics toolbox. Finally, the simulated mathematical model was introduced as an appropriate substitute in obtaining the optimized stiffness with a more convenient and efficient designed orthosis.
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Affiliation(s)
- Sayed Mohammad Ali Abtahi
- a Department of Biomedical Engineering, Faculty of Engineering , University of Isfahan , Isfahan , Iran
| | - Nima Jamshidi
- a Department of Biomedical Engineering, Faculty of Engineering , University of Isfahan , Isfahan , Iran
| | - Aram Ghaziasgar
- b Department of Mechanical Engineering , Isfahan University of Technology , Isfahan , Iran
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19
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Muñoz-García D, López-de-Uralde-Villanueva I, Beltrán-Alacreu H, La Touche R, Fernández-Carnero J. Patients with Concomitant Chronic Neck Pain and Myofascial Pain in Masticatory Muscles Have More Widespread Pain and Distal Hyperalgesia than Patients with Only Chronic Neck Pain. PAIN MEDICINE 2017; 18:526-537. [PMID: 28034980 DOI: 10.1093/pm/pnw274] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective Insufficient evidence exists to compare widespread pain (WP), pain sensibility, and psychological factors that occur in patients presenting with chronic neck pain (CNP) or a combination of temporomandibular disorder (TMD) and other complaints. The present study compared the pain sensibility and psychological factors of subjects with CNP with those with TMD + CNP. Design Cross-sectional study. Setting Local community. Subjects A nonprobabilistic convenience sample of 86 persons with CNP or TMD was recruited into three groups: CNP, TMD with myofascial pain in masticatory muscles with cocomitant CNP (TMD + CNP), and asymptomatic control groups consisted of 27, 29, and 30 participants, respectively. Methods Participants underwent a clinical examination to evaluate WP with computerized assessment based on the pain drawing, pressure pain thresholds (PPT), and psychological factors, which were evaluated using the pain catastrophizing scale (PCS) and the state-trait anxiety inventory (STAI). Results Statistically significant differences were observed between participants with CNP and TMD + CNP for WP (t = -2.80, P < 0.01, d = -1.06). Post hoc analyses only revealed significant differences between TMD + CNP participants and asymptomatic controls for PPT at extratrigeminal areas. Pearson correlation analyses showed a moderate positive association between symptomatic groups within the WP and STAI ( P < 0.05) and a moderate negative association between PCS and PPT ( P < 0.05) at the right tibialis muscle. Conclusion TMD + CNP participants had more areas of pain and also showed widespread pain hyperalgesia. Both groups of participants had psychological factors positively associated with STAI and WP; further, PCS and the PPT at the extratrigeminal region were negatively associated with each other in both groups, except for the left tibialis in the TMD + CNP group.
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Affiliation(s)
- Daniel Muñoz-García
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle. Universidad Autónoma de Madrid, Aravaca, Madrid, Spain.,Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain
| | - Ibai López-de-Uralde-Villanueva
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle. Universidad Autónoma de Madrid, Aravaca, Madrid, Spain.,Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain.,Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain.,Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain
| | - Héctor Beltrán-Alacreu
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle. Universidad Autónoma de Madrid, Aravaca, Madrid, Spain.,Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain.,Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle. Universidad Autónoma de Madrid, Aravaca, Madrid, Spain.,Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain.,Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain.,Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain
| | - Josué Fernández-Carnero
- Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain.,Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain.,Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain.,Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
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von Piekartz H, Stotz E, Both A, Bahn G, Armijo-Olivo S, Ballenberger N. Psychometric evaluation of a motor control test battery of the craniofacial region. J Oral Rehabil 2017; 44:964-973. [PMID: 28892191 DOI: 10.1111/joor.12574] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2017] [Indexed: 01/14/2023]
Abstract
The primary objective of this study was to determine the structural and known-group validity as well as the inter-rater reliability of a test battery to evaluate the motor control of the craniofacial region. Seventy volunteers without TMD and 25 subjects with TMD (Axes I) per the DC/TMD were asked to execute a test battery consisting of eight tests. The tests were video-taped in the same sequence in a standardised manner. Two experienced physical therapists participated in this study as blinded assessors. We used exploratory factor analysis to identify the underlying component structure of the eight tests. Internal consistency (Cronbach's α), inter-rater reliability (intra-class correlation coefficient) and construct validity (ie, hypothesis testing-known-group validity) (receiver operating curves) were also explored for the test battery. The structural validity showed the presence of one factor underlying the construct of the test battery. The internal consistency was excellent (0.90) as well as the inter-rater reliability. All values of reliability were close to 0.9 or above indicating very high inter-rater reliability. The area under the curve (AUC) was 0.93 for rater 1 and 0.94 for rater two, respectively, indicating excellent discrimination between subjects with TMD and healthy controls. The results of the present study support the psychometric properties of test battery to measure motor control of the craniofacial region when evaluated through videotaping. This test battery could be used to differentiate between healthy subjects and subjects with musculoskeletal impairments in the cervical and oro-facial regions. In addition, this test battery could be used to assess the effectiveness of management strategies in the craniofacial region.
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Affiliation(s)
- H von Piekartz
- Department of Physical Therapy and Rehabilitation, University of Applied Science Osnabrück, Osnabrueck, Germany
| | - E Stotz
- Privat Praxis for Physiotherapy Specialized in Orofacial Pain, Physical Therapy, Graz, Austria
| | - A Both
- Department of Physical Therapy and Rehabilitation, University of Applied Science Osnabrück, Osnabrueck, Germany
| | - G Bahn
- Department of Physical Therapy and Rehabilitation, University of Applied Science Osnabrück, Osnabrueck, Germany
| | - S Armijo-Olivo
- Department of Physical Therapy, Canada Faculty of Rehabilitation Medicine, Edmonton, AB, Canada
| | - N Ballenberger
- Department of Physical Therapy and Rehabilitation, University of Applied Science Osnabrück, Osnabrueck, Germany
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21
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Greenbaum T, Dvir Z, Reiter S, Winocur E. Cervical flexion-rotation test and physiological range of motion - A comparative study of patients with myogenic temporomandibular disorder versus healthy subjects. Musculoskelet Sci Pract 2017. [PMID: 28637604 DOI: 10.1016/j.msksp.2016.11.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Temporomandibular Disorders (TMD) refer to several common clinical disorders which involve the masticatory muscles, the temporomandibular joint (TMJ) and the adjacent structures. Although neck signs and symptoms are found with higher prevalence in TMD patients compared to the overall population, whether limitation of cervical mobility is an additional positive finding in this cohort is still an open question. OBJECTIVE To compare the physiological cervical range of motion (CROM) and the extent of rotation during cervical flexion (flexion-rotation test, FRT) in people with TMD (muscular origin) and healthy control subjects. METHOD The range of motion of the neck and FRT was measured in 20 women with myogenic TMD and 20 age matched healthy controls. RESULTS Women with myogenic TMD had significantly lower FRT scores compared to their matched healthy women. No difference was found between groups in CROM in any of the planes of movement. The FRT was positive (less than 32°) in 90% of the TMD participants versus 5% in the healthy control but the findings were not correlated with TMD severity. CONCLUSION The results point out a potential involvement of the upper cervical joints (c1-c2) in women with myogenic TMD.
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Affiliation(s)
- Tzvika Greenbaum
- Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Israel.
| | - Zeevi Dvir
- Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Shoshana Reiter
- Department of Oral Pathology & Oral Medicine, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Israel
| | - Ephraim Winocur
- Department of Oral Rehabilitation, Charge of, TMD & Orofacial Pain Clinic, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Israel
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22
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High-density EMG Reveals Novel Evidence of Altered Masseter Muscle Activity During Symmetrical and Asymmetrical Bilateral Jaw Clenching Tasks in People With Chronic Nonspecific Neck Pain. Clin J Pain 2017; 33:148-159. [DOI: 10.1097/ajp.0000000000000381] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Calixtre LB, Grüninger BLDS, Haik MN, Alburquerque-Sendín F, Oliveira AB. Effects of cervical mobilization and exercise on pain, movement and function in subjects with temporomandibular disorders: a single group pre-post test. J Appl Oral Sci 2016; 24:188-97. [PMID: 27383698 PMCID: PMC5022215 DOI: 10.1590/1678-775720150240] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 03/09/2016] [Indexed: 11/24/2022] Open
Abstract
Objective To investigate the effect of a rehabilitation program based on cervical mobilization and exercise on clinical signs and mandibular function in subjects with temporomandibular disorder (TMD). Material and Methods: Single-group pre-post test, with baseline comparison. Subjects Twelve women (22.08±2.23 years) with myofascial pain and mixed TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders. Outcome measures Subjects were evaluated three times: twice before (baseline phase) and once after intervention. Self-reported pain, jaw function [according to the Mandibular Functional Impairment Questionnaire (MFIQ)], pain-free maximum mouth opening (MMO), and pressure pain thresholds (PPTs) of both masseter and temporalis muscles were obtained. Baseline and post-intervention differences were investigated, and effect size was estimated through Cohen’s d coefficient. Results Jaw function improved 7 points on the scale after the intervention (P=0.019), and self-reported pain was significantly reduced (P=0.009). Pain-free MMO varied from 32.3±8.8 mm to 38±8.8 mm and showed significant improvement (P=0.017) with moderate effect size when compared to the baseline phase. PPT also increased with moderate effect size, and subjects had the baseline values changed from 1.23±0.2 kg/cm2 to 1.4±0.2 kg/cm2 in the left masseter (P=0.03), from 1.31±0.28 kg/cm2 to 1.51±0.2 kg/cm2 in the right masseter (P>0.05), from 1.32±0.2 kg/cm2 to 1.46±0.2 kg/cm2 in the left temporalis (P=0.047), and from 1.4±0.2 kg/cm2 to 1.67±0.3 kg/cm2 in the right temporalis (P=0.06). Conclusions The protocol caused significant changes in pain-free MMO, self-reported pain, and functionality of the stomatognathic system in subjects with myofascial TMD, regardless of joint involvement. Even though these differences are statistically significant, their clinical relevance is still questionable.
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Affiliation(s)
- Letícia Bojikian Calixtre
- - Universidade Federal de São Carlos, Departamento de Fisioterapia, Laboratório de Cinesiologia Clínica e Ocupacional, São Carlos, SP, Brasil
| | - Bruno Leonardo da Silva Grüninger
- - Universidade Federal de São Carlos, Departamento de Fisioterapia, Laboratório de Cinesiologia Clínica e Ocupacional, São Carlos, SP, Brasil
| | - Melina Nevoeiro Haik
- - Universidade Federal de São Carlos, Departamento de Fisioterapia, Laboratório de Avaliação e Intervenção do Complexo do Ombro, São Carlos, SP, Brasil
| | - Francisco Alburquerque-Sendín
- - Universidad de Salamanca, Departamento de Enfermería y Fisioterapia; Instituto de Investigación Biomédica de Salamanca, Salamanca,España
| | - Ana Beatriz Oliveira
- - Universidade Federal de São Carlos, Departamento de Fisioterapia, Laboratório de Cinesiologia Clínica e Ocupacional, São Carlos, SP, Brasil
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Baldini A, Nota A, Tecco S, Ballanti F, Cozza P. Influence of the mandibular position on the active cervical range of motion of healthy subjects analyzed using an accelerometer. Cranio 2016; 36:29-34. [PMID: 27786075 DOI: 10.1080/08869634.2016.1249994] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The aim of this study is to analyze the influence of the mandibular positions (habitual rest position, habitual maximum intercuspation, habitual maximum intercuspation with clenching, and mandibular position with cotton rolls) on the active cervical range of motion (ROM) (flexion-extension, lateroflexions, rotations) using an accelerometer in a sample of healthy subjects. METHODS A total of 21 (14 M, 7 F) healthy volunteers aged from 18 to 27 years (mean age 23.88 ± 2.34 years; mean weight 67.86 ± 11.38 kg; mean height 172.52 ± 9.00 cm) underwent a cervical range of movement examination using a 9-axis accelerometer. A one-way ANOVA analysis was performed in order to statistically evaluate the effective influence of the mandibular position on the recorded parameters. RESULTS The analysis showed no statistically significant differences (all p-values > 0.1) with variations smaller than three degrees among the different mandibular positions. DISCUSSION The mandibular position seems to have no influence on the active cervical ROM in healthy subjects. Further studies are needed to assess the usefulness of the accelerometer in the cervical analysis of temporomandibular disorder subjects.
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Affiliation(s)
- Alberto Baldini
- a Department of Orthodontics , University of Rome Tor Vergata , Rome , Italy
| | - Alessandro Nota
- a Department of Orthodontics , University of Rome Tor Vergata , Rome , Italy
| | - Simona Tecco
- b Dental School , Vita-Salute San Raffaele University , Milan , Italy
| | - Fabiana Ballanti
- a Department of Orthodontics , University of Rome Tor Vergata , Rome , Italy
| | - Paola Cozza
- a Department of Orthodontics , University of Rome Tor Vergata , Rome , Italy
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25
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Guarda-Nardini L, Cadorin C, Frizziero A, Masiero S, Manfredini D. Interrelationship between temporomandibular joint osteoarthritis (OA) and cervical spine pain: Effects of intra-articular injection with hyaluronic acid. Cranio 2016; 35:276-282. [PMID: 27638344 DOI: 10.1080/08869634.2016.1232788] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate cervical spine pain and function after five sessions of viscosupplementation with hyaluronic acid (HA) in patients with temporomandibular joint (TMJ) osteoarthritis. METHODS Forty-nine patients, (79% females, aged between 43-81 years), affected by TMJ osteoarthritis and concurrent cervical spine pain and limited function were recruited. All patients underwent a cycle of five weekly arthrocenteses and viscosupplementation with 1 ml of medium molecular weight HA according to the single-needle arthrocentesis technique. Outcome variables were TMJ pain (VAS), cervical active ranges of motion, cervical disability (NPDS), and presence of painful palpation sites. Assessments were carried out at baseline and at one, three and six months after the end of treatment protocol. RESULTS A significant reduction over time was shown both in TMJ pain levels and in NPDS values with respect to baseline (p < 0.001). Most parameters of active cervical range of motion showed an improvement with time. Benefits remained stable throughout six months after the viscosupplementation protocol. CONCLUSIONS A protocol of TMJ intra articular arthrocentesis and viscosupplementation improved cervical function and reduced disability in patients with concurrent cervical spine pain. These findings add to the complex amount of literature on the relationship between temporomandibular disorders and cervical spine disorders.
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Affiliation(s)
- Luca Guarda-Nardini
- a TMD Clinic, Department of Neuroscience , University of Padua , Padova , Italy.,b Section of Dentistry and Maxillofacial Surgery , Hospital of Treviso , Treviso , Italy
| | - Cristina Cadorin
- c Department of Physical and Rehabilitation Medicine , University of Padua , Padova , Italy
| | - Antonio Frizziero
- c Department of Physical and Rehabilitation Medicine , University of Padua , Padova , Italy
| | - Stefano Masiero
- c Department of Physical and Rehabilitation Medicine , University of Padua , Padova , Italy
| | - Daniele Manfredini
- a TMD Clinic, Department of Neuroscience , University of Padua , Padova , Italy.,d School of Dentistry , University of Padova , Padova , Italy
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26
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Pasinato F, Bordin J, Santos-Couto-Paz CC, Souza JA, Corrêa ECR. Cervical-scapular muscles strength and severity of temporomandibular disorder in women with mechanical neck pain. FISIOTERAPIA EM MOVIMENTO 2016. [DOI: 10.1590/0103-5150.029.002.ao05] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Changes in cervical muscle function have been observed in patients with neck pain (NP) and TMD. However, the relationship between TMD severity and neck muscle strength in the presence/absence of NP is unknown. Objective: To determine the prevalence of TMD in women with and without mechanical NP and assess the cervical-scapular muscle strength and its association with TMD severity. Methods: Fifteen volunteers without neck pain (CG) and 14 women with mechanical neck pain (NPG) took part and were selected by the Neck Disability Index. The diagnosis and severity of TMD were determined by the Research Diagnostic Criteria for TMD and Temporomandibular Index (TI), respectively. The strength of the upper trapezius muscle, and cervical flexor and extensor muscles was measured by digital hand dynamometer. Results: 64.5% of women with NP and 33.3% without NP were diagnosed with TMD (p = 0.095). The NPG showed lower strength of the cervical flexor (p = 0.044) and extensor (p=0.006) muscles, and higher TI (p = 0.038) than in the CG. It was also verified moderate negative correlation between TI and the strength of dominant (p = 0.046, r = -0.547) and non-dominant (p = 0.007, r = -0.695) upper trapezius, and cervical flexors (p = 0.023, r = -0.606) in the NPG. Conclusion: There was no difference in the prevalence of TMD in women with and without NP. However, women with NP have lower cervical muscle strength - compared to those without NP - which was associated with greater severity of TMD. Thus, in women with NP associated with TMD, it is advisable to assess and address the severity of this dysfunction and identify the cervical-scapular muscles compromise.
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27
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Bragatto MM, Bevilaqua-Grossi D, Regalo SCH, Sousa JD, Chaves TC. Associations among temporomandibular disorders, chronic neck pain and neck pain disability in computer office workers: a pilot study. J Oral Rehabil 2016; 43:321-32. [DOI: 10.1111/joor.12377] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2015] [Indexed: 11/30/2022]
Affiliation(s)
- M. M. Bragatto
- Rehabilitation and Functional Performance Postgraduate Program; Ribeirão Preto School of Medicine; University of São Paulo - USP; Ribeirão Preto Brazil
| | - D. Bevilaqua-Grossi
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus; Ribeirão Preto School of Medicine, Rehabilitation and Functional Performance Postgraduate Program; University of São Paulo - USP; Ribeirão Preto Brazil
| | - S. C. H. Regalo
- Department of Morphology, Physiology and Basic Pathology; Ribeirão Preto School of Dentistry; University of São Paulo - USP; Ribeirão Preto Brazil
| | - J. D. Sousa
- Physical Therapy Graduation Course; Ribeirão Preto School of Medicine; University of São Paulo - USP; Ribeirão Preto Brazil
| | - T. C. Chaves
- Department of Neuroscience and Behavioral Sciences, Rehabilitation and Functional Performance Postgraduate Program; Ribeirão Preto School of Medicine; University of São Paulo - USP; Ribeirão Preto Brazil
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28
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Involvement of IL-1 in the Maintenance of Masseter Muscle Activity and Glucose Homeostasis. PLoS One 2015; 10:e0143635. [PMID: 26599867 PMCID: PMC4658060 DOI: 10.1371/journal.pone.0143635] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 11/06/2015] [Indexed: 11/19/2022] Open
Abstract
Physical exercise reportedly stimulates IL-1 production within working skeletal muscles, but its physiological significance remains unknown due to the existence of two distinct IL-1 isoforms, IL-1α and IL-1β. The regulatory complexities of these two isoforms, in terms of which cells in muscles produce them and their distinct/redundant biological actions, have yet to be elucidated. Taking advantage of our masticatory behavior (Restrained/Gnawing) model, we herein show that IL-1α/1β-double-knockout (IL-1-KO) mice exhibit compromised masseter muscle (MM) activity which is at least partially attributable to abnormalities of glucose handling (rapid glycogen depletion along with impaired glucose uptake) and dysfunction of IL-6 upregulation in working MMs. In wild-type mice, masticatory behavior clearly increased IL-1β mRNA expression but no incremental protein abundance was detectable in whole MM homogenates, whereas immunohistochemical staining analysis revealed that both IL-1α- and IL-1β-immunopositive cells were recruited around blood vessels in the perimysium of MMs after masticatory behavior. In addition to the aforementioned phenotype of IL-1-KO mice, we found the IL-6 mRNA and protein levels in MMs after masticatory behavior to be significantly lower in IL-1-KO than in WT. Thus, our findings confirm that the locally-increased IL-1 elicited by masticatory behavior, although present small in amounts, contributes to supporting MM activity by maintaining normal glucose homeostasis in these muscles. Our data also underscore the importance of IL-1-mediated local interplay between autocrine myokines including IL-6 and paracrine cytokines in active skeletal muscles. This interplay is directly involved in MM performance and fatigability, perhaps mediated through maintaining muscular glucose homeostasis.
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29
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Chaves TC, Turci AM, Pinheiro CF, Sousa LM, Grossi DB. Static body postural misalignment in individuals with temporomandibular disorders: a systematic review. Braz J Phys Ther 2014; 18:481-501. [PMID: 25590441 PMCID: PMC4311593 DOI: 10.1590/bjpt-rbf.2014.0061] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 06/04/2014] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND: The association between body postural changes and temporomandibular disorders
(TMD) has been widely discussed in the literature, however, there is little
evidence to support this association. OBJECTIVES: The aim of the present study was to conduct a systematic review to assess the
evidence concerning the association between static body postural misalignment and
TMD. METHOD: A search was conducted in the PubMed/Medline, Embase, Lilacs, Scielo, Cochrane,
and Scopus databases including studies published in English between 1950 and March
2012. Cross-sectional, cohort, case control, and survey studies that assessed body
posture in TMD patients were selected. Two reviewers performed each step
independently. A methodological checklist was used to evaluate the quality of the
selected articles. RESULTS: Twenty studies were analyzed for their methodological quality. Only one study was
classified as a moderate quality study and two were classified as strong quality
studies. Among all studies considered, only 12 included craniocervical postural
assessment, 2 included assessment of craniocervical and shoulder postures,, and 6
included global assessment of body posture. CONCLUSION: There is strong evidence of craniocervical postural changes in myogenous TMD,
moderate evidence of cervical postural misalignment in arthrogenous TMD, and no
evidence of absence of craniocervical postural misalignment in mixed TMD patients
or of global body postural misalignment in patients with TMD. It is important to
note the poor methodological quality of the studies, particularly those regarding
global body postural misalignment in TMD patients.
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Affiliation(s)
- Thaís C Chaves
- Departamento de Neurosciências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Aline M Turci
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, FMRP, USP, Ribeirão Preto, SP, Brazil
| | - Carina F Pinheiro
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, FMRP, USP, Ribeirão Preto, SP, Brazil
| | - Letícia M Sousa
- Departamento de Medicina Social, FMRP, USP, Ribeirão Preto, SP, Brazil
| | - Débora B Grossi
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, FMRP, USP, Ribeirão Preto, SP, Brazil
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Bortoletto CC, Cordeiro da Silva F, Silva PFDC, Leal de Godoy CH, Albertini R, Motta LJ, Mesquita-Ferrari RA, Fernandes KPS, Romano R, Bussadori SK. Evaluation of Cranio-cervical Posture in Children with Bruxism Before and After Bite Plate Therapy: A Pilot Project. J Phys Ther Sci 2014; 26:1125-8. [PMID: 25140110 PMCID: PMC4135211 DOI: 10.1589/jpts.26.1125] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 02/07/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of the present study was to evaluate the effect of a biteplate on the
cranio-cervical posture of children with bruxism. [Subjects and Methods] Twelve male and
female children aged six to 10 years with a diagnosis of bruxism participated in this
study. The children used a biteplate during sleep for 30 days and were submitted to three
postural evaluations: initial, immediately following placement of the biteplate, and at
the end of treatment. Posture analysis was performed with the aid of the
Alcimagem® 2.1 program. Data analysis (IBM SPSS Statistics 2.0) involved
descriptive statistics and the Student’s t-test. [Results] A statistically significant
difference was found between the initial cranio-cervical angle and the angle immediately
following placement of the biteplate. However, no statistically significant difference was
found between the initial angle and the angle after one month of biteplate usage.
[Conclusion] No significant change in the cranio-cervical posture of the children was
found one month of biteplate usage. However, a reduction occurred in the cranio-cervical
angle when the biteplate was in position.
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Affiliation(s)
| | | | | | | | - Regiane Albertini
- Master's Course in Rehabilitation Sciences, Nove de Julho University (UNINOVE), 235, Brazil
| | - Lara J Motta
- Master's Program Management Healthcare System, Nove de Julho University (UNINOVE), Brazil
| | | | | | - Renata Romano
- Rehabilitation Sciences, Nove de Julho University (UNINOVE), Brazil
| | - Sandra Kalil Bussadori
- Master's Course in Rehabilitation Sciences, Nove de Julho University (UNINOVE), 235, Brazil
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Grondin F, Hall T, Laurentjoye M, Ella B. Upper cervical range of motion is impaired in patients with temporomandibular disorders. Cranio 2014; 33:91-9. [PMID: 25919749 DOI: 10.1179/0886963414z.00000000053] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
AIMS Clinicians increasingly suggest assessment and treatment of the cervical spine in patients with temporomandibular dysfunction (TMD); however, few studies have investigated upper cervical spine mobility in people who suffer from TMD. The purpose of this study was to investigate whether patients with TMD pain (with or without headache) present with upper cervical spine impairment when compared with asymptomatic subjects. METHODOLOGY A single blind examiner evaluated cervical range of motion (ROM) measures including axial rotation during the flexion-rotation test (FRT) and sagittal plane ROM. Twenty asymptomatic subjects were compared with 37 subjects with pain attributed to TMD, confirmed by the Revised Research Diagnostic Criteria. Subjects with TMD were divided according to the presence of headache (26 without headache TMDNHA, 11 with headache TMDHA). One-way analysis of variance and planned orthogonal comparisons were used to determine differences in cervical mobility between groups. All subjects with TMD were positive on the FRT with restricted ROM, while none were in the control group. RESULTS The analysis of variance revealed significant differences between groups for the FRT F(2,54) = 57.96, P<0.001) and for sagittal ROM [F(2,54) = 5.69, P = 0.006]. Findings show that the TMDHA group had less axial rotation than group TMDNHA, and both TMD groups had less ROM than controls. For sagittal ROM, the only difference was between group TMDHA and controls. CONCLUSIONS Subjects with TMD had signs of upper cervical spine movement impairment, greater in those with headache. Only subjects with TMD and headache had impairment of cervical spine sagittal plane mobility. This study provides evidence for the importance of examination of upper cervical mobility determined by the FRT in patients who suffer from TMD.
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Case series of an intraoral balancing appliance therapy on subjective symptom severity and cervical spine alignment. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:181769. [PMID: 23935655 PMCID: PMC3713604 DOI: 10.1155/2013/181769] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 06/07/2013] [Indexed: 11/17/2022]
Abstract
Objective. The objective of this study was to investigate the effect of a holistic intraoral appliance (OA) on cervical spine alignment and subjective symptom severity.
Design. An observational study on case series with holistic OA therapy. Setting. An outpatient clinic for holistic temporomandibular joint (TMJ) therapy under the supervision of the Pain Center, CHA Biomedical center, CHA University. Subjects. Ambulatory patients presenting with diverse chief complaints in the holistic TMJ clinic. Main Measures. Any immediate change in the curvature of cervical spine and the degree of atlantoaxial rotation was investigated in the images of simple X-ray and computed tomography of cervical spine with or without OA. Changes of subjective symptom severity were also analyzed for the holistic OA therapy cases. Results. A total of 59 cases were reviewed. Alignment of upper cervical spine rotation showed an immediate improvement (P < 0.001). Changes of subjective symptom severity also showed significant improvement (P < 0.05). Conclusion. These cases revealed rudimentary clinical evidence that holistic OA therapy may be related to an alleviated symptom severity and an improved cervical spinal alignment. These results show that further researches may warrant for the holistic TMJ therapy.
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Armijo-Olivo S, Magee D. Cervical musculoskeletal impairments and temporomandibular disorders. J Oral Maxillofac Res 2013; 3:e4. [PMID: 24422022 PMCID: PMC3886095 DOI: 10.5037/jomr.2012.3404] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 09/13/2012] [Indexed: 12/04/2022]
Abstract
Objectives The study of cervical muscles and their significance in the development and
perpetuation of Temporomandibular Disorders has not been elucidated. Thus
this project was designed to investigate the association between cervical
musculoskeletal impairments and Temporomandibular Disorders. Material and Methods A sample of 154 subjects participated in this study. All subjects underwent a
series of physical tests and electromyographic assessment (i.e. head and
neck posture, maximal cervical muscle strength, cervical flexor and extensor
muscles endurance, and cervical flexor muscle performance) to determine
cervical musculoskeletal impairments. Results A strong relationship between neck disability and jaw disability was found (r
= 0.82). Craniocervical posture was statistically different between patients
with myogenous Temporomandibular Disorders (TMD) and healthy subjects.
However, the difference was too small (3.3º) to be considered
clinically relevant. Maximal cervical flexor muscle strength was not
statistically or clinically different between patients with TMD and healthy
subjects. No statistically significant differences were found in
electromyographic activity of the sternocleidomastoid or the anterior
scalene muscles in patients with TMD when compared to healthy subjects while
executing the craniocervical flexion test (P = 0.07). However, clinically
important effect sizes (0.42 - 0.82) were found. Subjects with TMD presented
with reduced cervical flexor as well as extensor muscle endurance while
performing the flexor and extensor muscle endurance tests when compared to
healthy individuals. Conclusions Subjects with Temporomandibular Disorders presented with impairments of the
cervical flexors and extensors muscles. These results could help guide
clinicians in the assessment and prescription of more effective
interventions for individuals with Temporomandibular Disorders.
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Affiliation(s)
- Susan Armijo-Olivo
- Faculty of Rehabilitation Medicine, Department of Physical Therapy and Faculty of Medicine and dentistry, Department of Pediatrics, University of Alberta Canada
| | - David Magee
- Faculty of Rehabilitation Medicine Department of Physical Therapy, University of Alberta Canada
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Armijo-Olivo S, Warren S, Fuentes J, Magee DJ. Clinical relevance vs. statistical significance: Using neck outcomes in patients with temporomandibular disorders as an example. ACTA ACUST UNITED AC 2011; 16:563-72. [DOI: 10.1016/j.math.2011.05.006] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Revised: 04/16/2011] [Accepted: 05/09/2011] [Indexed: 11/30/2022]
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