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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 2024; 41:169-175. [PMID: 36939816 DOI: 10.1080/08990220.2023.2188931] [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: 06/23/2022] [Accepted: 03/06/2023] [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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Tavares LF, Gadotti IC, Carvalho BG, Fernandes APM, Padilha Silva J, Barbosa GAS, Almeida EO, Ribeiro KF. Are neck pain, disability, and deep neck flexor performance the same for the different types of temporomandibular disorders? Cranio 2024; 42:770-778. [PMID: 35300577 DOI: 10.1080/08869634.2022.2052582] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate neck pain, disability, and deep neck flexor (DNF) performance of individuals with temporomandibular disorders (TMD). METHODS Eighty individuals were divided into the following: arthrogenic TMD (n = 40), myogenic TMD (n = 12), and mixed TMD (n = 28). Neck pain intensity, neck disability, and DNF performance were evaluated. RESULTS Individuals with arthrogenic TMD reported lower intensity of neck pain when compared to mixed TMD (p = 0.01). Individuals with arthrogenic TMD had less neck disability than individuals with myogenic TMD (p = 0.037) and mixed TMD (p < 0.001). A moderate positive correlation was found between neck pain and neck disability (p < 0.001). No differences were found for DNF performance. CONCLUSION Neck pain and disability differs according to subtype of TMD, but performance of the deep neck flexors does not. Neck pain intensity and neck disability were correlated in patients with TMD.
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Affiliation(s)
- Luiz Felipe Tavares
- Department of Physical Therapy, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Inae Caroline Gadotti
- Department of Physical Therapy, Florida International University, Miami, FL, United States
| | | | | | - Jade Padilha Silva
- Department of Physical Therapy, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
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Campos López A, De-Miguel EE, Malo-Urriés M, Acedo TC. Mouth opening, jaw disability, neck disability, pressure pain thresholds, and myofascial trigger points in patients with disc displacement with reduction: A descriptive and comparative study. Cranio 2024; 42:309-315. [PMID: 34382921 DOI: 10.1080/08869634.2021.1956214] [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: 10/20/2022]
Abstract
OBJECTIVE To assess jaw and neck function, pressure pain threshold (PPT), and the presence of trigger points (TrPs) in disc displacement with reduction (DDWR) subjects compared to healthy subjects. METHODS One hundred DDWR subjects and 100 matched controls were studied. Clinical evaluations included demographic data, range of motion, jaw and neck disability, PPT, and muscle TrPs. RESULTS DDWR subjects have limited pain-free opening limitation (p < 0.001), jaw and neck disability limitation (p < 0.001), and higher presence of active and latent TrPs limitation (p < 0.001) compared to healthy subjects. CONCLUSION DDWR subjects present a limited pain-free mouth opening, higher jaw and neck disability, lower PPT, and major presence of active and latent TrPs compared to healthy subjects. Cervical spine and TMJ evaluation and treatment should be considered in DDWR patients.
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Affiliation(s)
| | - Elena Estébanez De-Miguel
- Department Of Physiatrist And Nursery, Faculty Of Heath Sciences, University Of Zaragoza, Zaragoza, Spain
| | - Miguel Malo-Urriés
- Department Of Physiatrist And Nursery, Faculty Of Heath Sciences, University Of Zaragoza, Zaragoza, Spain
| | - Tania Camou Acedo
- Academic Department, Orthopedic Manual Therapy Center, Hermosillo, Mexico
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Ekici Ö, Camcı H. Relationship of temporomandibular joint disorders with cervical posture and hyoid bone position. Cranio 2024; 42:132-141. [PMID: 34000977 DOI: 10.1080/08869634.2021.1926745] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate craniocervical posture and hyoid bone position in patients with and without temporomandibular joint disorder (TMD). METHODS A total of 113 people were included in the study, including 55 TMD patients and 58 healthy controls. Using lateral cephalograms, the craniofacial, craniocervical, and hyoid bone positions of the participants were evaluated in terms of 27 variables. RESULTS There was no significant difference in craniocervical angles between participants with or without TMD. While the Hy-B, Hy-NSL, Hy-NL measurements and FMA (°), AFH (mm) measurements of participants with TMD were lower than the control group, the hyoid angle was greater than the control group. CONCLUSION These study findings provide evidence that TMD is not related to craniocervical posture but to the position of the hyoid bone and craniofacial morphology.
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Affiliation(s)
- Ömer Ekici
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Hasan Camcı
- Department of Orthodontics, Faculty of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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Dinsdale A, Thomas L, Forbes R, Treleaven J. Is proprioception affected in those with persistent intra-articular temporomandibular disorders? A cross-sectional study exploring joint position sense and force sense of the jaw. Musculoskelet Sci Pract 2024; 69:102904. [PMID: 38171215 DOI: 10.1016/j.msksp.2023.102904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/20/2023] [Accepted: 12/26/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Proprioception is an important component of normal jaw function, although to date it is unknown if and how proprioception is affected in those with intra-articular temporomandibular disorders (IA-TMDs). This challenges effective management of this subgroup. OBJECTIVES Determine whether differences in local joint position sense and force sense exist between individuals with IA-TMD and those without a jaw problem. DESIGN Cross-sectional study. METHOD Sixty age and sex matched participants were recruited (n = 30 IA-TMD, n = 30 healthy controls). Temporomandibular joint position sense was tested to one target (50% of maximal mouth opening) using a ruler. Temporomandibular force sense was tested to two targets (50% and 70% of maximal molar pain-free bite force) using a bite sensor. Constant, absolute and variable errors were calculated for each outcome and compared between groups using p-values and 95% confidence intervals for effect size (d). RESULTS Significantly greater degrees of constant, absolute and variable error were seen for force sense testing at the 50% target (p < 0.05). No statistically significant difference was observed between groups for joint position sense, or for constant or variable force sense error at the 70% target (p > 0.05). Despite this, all joint position sense and force sense measures demonstrated possible clinical significance (upper limits 95% CI d ≥ 0.5). CONCLUSIONS Force sense, particularly at lower levels, appears impaired in those with IA-TMD. Joint position sense and force sense at higher levels appear less affected, although may still be important to consider in the management of IA-TMD in some patients.
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Affiliation(s)
- Alana Dinsdale
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Saint Lucia.
| | - Lucy Thomas
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Saint Lucia.
| | - Roma Forbes
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Saint Lucia.
| | - Julia Treleaven
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Saint Lucia.
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Bae S, Jung J, Moon D. Impact of Movement Control Training Using a Laser Device on the Neck Pain and Movement of Patients with Cervicogenic Headache: A Pilot Study. Healthcare (Basel) 2023; 11:healthcare11101439. [PMID: 37239725 DOI: 10.3390/healthcare11101439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 05/03/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
This study verified the effect of movement control training using a laser device on the neck pain and movement of patients with cervicogenic headache. A total of twenty outpatients recruited from two Busan hospitals were equally divided into two groups. The experimental group underwent movement control training with visual biofeedback, while the control group performed self-stretching. Both groups received therapeutic massage and upper cervical spine mobilization. A four-week intervention program was also conducted. Measurement tools including the cervical flexion-rotation test, visual analog scale, Headache Impact Test-6, pressure pain threshold, range of motion, sensory discrimination, and Neck Disability Index helped assess the participating patients before and after the intervention. Additionally, the Wilcoxon signed-rank test and the Mann-Whitney U test helped determine inter and intra-group variations, respectively, before and after the intervention. Most of the measurement regions revealed significant changes post-intervention within the experimental group, while only the cervical flexion-rotation test, visual analog scale, Headache Impact Test-6, and Neck Disability Index indicated significant changes post-intervention within the control group. There were also considerable inter-group differences. Thus, movement control training using a laser device more effectively improves neck pain and movement of patients with cervicogenic headache.
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Affiliation(s)
- Songui Bae
- Department of Physical Therapy, Graduate School, Dong-Eui University, Busan 47340, Republic of Korea
| | - Juhyeon Jung
- Department of Physical Therapy, College of Nursing, Healthcare Sciences and Human Ecology, Dong-Eui University, Busan 47340, Republic of Korea
| | - Dongchul Moon
- Department of Physical Therapy, Gimhae College, Gimhae-si 50811, Republic of Korea
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Szarejko KD, Gołębiewska M, Lukomska-Szymanska M, Kuć J. Stress Experience, Depression and Neck Disability in Patients with Temporomandibular Disorder-Myofascial Pain with Referral. J Clin Med 2023; 12:jcm12051988. [PMID: 36902775 PMCID: PMC10004681 DOI: 10.3390/jcm12051988] [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: 02/05/2023] [Revised: 02/23/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
The etiology of temporomandibular disorders (TMDs) is firmly anchored in the biopsychosocial model in which a special role is attributed to the stress, depression, somatic symptoms, and anxiety. The aim of the study was to assess the level of stress, depression and neck disability in patients with temporomandibular disorder-myofascial pain with referral. The study group enrolled 50 people (37 women and 13 men) with complete natural dentition. All the patients underwent a clinical examination according to the Diagnostic Criteria for Temporomandibular Disorders and were diagnosed as individuals with myofascial pain with referral. The questionnaires were associated with stress, depression, and neck disability; Perceived Stress Scale (PSS-10), Beck Depression Inventory(BDI), and Neck Disability Index (NDI) were evaluated. Of the individuals evaluated, 78% showed elevated levels of stress, and the average value of the PSS-10 in the study group was 18 points (Me = 17). Furthermore, 30% of the subjects presented depressive symptoms, with the average value of BDI was 8.94 points (Me = 8), and 82% of the subjects showed neck disability. The multiple linear regression model revealed that BDI and NDI allowed explanations for the 53% differentiation of PSS-10. In conclusion, stress, depression, and neck disability coexist with temporomandibular disorder-myofascial pain with referral.
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Affiliation(s)
- Krzysztof Dariusz Szarejko
- Private Health Care, Physical Therapy and Rehabilitation, Bialystok, 79 Warsaw St., 15-201 Bialystok, Poland
| | - Maria Gołębiewska
- Department of Dental Techniques, Medical University of Bialystok, 13 Washington St., 15-269 Bialystok, Poland
| | | | - Joanna Kuć
- Department of Prosthodontics, Medical University of Bialystok, 24A M. Sklodowskiej-Curie St., 15-276 Bialystok, Poland
- Correspondence:
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Sanchla AD, Shrivastav S, Bharti L, Kamble R. Comparative Evaluation and Correlation of Pain Pattern in Neck Musculature Observed in Mild, Moderate, and Severe Temporomandibular Joint Disorder Cases as Compared to Non-temporomandibular Joint Disorder Cases. Cureus 2022; 14:e30099. [PMID: 36381943 PMCID: PMC9642967 DOI: 10.7759/cureus.30099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 10/09/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction Temporomandibular disorder (TMD) is a broad term used to describe several interlinked disorders affecting the temporomandibular joint (TMJ), muscles of the craniofacial region, and associated structures, all of which have common symptoms such as pain and reduced jaw opening. Along with these, extra-craniofacial symptoms may also be present, which need to be assessed for early diagnosis of TMD. Considering the extra-craniofacial symptoms of TMD, this observational study aimed to evaluate the severity of pain in the neck musculature of patients with TMD and correlate it with the severity of the disorder. Material and methods A total of 44 patients were included in the study who were graded for severity of TMD based on the amnestic and dysfunctional components of the Helkimo index separately. The pain was evaluated bilaterally in five groups of neck muscles in all cases using manual palpation. The severity of pain in these neck muscles was then correlated with the severity of both subjective and objective symptoms of TMD and compared with patients without TMD. Results The Chi-square test revealed a statistically significant association between the severity of pain in all five groups of neck muscles and the severity of TMD. The severity of pain increased with the increasing severity of TMD, with a total of 59.09% of TMD patients presenting with varying degrees of pain in the neck musculature and a p-value of 0.0001% which was significant. Negligible pain in the neck musculature was present in patients without TMD. Conclusion Based on the results, it was observed that the severity of TMD directly correlated with pain in various groups of neck muscles. 59.09% of patients with TMD reported varying degrees of pain in the neck musculature. The severity and distribution of pain in the neck muscles increased with the increasing severity of TMD.
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Tuncer A, Atay F, Guzel HC, Tuncer AH. Comparison of factors affecting patients with a myofascial temporomandibular disorder with and without sleep bruxism. Niger J Clin Pract 2022; 25:273-280. [PMID: 35295048 DOI: 10.4103/njcp.njcp_1420_21] [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: 11/04/2022]
Abstract
Aims and Background The aim of the present study was to evaluate the relationship between jaw function, neck disability, sleep quality, fatigue, and headache in patients with myofascial temporomandibular disorder (TMD) with sleep Bruxism (SB) and without it (non-SB). Subjects and Methods This case-control study was conducted with a total of 200 myofascial TMD patients, comprising 91 identified as SB and 109 as non-SB. The Jaw Function Limitations Scale (JFLS), Neck Disability Index (NDI), Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), and Headache Impact Test-6 (HIT-6) scales and indexes were used. Results In the group with SB compared to the non-SB group, JFLS, NDI, PUKI, and FSS scores were statistically significantly higher (P < 0.001). No statistically significant difference was found between the groups in terms of visual analog scale (VAS) (P = 0.127) and HIT-6 scores (P = 0.365). The probability of having JFLS in patients with SB compared to those without was folded 3.551 times (P = 0.002), and the probability of having NDI increased 3.473 times (P = 0.002). In addition, SB was observed to trigger poor sleep quality (P < 0.001). There was no statistically significant determinant of bruxism on FSS (P = 0.196), and on HIT-6 (P = 0.488). Conclusion It can be concluded that SB causes limitation of the jaw's functional activities, neck problems, and decreased sleep quality in myofascial TMD. These findings emphasize the importance of considering SB when evaluating and treating patients with myofascial TMD problems.
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Affiliation(s)
- A Tuncer
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hasan Kalyoncu University, Gaziantep, Turkey
| | - F Atay
- Abdulkadir Konukoğlu, Healthy Life Center, Gaziantep, Turkey
| | - H C Guzel
- Umut Rehabilitation Center, Sanliurfa, Turkey
| | - A H Tuncer
- Department of Pediatric Dentistry, Henry M. Goldman School of Dental Medicine, Boston University, Boston, USA
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Prodoehl J, Kraus S, Buros Stein A. Predicting the number of physical therapy visits and patient satisfaction in individuals with temporomandibular disorder: A cohort study. J Oral Rehabil 2021; 49:22-36. [PMID: 34674278 DOI: 10.1111/joor.13272] [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] [Received: 05/19/2021] [Revised: 09/21/2021] [Accepted: 10/12/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Temporomandibular disorders (TMD) can be challenging to manage for clinicians and patients alike. It is unclear which factors are associated with prolonging conservative care and patient dissatisfaction with treatment outcomes. OBJECTIVES To examine factors collected during a physical therapy (PT) evaluation in a cohort of individuals with TMD to determine factors associated with an increased number of PT visits and reduced patient satisfaction. METHODS Records of 511 patients referred to PT over 18 months were reviewed to extract 27 variables to develop a predictive model. Outcomes were patient satisfaction following PT and number of PT visits. Linear and zero inflated negative binomial regressions were used, and a multivariate regression model was built for both outcomes. RESULTS Two factors were associated with both lower patient satisfaction and an increased number of PT visits: higher patient rated functional neck disability and a greater number of healthcare professionals seen. Other factors associated with patient satisfaction were duration of symptoms, subluxation, and referral from an oral surgeon. Only patient rated functional neck disability score was a significant predictive factor in the multivariate model. Factors associated with number of PT visits were gender, educational level, time between initial visit and discharge, number of pain areas, bruxism, biopsychosocial factors, dizziness, pain rating, and presence of neck pain. In the multivariate model, gender, number of healthcare professionals seen, and resting pain rating were significant predictors of number of PT visits. CONCLUSION Considering key factors on initial evaluation, specifically functional neck disability and the number of prior healthcare professionals seen before starting PT, can help to predict a higher number of PT visits and reduced patient satisfaction with outcomes.
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Affiliation(s)
- Janey Prodoehl
- Physical Therapy Program, Midwestern University, Downers Grove, Illinois, USA
| | - Steven Kraus
- Horizon Physical Therapy LLC, Atlanta, Georgia, USA
| | - Amy Buros Stein
- Office of Research and Sponsored Programs, Midwestern University, Glendale, Arizona, USA
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Kuć J, Szarejko KD, Gołębiewska M. The Prevalence and Overlaps of Temporomandibular Disorders in Patients with Myofascial Pain with Referral-A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9842. [PMID: 34574764 PMCID: PMC8471332 DOI: 10.3390/ijerph18189842] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022]
Abstract
The aim of the study was to evaluate the temporomandibular joint, the prevalence of single and multiple diagnosis and potential sided domination of temporomandibular dysfunction in patients with temporomandibular disorder-myofascial pain with referral. The study group enrolled 50 people-37 females and 13 males between 18 and 25 years old with an average age of 23.36 ± 2.14. The patients underwent joint vibration analysis. Sixty seven percent of all examined tem-poromandibular joints were classified as group I according to Mark Piper's classification. Class IIIA appeared in 17% of joints. Eight percent of temporomandibular joints were classified as class IVA. There were no statistically significant differences in the prevalence of temporomandibular disorder with respect to gender (p = 0.838639). The relatively high prevalence of multiple diagnoses proved the overlapping nature of muscle and intraarticular disorders. Twenty eight percent of the subjects suffered from a combination of myofascial pain with referral and bilateral temporoman-dibular dysfunction. In 62% of the patients a lack of intraarticular disorders was reported. The suggestion that there exists sided domination in the occurrence of temporomandibular disorders has not been confirmed. Due to the small sample size, such differences cannot be excluded. Fur-ther research is needed.
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Affiliation(s)
- Joanna Kuć
- Department of Prosthodontics, Medical University of Bialystok, 24A M. Sklodowskiej-Curie St., 15-276 Bialystok, Poland
| | | | - Maria Gołębiewska
- Department of Dental Techniques, Medical University of Bialystok, 13 Washington St., 15-269 Bialystok, Poland;
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Exploring the utility of motion analysis in osteopathic clinical trials; a school-based pilot study on jaw and cervical range of motion. INT J OSTEOPATH MED 2021. [DOI: 10.1016/j.ijosm.2021.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Role of Photobiomodulation Therapy in Modulating Oxidative Stress in Temporomandibular Disorders. A Systematic Review and Meta-Analysis of Human Randomised Controlled Trials. Antioxidants (Basel) 2021; 10:antiox10071028. [PMID: 34202292 PMCID: PMC8300797 DOI: 10.3390/antiox10071028] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/14/2021] [Accepted: 06/22/2021] [Indexed: 02/08/2023] Open
Abstract
This systematic review and meta-analysis (PROSPERO registration; ref CRD 42020198921) aimed to govern photobiomodulation therapy (PBMT) efficacy in temporomandibular disorder (TMD). PRISMA guidelines and Cochrane Collaboration recommendations were followed. Differences in pain reduction assessment by qualitative measurement with visual analogue scale pain (VAS), pressure threshold (PPT) and maximum mouth opening (MMO) were calculated with 95% confidence intervals and pooled in a random effects model with a subgroup analysis, evaluating the role of follow-up duration. Heterogeneity was analysed using Q and I2 tests. Publication bias was assessed by visual examination of funnel plot symmetry. Qualitative analysis revealed 46% of the 44 included studies showed a high risk of bias. Meta-analysis on 32 out of 44 studies revealed statistically significant intergroup differences (SSID) for VAS (SMD = -0.55; 95% CI = -0.82 to -0.27; Z = 3.90 (p < 0.001)), PPT (SMD = -0.45; 95% CI = -0.89 to 0.00; Z = 1.97 (p = 0.05)) and MMO (SMD = -0.45; 95% CI = -0.89 to 0.00; Z = 1.97 (p = 0.05)), favouring PBMT compared to control treatment strategies. Sensitivity analysis revealed SSID (SMD = -0.53; 95% CI = -0.73 to -0.32; Z = 5.02 (p < 0.0001)) with low heterogeneity (Τ2 = 0.02; χ2 = 16.03 (p = 0.31); I2 = 13%). Hence, this review, for first time, proposed suggested recommendations for PBMT protocols and methodology for future extensive TMD research.
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14
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Balthazard P, Hasler V, Goldman D, Grondin F. Association of cervical spine signs and symptoms with temporomandibular disorders in adults: a systematic review protocol. JBI Evid Synth 2021; 18:1334-1340. [PMID: 32813383 DOI: 10.11124/jbisrir-d-19-00107] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The objective of this systematic review is to assess the evidence of association of cervical spine signs and symptoms with temporomandibular disorders (TMD). This will help to lend credence to mechanisms supporting the association in order to improve care strategies for this condition. INTRODUCTION The association of cervical spine impairments (in relation to neck posture, cervical spine mobility, muscle tenderness, muscle activity, and neck disability) with TMD has been widely discussed in the literature. Clarification of this relationship is important for health professionals to better assess and treat TMD. INCLUSION CRITERIA Eligible studies will include participants aged 18 years and over, with a diagnosis of TMD from the Research and Diagnostic Criteria for Temporomandibular Disorders or a revised version. Exclusion criteria will be participants with previous temporomandibular joint surgery, history of trauma or fracture in the temporomandibular joint or the craniomandibular system; serious comorbid conditions such as cancer, rheumatic disease, and neurological problems; primary cervical spine disorders such as disc herniation or spinal degenerative changes; or systemic disease such as ankylosing spondylitis. METHODS The search for articles will be conducted in the databases PubMed, PEDro, CINAHL, Web of Science, and Embase, without language or time restrictions. Two independent reviewers will review the title, abstract, and full texts of identified studies; select studies against the inclusion criteria; assess the methodological quality of eligible studies using critical appraisal tools; and perform data extraction. Relevant quantitative data will be pooled with statistical meta-analysis, when possible. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42019123698.
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Affiliation(s)
- Pierre Balthazard
- Department of Physiotherapy, School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland.,Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST): A JBI Centre of Excellence
| | - Véronique Hasler
- Department of Physiotherapy, School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland.,Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST): A JBI Centre of Excellence
| | | | - Francis Grondin
- Laboratoire IRISSE, Université de La Réunion, Tampon, France
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Pitance L, De Longhi B, Gerard E, Cayrol T, Roussel N, Cescon C, Falla D, Barbero M. Digital pain drawings are a useful and reliable tool for assessing patients with temporomandibular disorders. J Oral Rehabil 2021; 48:798-808. [PMID: 33783832 DOI: 10.1111/joor.13168] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Temporomandibular disorders (TMD) are characterised by complex symptomatology and their assessment can be enhanced using pain drawings (PD). OBJECTIVES To evaluate the location and extent of pain in people TMD using digital PD, and to explore their association with clinical features. Reliability of pain extent and pain location using PD was also assessed. METHODS Forty volunteers with TMD completed two consecutive digital PDs. Clinical features were captured from self-reported questionnaire. Additionally, secondary hyperalgesia was measured using the pressure pain threshold (PPT). The correlation between pain extent and clinical features was investigated using Spearman rank correlation coefficients. Reliability of pain extent was evaluated using intraclass correlation coefficient (ICC) and Bland-Altman plots. The Jaccard index was computed to assess the reliability of pain location. RESULTS Analysis of the PDs indicated that people with TMD commonly experience pain in other body regions including the neck, the shoulder and the low back. Except for PPT and pain catastrophising, all other clinical features were significantly correlated with pain extent. The ICCs of pain extent for all body charts were very high (ICCs 95% CI from 0.73 to 0.96), and Bland-Altman plots showed mean biases close to zero with narrow limits of agreement. The reliability of pain location was also supported by Jaccard index mean scores above 0.68. CONCLUSIONS People with TMD showed widespread pain, and pain extent was associated with pain intensity, neck and headache-related disability, depression, anxiety, hyperventilation and central sensitivity. The reliability of measuring pain extent and pain location was confirmed.
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Affiliation(s)
- Laurent Pitance
- Institute of Experimental and Clinical Research, Health Sciences division, Université Catholique de Louvain, Neuro-Musculo-Skeletal-Lab (NMSK), Brussels, Belgium.,Oral and Maxilofacial Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Benjamin De Longhi
- Department of Physical Therapy, Institut Parnasse-ISEI, Brussels, Belgium
| | - Eve Gerard
- Oral and Maxilofacial Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Timothee Cayrol
- Institute of Experimental and Clinical Research, Health Sciences division, Université Catholique de Louvain, Neuro-Musculo-Skeletal-Lab (NMSK), Brussels, Belgium
| | - Nathalie Roussel
- Department of Rehabilitation Sciences and Physiotherapy (MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Corrado Cescon
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno/Landquart, Switzerland
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Marco Barbero
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno/Landquart, Switzerland
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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: 11] [Impact Index Per Article: 2.8] [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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17
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Kuć J, Żendzian-Piotrowska M. Evaluation of the Cervical Physiotherapeutic Treatment Needs, Work Ergonomics, and Necessity for Physical Activity Among Students of Dentistry at a Medical University. A Pilot Study. Front Psychol 2020; 11:559657. [PMID: 33192822 PMCID: PMC7642220 DOI: 10.3389/fpsyg.2020.559657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 09/24/2020] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION A lot of general dental practitioners suffer from job-related health problems. They are more prone to numerous different physical and psycho-emotional triggers that aggravate their working conditions. THE AIM The aim of the study was to evaluate cervical physiotherapeutic treatment needs, daily ergonomic habits and the necessity for physical activity among students of dentistry at a medical university. MATERIALS AND METHODS 112 generally healthy dentistry students (73 women, 39 men) were enrolled for the study. The age range was 20-32, with an average of 22.88 ± 2.7. The study included subjects in their second to fifth year of studies. The survey was conducted with respect to the questionnaires about possible physiotherapeutic treatments, physical activities, imaging tests and diagnoses as well as statements regarding the respondents' knowledge and ergonomics habits. To estimate the association between the risk factor and neck disability as well as chronic pain, the Neck Disability Index, Perceived Stress Scale and the Graded Chronic Pain Scale were additionally applied. RESULTS 35.71% of dentistry students had undergo physiotherapy in the preceding year. 26.79% of the respondents declared that they underwent rehabilitation on a regular basis. The most common reasons for treatment were complaints of the cervical (7.14%), lumbar (3.57%), and thoracic spine (1.79%) as well as a combination of these symptoms. 6.25% of the subjects had started rehabilitation due to muscle relaxation. 34.82% of the study participants did not do any physical activity. Females exercised more often than males (p = 0.02; 1-β = 0.65). Therapeutic exercises contributed to the improvement of well-being of 56% of students. 64.29% of the respondents chose a sitting position during pre-clinical and clinical classes and 26.79% of the subjects worked in sitting and standing postures. CONCLUSION 26.79% of dentistry students required periodic therapeutic rehabilitation. 34.82% of the respondents were advised to implement systematic physical activity. Due to professional conditions, dental students are exposed to an early cervical spine disorders. The main factor influencing an early onset of such dysfunctions is increased stress level. An average level of pro-health awareness may be the reason for elevated cost of rehabilitation among this group of patients.
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Affiliation(s)
- Joanna Kuć
- Department of Prosthodontics, Medical University of Bialystok, Bialystok, Poland
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18
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de Oliveira-Souza AIS, de O Ferro JK, Barros MMMB, Oliveira DAD. 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: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [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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Affiliation(s)
| | - Josepha Karinne de O Ferro
- Department of Physical Therapy, Health Sciences Center, Federal University of Pernambuco, Recife, PE, Brazil.
| | - Manuella M M B Barros
- Department of Physical Therapy, Health Sciences Center, Federal University of Pernambuco, Recife, PE, Brazil.
| | - Daniella A de Oliveira
- Department of Physical Therapy, Health Sciences Center, Federal University of Pernambuco, Recife, PE, Brazil.
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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:E2806. [PMID: 32872670 PMCID: PMC7565821 DOI: 10.3390/jcm9092806] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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
| | - 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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Effectiveness of Cervical Spine High-Velocity, Low-Amplitude Thrust Added to Behavioral Education, Soft Tissue Mobilization, and Exercise for People With Temporomandibular Disorder With Myalgia: A Randomized Clinical Trial. J Orthop Sports Phys Ther 2020; 50:455-465. [PMID: 31905097 DOI: 10.2519/jospt.2020.9175] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine the immediate and short-term effects of adding cervical spine high-velocity, low-amplitude thrust (HVLAT) to behavioral education, soft tissue mobilization, and a home exercise program on pain and dysfunction for people with a primary complaint of temporomandibular disorder (TMD) with myalgia. DESIGN Randomized clinical trial. METHODS Fifty individuals with TMD were randomly assigned to receive cervical HVLAT or sham manipulation for 4 visits over 4 weeks. Participants in both groups received other treatments, including standardized behavioral education, soft tissue mobilization, and a home exercise program. Primary outcomes included maximal mouth opening, the numeric pain-rating scale, the Jaw Functional Limitation Scale (JFLS), the Tampa Scale of Kinesiophobia for TMD (TSK-TMD), and a global rating of change (GROC). Self-report and objective measurements were taken at baseline, immediately after initial treatment, and follow-ups of 1 week and 4 weeks. A 2-by-4 mixed-model analysis of variance was used, with intervention group as the between-subjects factor and time as the within-subject factor. Separate analyses of variance were performed for dependent variables, and the hypothesis of interest was the group-by-time interaction. RESULTS There was no significant interaction for maximal mouth opening, the numeric pain-rating scale, or secondary measures. There were significant 2-way interactions for the JFLS (d = 0.60) and TSK-TMD (d = 0.80). The HVLAT group had lower fear at 4 weeks and improved jaw function earlier (1 week). The GROC favored the HVLAT group, with significant differences in successful outcomes noted immediately after baseline treatment (thrust, 6/25; sham, 0/25) and at 4 weeks (thrust, 17/25; sham, 10/25). CONCLUSION Both groups improved over time; however, differences between groups were small. There were significant differences between groups for the JFLS, TSK-TMD, and GROC. The additive clinical effect of cervical HVLAT to standard care remains unclear for treating TMD. J Orthop Sports Phys Ther 2020;50(8):455-465. Epub 6 Jan 2020. doi:10.2519/jospt.2020.9175.
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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: 11] [Impact Index Per Article: 2.2] [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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Gouw S, Frowein A, Braem C, de Wijer A, Creugers NHJ, Pasman JW, Doorduin J, Kalaykova SI. Coherence of jaw and neck muscle activity during sleep bruxism. J Oral Rehabil 2020; 47:432-440. [PMID: 31926031 PMCID: PMC7079051 DOI: 10.1111/joor.12932] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 12/05/2019] [Accepted: 12/31/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Studies have shown co-contraction of jaw and neck muscles in healthy subjects during (sub) maximum voluntary jaw clenching, indicating functional inter-relation between these muscles during awake bruxism. So far, coherence of jaw and neck muscles has not been evaluated during either awake or sleep bruxism. OBJECTIVE The objective of this study was to evaluate the coherence between jaw and neck muscle activity during sleep bruxism. METHODS In a cross-sectional observational design, the electromyographic activity of jaw (masseter, temporalis) and neck (sternocleidomastoid, trapezius) muscles in individuals with "definite" sleep bruxism was measured using ambulatory polysomnography (PSG). Coherence for masseter-temporalis, masseter-sternocleidomastoid and masseter-trapezius was measured during phasic and mixed rhythmic masticatory muscle activity episodes using coherence-analysing software. Outcome measures were as follows: presence or absence of significant coherence per episode (in percentages), frequency of peak coherence (FPC) per episode and sleep stage. RESULTS A total of 632 episodes within 16 PSGs of eight individuals were analysed. Significant coherence was found between the jaw and neck muscles in 84.9% of the episodes. FPCs of masseter-temporalis were significantly positively correlated with those of masseter-sternocleidomastoid or masseter-trapezius (P < .001). Sleep stages did not significantly influence coherence of these muscular couples. CONCLUSION During sleep bruxism, jaw and neck muscle activation is significantly coherent. Coherence occurs independently of sleep stage. These results support the hypothesis of bruxism being a centrally regulated phenomenon.
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Affiliation(s)
- Simone Gouw
- Department of Oral Function and Prosthetic DentistryCollege of Dental SciencesRadboud University Medical CenterNijmegenThe Netherlands
- Academic InstituteUtrechtThe Netherlands
| | - Angela Frowein
- Department of Oral Function and Prosthetic DentistryCollege of Dental SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Carlijn Braem
- Department of NeurologyRadboud University Medical CenterNijmegenThe Netherlands
- Technical MedicineUniversity of TwenteEnschedeThe Netherlands
| | - Anton de Wijer
- Department of Oral Function and Prosthetic DentistryCollege of Dental SciencesRadboud University Medical CenterNijmegenThe Netherlands
- Academic InstituteUtrechtThe Netherlands
| | - Nico H. J. Creugers
- Department of Oral Function and Prosthetic DentistryCollege of Dental SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Jaco W. Pasman
- Department of NeurologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Jonne Doorduin
- Department of NeurologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Stanimira I. Kalaykova
- Department of Oral Function and Prosthetic DentistryCollege of Dental SciencesRadboud University Medical CenterNijmegenThe Netherlands
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Bilgin E, Bilgin E, Özdemir O, Kalyoncu U. Temporomandibular disorders in ankylosing spondylitis: a cross-sectional, monocentric study. Rheumatol Int 2020; 40:933-940. [PMID: 32239320 DOI: 10.1007/s00296-020-04563-y] [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: 01/30/2020] [Accepted: 03/21/2020] [Indexed: 12/30/2022]
Abstract
There are contradictory results in the relevant literature about the relationship between objective determinants of craniocervical posture and temporomandibular disorder (TMD), whereas no study has worked on ankylosing spondylitis (AS) and TMD relationship. We conducted this study to test the predictors of TMD in AS patients and its relationship with craniocervical posture. AS patients aged between 18 and 50 years consecutively admitted to our outpatient clinics were recruited. TMD was diagnosed by 'Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)'. Spinal mobility was assessed by BASMI; disease activity by ASDAS-CRP and neck disability by Neck Disability Index. Craniocervical posture was assessed on lateral cervical X-ray by measuring the craniocervical angle, cervical curvature angle, suboccipital distance, atlas-axis distance, and anterior translation distance. A total of 98 (58.2% female) patients with a mean age of 37.4 ± 8.2 years were enrolled in this study. TMD was diagnosed in 58 (59.2%) patients. Spinal mobility and craniocervical posture measurements were similar among the two groups. Smoking, bruxism (in females), neck disability and AS disease activity (in males) were higher in TMD patients. Multivariate analysis revealed active smoking (aOR 6.9; 95% CI 1.8-25.6; p = 0.004), bruxism in females (aOR 17.9; 95% CI 2.0-159.2; p = 0.01), high ASDAS in males (aOR 11.8; 95% CI 1.2-122.5; p = 0.038) and neck disability (aOR 12.7; 95% CI 3.8-42.9; p < 0.001) as independent risk factors for TMD in AS patients. No relationship between the craniocervical posture measurements and TMD was found in AS patients. Active smoking, high disease activity in males, bruxism in females and neck disability were found as predictors of TMD in AS patients.
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Affiliation(s)
- Esra Bilgin
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Emre Bilgin
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
| | - Oya Özdemir
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Umut Kalyoncu
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Lam KC, Marshall AN, Snyder Valier AR. Patient-Reported Outcome Measures in Sports Medicine: A Concise Resource for Clinicians and Researchers. J Athl Train 2020; 55:390-408. [PMID: 32031883 DOI: 10.4085/1062-6050-171-19] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Despite the importance of assessing patient outcomes during patient care, current evidence suggests relatively limited use of patient-reported outcome measures (PROMs) by athletic trainers (ATs). Major barriers to PROM use include lack of knowledge, navigating the intricate process of assessing a wide variety of PROMs, and selecting the most appropriate PROM to use for care. A concise resource for ATs to consult when selecting and implementing PROMs may help facilitate the use of PROMs in athletic health care. OBJECTIVE To review the instrument essentials and clinical utility of PROMs used by ATs. METHODS We studied 11 lower extremity region-specific, 10 upper extremity region-specific, 6 generic, and 3 single-item PROMs based on the endorsement of at least 10% of ATs who use PROMs, as reported in a recent investigation of PROM use in athletic training. A literature search was conducted for each included PROM that focused on identifying and extracting components of the instrument essentials (ie, instrument development, reliability, validity, responsiveness and interpretability, and precision) and clinical utility (ie, acceptability, feasibility, and appropriateness). Through independent review and group consensus, we also classified each PROM question by International Classification of Functioning, Disability and Health domain and health-related quality-of-life dimensions. KEY FINDINGS The PROMs contained in this report generally possessed appropriate instrument essentials and clinical utility. Moreover, the PROMs generally emphasized body structure and function as well as the physical functioning of the patient. Athletic trainers aiming to assess patients via a whole-person approach may benefit from combining different PROMs for use in patient care to ensure broader attention to disablement health domains and health-related quality-of-life dimensions.
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Affiliation(s)
| | - Ashley N Marshall
- Dr Marshall is now in the Department of Health and Exercise Science, Appalachian State University, Boone, NC
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Piekartz HV, Rösner C, Batz A, Hall T, Ballenberger N. Bruxism, temporomandibular dysfunction and cervical impairments in females - Results from an observational study. Musculoskelet Sci Pract 2020; 45:102073. [PMID: 31678819 DOI: 10.1016/j.msksp.2019.102073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 10/11/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE Bruxism is highly prevalent and defined as abnormal habitual mouth activity including clenching of the teeth and increased jaw muscle activity. The association between bruxism and temporomandibular dysfunction (TMD) is debated, in particular the association between cervical spine impairments, bruxism, and TMD. Hence the purpose of this study was to identify the relationship between bruxism, TMD, and cervical spine impairments. METHODS This observational study categorized 55 female volunteers suitable for evaluation to a bruxism (n = 33) or non-bruxism group (n = 22) based on comprehensive screening using questionnaires and visual observation of the mouth by 2 independent dentists. Following this, both groups were evaluated for TMD, severity and location of head/neck pain, neck disability index (NDI), cervical spine impairments, and tissue mechanosensitivity. Regression analysis was used to evaluate the relationship between bruxism, TMD severity, and cervical impairments. RESULTS Coefficients of pain and bruxism were significantly associated with NDI scores (0.43, p < 0.001; 3.24, p = 0.01) with large and medium sized effects. As a consequence, both severity of TMD and bruxism status are independently associated with cervical impairments. Having TMD is an independent predictor for head/neck pain and cervical impairments. Pain associated with movement tests and tissue mechanosensitivity was found to be an important factor in bruxism. CONCLUSION Clinicians need to be aware that signs of cervical movement impairment are not likely to be associated with bruxism, rather they should focus on improving orofacial function and tissue mechanosensitivity.
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Affiliation(s)
- Harry von Piekartz
- University of Applied Science Osnabrück, Department of Physical Therapy and Rehabilitation, Caprivistrasse 30a, 49076, Osnabrueck, Germany.
| | - Charlotte Rösner
- University of Applied Science Osnabrück, Department of Physical Therapy and Rehabilitation, Caprivistrasse 30a, 49076, Osnabrueck, Germany.
| | - Angelina Batz
- University of Applied Science Osnabrück, Department of Physical Therapy and Rehabilitation, Caprivistrasse 30a, 49076, Osnabrueck, Germany.
| | - Toby Hall
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
| | - Nicolaus Ballenberger
- University of Applied Science Osnabrück, Department of Physical Therapy and Rehabilitation, Caprivistrasse 30a, 49076, Osnabrueck, Germany.
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Akıncı B, Zorlutuna B, Gürlek S. KRONİK BOYUN AĞRISI TEDAVİSİNDE ÇENE KASLARI EGZERSİZLERİ İLE BOYUN İZOMETRİK EGZERSİZLERİNİN ETKİNLİKLERİNİN KARŞILAŞTIRILMASI: RANDOMİZE, KONTROLLÜ ÇALIŞMA. DÜZCE ÜNIVERSITESI SAĞLIK BILIMLERI ENSTITÜSÜ DERGISI 2020. [DOI: 10.33631/duzcesbed.590675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Kim JR, Jo JH, Chung JW, Park JW. Upper cervical spine abnormalities as a radiographic index in the diagnosis and treatment of temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 129:514-522. [PMID: 31780398 DOI: 10.1016/j.oooo.2019.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 10/04/2019] [Accepted: 10/12/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the clinical characteristics and treatment outcomes of patients with temporomandibular disorders (TMD) according to the presence of upper cervical spine abnormalities and craniofacial morphology. STUDY DESIGN Clinical examinations were conducted on 43 patients with TMD. Upper cervical spine characteristics (fusion, posterior arch deficiency [PAD], and craniofacial morphology) reflecting head-and-neck posture were evaluated on lateral cephalograms. Condylar bone changes in the temporomandibular joint were evaluated by using cone beam computed tomography. Clinical characteristics and treatment outcomes after 1 year of conservative therapy were statistically analyzed between groups, according to the presence of upper cervical spine abnormalities. RESULTS Pain on neck muscle palpation was more frequent in patients with cervical fusion (P = .019) and with either fusion or PAD (P = .004) before treatment. Patients with PAD had smaller comfortable mouth opening ranges compared with those without the deficiency (P = .044) before treatment and smaller comfortable (P = .020) and maximum (P = .021) mouth opening ranges after treatment. Patients with PAD also had mouth opening limitation (P = .028) and pain on masticatory muscle palpation (P = .014) more frequently after treatment compared with patients without the deficiency. CONCLUSIONS Associations exist between upper cervical spine characteristics and treatment outcomes in patients with TMD, suggesting such parameters as a possible radiographic index in TMD diagnosis and treatment.
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Affiliation(s)
- Ji Rak Kim
- Department of Dentistry and Oral Medicine, School of Medicine, Daegu Catholic University, Daegu, Korea
| | - Jung Hwan Jo
- Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Korea
| | - Jin Woo Chung
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| | - Ji Woon Park
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea.
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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: 1.3] [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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Ferreira MP, Waisberg CB, Conti PCR, Bevilaqua‐Grossi D. Mobility of the upper cervical spine and muscle performance of the deep flexors in women with temporomandibular disorders. J Oral Rehabil 2019; 46:1177-1184. [DOI: 10.1111/joor.12858] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/18/2019] [Accepted: 06/28/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Michele P. Ferreira
- Department of Healthy Science, Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil
| | - César B. Waisberg
- Department of Prosthodontics, Bauru School of Dentistry University of São Paulo Bauru Brazil
| | - Paulo César R. Conti
- Department of Prosthodontics, Bauru School of Dentistry University of São Paulo Bauru Brazil
| | - Débora Bevilaqua‐Grossi
- Department of Healthy Science, Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil
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Wiest DM, Candotti CT, Sedrez JA, Pivotto LR, Costa LMRD, Loss JF. Severidade da disfunção temporomandibular e sua relação com a postura corporal. FISIOTERAPIA E PESQUISA 2019. [DOI: 10.1590/1809-2950/18037026022019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo deste estudo foi identificar se existe correlação entre a severidade da disfunção temporomandibular (DTM) e postura corporal, bem como evidenciar as diferenças existentes na postura corporal nos diferentes graus de severidade. Foram avaliadas 71 mulheres de 18 a 35 anos quanto à severidade da DTM e à postura corporal, sendo divididas em grupo sem DTM e grupo com DTM. Foram utilizados o questionário Mandibular Function Impairment Questionnaire e o software Digital Image-Based Postural Assessment de avaliação postural por fotogrametria. Foi realizada análise estatística com ANOVA de um fator e teste de correlação Tau B de Kendall (α<0,05). Os grupos com e sem DTM apresentaram diferenças estatísticas, com tamanho de efeito grande (ŋ2>0,528), para: lordose cervical, pulsão e inclinação da pelve. Quanto à correlação da postura com a severidade da DTM, índices fracos, mas significativos, foram encontrados: ângulo da lordose cervical (τ=0,250), ângulo da cifose dorsal (τ=0,192), ângulo de inclinação pélvica (τ=−0,222) e medida de pulsão da pelve (τ=0,283). Esses resultados indicam que a lordose cervical e a pulsão da pelve se apresentam em aumento da lordose e da pulsão conforme o acréscimo da severidade da DTM, enquanto o ângulo de inclinação se apresenta em menor grau, tendendo à retroversão. Apesar das correlações fracas, os resultados evidenciam alguma relação da postura corporal com a DTM.
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Kuć J, Szarejko KD, Sierpińska T. Evaluation of Orofacial and General Pain Location in Patients With Temporomandibular Joint Disorder-Myofascial Pain With Referral. Front Neurol 2019; 10:546. [PMID: 31191438 PMCID: PMC6549135 DOI: 10.3389/fneur.2019.00546] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 05/07/2019] [Indexed: 12/02/2022] Open
Abstract
Introduction: Pain is an emotional experience. As a subjective feeling, it is associated with pathophysiological processes occurring in the central nervous system, which in turn may negatively affect the psychophysical function, cognitive abilities, level of functioning and quality of life. The Aim: The aim of the study was to assess orofacial and general pain location in patients with temporomandibular joint disorder—myofascial pain with referral. Materials and Methods: The study group consisted of 50 randomly selected, generally healthy people with complete natural dentition (37 women and 13 men) at the age of 23.36 ± 2.14 years, referred to the Department of Prosthodontics of the Medical University. All patients underwent clinical examination according to the Diagnostic Criteria for Temporomandibular Disorders (Axes I and II). The subjects were classified as people with myofascial pain with referral. The evaluation of severity of temporomandibular disorders was based on the Temporomandibular Disorder Pain Screener and the Graded Chronic Pain Scale. In order to assess orofacial and general pain location, a bodychart drawing of pain was used. Results: The study group indicated 40 different areas of the body affected by pain. 2–3 isolated pain locations were declared by a total of six subjects. One person identified 17 affected areas. Forty four people reported pain in at least four regions of the body. 70% of patients suffered from pain within the right masseter muscle. Pain of the left masseter muscle was noted in 68% of cases. Cervical ailments were reported by 56% of people. Pain of the left temporomandibular joint was observed in 68% of patients, and of the right one in 54%. Conclusion: The patients with myofascial pain with referral suffer from general ailments in different regions of the body. Only the frequency of pain in the right masseter muscle and right temporomandibular joint differed with respect to gender. The suggestion that the prevalence of pain in other areas of the body varies between men and women has not been confirmed. Due to a small sample size, such differences cannot be excluded. Further studies in this area are needed.
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Affiliation(s)
- Joanna Kuć
- Department of Prosthodontics, Medical University of Bialystok, Bialystok, Poland
| | | | - Teresa Sierpińska
- Department of Prosthodontics, Medical University of Bialystok, Bialystok, Poland
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Hanskamp M, Armijo-Olivo S, von Piekartz H. Is there a difference in response to manual cranial bone tissue assessment techniques between participants with cervical and/or temporomandibular complaints versus a control group? J Bodyw Mov Ther 2019; 23:334-343. [PMID: 31103117 DOI: 10.1016/j.jbmt.2019.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 02/03/2019] [Indexed: 02/07/2023]
Abstract
AIM Manual cranial bone tissue techniques (CBTT) are used by physiotherapists as a tool for assessment and treatment of complaints in the craniocervical, face, and head regions. The goal of this study was to determine whether CBTT were able to discriminate between subjects with cervical and/or temporomandibular disorders (TMD) and a healthy group. In addition, the inter-rater reliability when applying CBTT was also investigated. METHODS A cross-sectional study was conducted and included 60 participants. Six standardized passive techniques were applied and judged for resistance, compliance, and sensory answer. In order to evaluate the inter-rater reliability of these techniques a cohort of participants was measured twice (by two evaluators) prospectively. A logistic regression model and Receiver Operating Curve (ROC) analyses were used to determining the discriminative validity of these techniques. RESULTS Logistic regression identified a significant difference for five techniques for resistance and/or compliance and/or the sensory answer between the groups. Based on the Area Under the Curve (AUC) analysis, the discriminative ability of the temporal rotation to distinguish between the groups was fair to good (for resistance AUC = 0.7775 and for compliance AUC = 0.8065). The highest agreement between the two assessors was for the resistance with occipital compression (73%) technique. CONCLUSION This study highlights that some of the CBTT could be potentially useful in distinguishing subjects with cervical and/or TMD from healthy subjects. Inter-rater reliability was moderate. CBTT could be potentially integrated in the examination of participants with complaints in the craniofacial region.
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Affiliation(s)
- Miranda Hanskamp
- Department of Movement and Rehabilitation Science, University of Applied Sciences, Osnabrück, Germany
| | - Susan Armijo-Olivo
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Harry von Piekartz
- Department of Movement and Rehabilitation Science, University of Applied Sciences, Osnabrück, Germany.
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Prodoehl J, Kraus S, Klasser GD, Hall KD. Temporomandibular disorder content in the curricula of physical therapist professional programs in the United States. Cranio 2019; 38:376-388. [DOI: 10.1080/08869634.2018.1560983] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Janey Prodoehl
- Physical Therapy Program, Midwestern University, Downers Grove, IL, USA
| | - Steven Kraus
- Horizon Physical Therapy LLC, Atlanta, GA, USA
- Division of Physical Therapy Department of Rehabilitation Medicine, Emory University of Medicine, Atlanta, GA, USA
| | - Gary D. Klasser
- School of Dentistry, Department of Diagnostic Sciences, Louisiana State University Health Sciences Center School of Dentistry, New Orleans, LA, USA
| | - Kathy D. Hall
- Physical Therapy Program, Midwestern University, Downers Grove, IL, USA
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Fenton BT, Goulet JL, Bair MJ, Cowley T, Kerns RD. Relationships Between Temporomandibular Disorders, MSD Conditions, and Mental Health Comorbidities: Findings from the Veterans Musculoskeletal Disorders Cohort. PAIN MEDICINE 2018; 19:S61-S68. [PMID: 30203016 DOI: 10.1093/pm/pny145] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective Temporomandibular disorders (TMDs) have been associated with other chronic painful conditions (e.g., fibromyalgia, headache) and suicide and mood disorders. Here we examined musculoskeletal, painful, and mental health comorbidities in men vs women veterans with TMD (compared with non-TMD musculoskeletal disorders [MSDs] cases), as well as comorbidity patterns within TMD cases. Design Observational cohort. Setting National Veterans Health Administration. Subjects A cohort of 4.1 million veterans having 1+ MSDs, entering the cohort between 2001 and 2011. Methods Chi-square tests, t tests, and logistic regression were utilized for cross-sectional analysis. Results Among veterans with any MSD, those with TMD were younger and more likely to be women. The association of TMD with race/ethnicity differed by sex. Odds of TMD were higher in men of Hispanic ethnicity (OR = 1.38, 95% CI = 1.27-1.48) and nonwhite race/ethnicity other than black or Hispanic (OR = 1.29, 95% CI = 1.16-1.45) compared with white men. Odds of TMD were significantly lower for black (OR = 0.54, 95% CI = 0.49-0.60) and Hispanic women (OR = 0.84, 95% CI = 0.73-0.995) relative to white women. Non-MSD comorbidities (e.g., irritable bowel syndrome, mental health, headaches) were significantly associated with TMD in male veterans; their pattern was similar in women. Veterans with back pain, nontraumatic joint disorder, or osteoarthritis had more MSD multimorbidity than those with TMD. Conclusions Complex patterns of comorbidity in TMD cases may indicate different underlying mechanisms of association in subgroups or phenotypes, thereby suggesting multiple targets to improve TMD. Longitudinal comprehensive studies powered to look at sex and racial/ethnic groupings are needed to identify targets to personalize care.
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Affiliation(s)
- Brenda T Fenton
- PRIME Center, VA Connecticut Healthcare System, West Haven, Connecticut
| | - Joseph L Goulet
- PRIME Center, VA Connecticut Healthcare System, West Haven, Connecticut.,Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Matthew J Bair
- VA HSR&D Center for Health Information and Communication, Indianapolis, Indiana.,Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, Indiana.,Regenstrief Institute, Center for Health Services Research, Indianapolis, Indiana
| | | | - Robert D Kerns
- PRIME Center, VA Connecticut Healthcare System, West Haven, Connecticut.,Departments of Psychiatry and Neurology, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Psychology, Yale University, New Haven, Connecticut, USA
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Coskun Benlidayi I, Guzel R, Tatli U, Salimov F, Keceli O. The relationship between neck pain and cervical alignment in patients with temporomandibular disorders. Cranio 2018; 38:174-179. [DOI: 10.1080/08869634.2018.1498181] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Ilke Coskun Benlidayi
- Department of Physical Medicine and Rehabilitation, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Rengin Guzel
- Department of Physical Medicine and Rehabilitation, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Ufuk Tatli
- Department of Maxillofacial Surgery, Cukurova University Faculty of Dentistry, Adana, Turkey
| | - Fariz Salimov
- Department of Maxillofacial Surgery, Cukurova University Faculty of Dentistry, Adana, Turkey
| | - Onur Keceli
- Department of Maxillofacial Surgery, Cukurova University Faculty of Dentistry, Adana, Turkey
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Gil-Martínez A, Navarro-Fernández G, Mangas-Guijarro MÁ, Lara-Lara M, López-López A, Fernández-Carnero J, La Touche R. Comparison Between Chronic Migraine and Temporomandibular Disorders in Pain-Related Disability and Fear-Avoidance Behaviors. PAIN MEDICINE 2018; 18:2214-2223. [PMID: 28575454 DOI: 10.1093/pm/pnx127] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objective To compare patients with chronic migraine (CM) and chronic temporomandibular disorders (TMD) on disability, pain, and fear avoidance factors and to associate these variables within groups. Design Descriptive, cross-sectional study. Settings A neurology department and a temporomandibular disorders consult in a tertiary care center. Subjects A total of 50 patients with CM and 51 patients with chronic TMD, classified by international criteria classifications. Methods The variables evaluated included pain intensity (visual analog scale [VAS]), neck disability (NDI), craniofacial pain and disability (CF-PDI), headache impact (HIT-6), pain catastrophizing (PCS), and kinesiophobia (TSK-11). Results Statistically significant differences were found between the CM group and the chronic TMD group in CF-PDI (P < 0.001), PCS (P = 0.03), and HIT-6 (P < 0.001); however, there were no differences between the CM group and the VAS, NDI, and TSK-11 groups (P > 0.05). For the chronic TMD group, the combination of NDI and TSK-11 was a significant covariate model of CF-PDI (adjusted R2 = 0.34). In the CM group, the regression model showed that NDI was a significant predictive factor for HIT-6 (adjusted R2 = 0.19). Conclusions Differences between the CM group and the chronic TMD group were found in craniofacial pain and disability, pain catastrophizing, and headache impact, but they were similar for pain intensity, neck disability, and kinesiophobia. Neck disability and kinesiophobia were covariates of craniofacial pain and disability (34% of variance) for chronic TMD. In the CM group, neck disability was a predictive factor for headache impact (19.3% of variance).
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Affiliation(s)
- Alfonso Gil-Martínez
- Departamento de Fisioterapia.,Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Hospital La Paz Institute for Health Research, Madrid, Spain
| | - Gonzalo Navarro-Fernández
- Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Manuel Lara-Lara
- Hospital La Paz Institute for Health Research, Madrid, Spain.,Servicio de Neurología, Hospital Universitario La Paz, Madrid, Spain
| | - Almudena López-López
- Departamento de Medicina y Cirugía, Psicología, Medicina Preventiva y Salud Pública e Inmunología Microbiología Médica
| | - 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, Madrid, Spain.,Hospital La Paz Institute for Health Research, Madrid, Spain.,Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Roy La Touche
- Departamento de Fisioterapia.,Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Hospital La Paz Institute for Health Research, Madrid, Spain
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Marcos-Martín F, González-Ferrero L, Martín-Alcocer N, Paris-Alemany A, La Touche R. Multimodal physiotherapy treatment based on a biobehavioral approach for patients with chronic cervico-craniofacial pain: a prospective case series. Physiother Theory Pract 2018; 34:671-681. [PMID: 29338489 DOI: 10.1080/09593985.2017.1423522] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The purpose of this prospective case series was to observe and describe changes in patients with chronic cervico-craniofacial pain of muscular origin treated with multimodal physiotherapy based on a biobehavioral approach. Nine patients diagnosed with chronic myofascial temporomandibular disorder and neck pain were treated with 6 sessions over the course of 2 weeks including: (1) orthopedic manual physiotherapy (joint mobilizations, neurodynamic mobilization, and dynamic soft tissue mobilizations); (2) therapeutic exercises (motor control and muscular endurance exercises); and (3) patient education. The outcome measures of craniofacial (CF-PDI) and neck disability (NDI), kinesiophobia (TSK-11) and catastrophizing (PCS), and range of cervical and mandibular motion (ROM) and posture were collected at baseline, and at 2 and 14 weeks post-baseline. Compared to baseline, statistically significant (p < 0.01) and clinically meaningful improvements that surpassed the minimal detectable change were observed at 14 weeks in CF-PDI (mean change, 8.11 points; 95% confidence interval (CI): 2.55 to 13.69; d = 1.38), in NDI (mean change, 5 cm; 95% CI: 1.74-8.25; d = 0.98), and in the TSK-11 (mean change, 6.55 cm; 95% CI: 2.79-10.32; d = 1.44). Clinically meaningful improvements in self-reported disability, psychological factors, ROM, and craniocervical posture were observed following a multimodal physiotherapy treatment based on a biobehavioral approach.
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Affiliation(s)
- Fernando Marcos-Martín
- a Departamento de Fisioterapia , Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid , Aravaca , Madrid , Spain
| | - Luis González-Ferrero
- a Departamento de Fisioterapia , Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid , Aravaca , Madrid , Spain
| | - Noelia Martín-Alcocer
- a Departamento de Fisioterapia , Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid , Aravaca , Madrid , Spain
| | - Alba Paris-Alemany
- a Departamento de Fisioterapia , Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid , Aravaca , Madrid , Spain.,b Motion in Brains Research Group, Centro Superior de Estudios Universitarios La Salle , Universidad Autónoma de Madrid , Aravaca , Madrid , Spain.,c Institute of Neuroscience and Craniofacial Pain (INDCRAN) , Madrid , Spain.,d Hospital La Paz Institute for Health Research, IdiPAZ , Madrid , Spain
| | - Roy La Touche
- a Departamento de Fisioterapia , Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid , Aravaca , Madrid , Spain.,b Motion in Brains Research Group, Centro Superior de Estudios Universitarios La Salle , Universidad Autónoma de Madrid , Aravaca , Madrid , Spain.,c Institute of Neuroscience and Craniofacial Pain (INDCRAN) , Madrid , Spain.,d Hospital La Paz Institute for Health Research, IdiPAZ , 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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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: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Al-Saleh MAQ, Punithakumar K, Lagravere M, Boulanger P, Jaremko JL, Wolfaardt J, Major PW, Seikaly H. Three-dimensional morphological changes of the temporomandibular joint and functional effects after mandibulotomy. J Otolaryngol Head Neck Surg 2017; 46:8. [PMID: 28129794 PMCID: PMC5273832 DOI: 10.1186/s40463-017-0184-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 01/14/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The midline and paramedian mandibulotomy are surgical procedures that divide the mandibular bone into two halves and disconnects the condylar heads of the TMJ from each other. This study aimed to prospectively evaluate the temporomandibular joint (TMJ) functional and morphological changes after mandibulotomy using a reconstructed 3D models of the TMJ. METHODS Sixteen adult patients diagnosed with oral and oropharyngeal tumors with planned surgical mandibulotomy (test group, 9 patients) or transoral (control group, seven patients) treatments were included in the study. MRI and CBCT images were obtained immediately preceeding surgery and 6-8 weeks after surgery. Using the MRI-CBCT registered images, TMJ tissues were segmented at the two occasions by the same operator and 3D models were reconstructed for morphological assessment. Changes across time were measured using the volume overlap and Hausdorff distance of the disc and condyle 3D models. Disc-condyle relationship was measured using point-based and color map analysis. To assess the early functional changes, the Jaw function limitation scale (JFLS) and the maximum mouth opening were measured. Two-sample Hotelling T2 t-test was performed to determine the significance of the morphological and clinical outcomes' differences between the two groups. RESULTS The two-sample Hotelling T2 t-test showed significant differences (T2 (df1,df2) = 0.97 (5,26), p <0.01) between the mean values of all outcomes among the 2 groups. The change in disc displacement was significantly different between the two groups (p <0.05). However, the condylar displacement was not significantly different between the two groups (p =0.3). The average of the JFLS score was five times larger after mandibulotomy, and was 2 times larger after transoral surgery (p < 0.01). Patients showed decrease in the average of the maximum interincisal mouth opening by 11 mm after mandibulotomy, and by 5.4 mm after transoral surgery. CONCLUSION The quantitative assessment of the TMJ showed minimal changes of the condylar position and variable degrees of articular disc displacement associated with the paramedian split mandibulotomy. As well, limited jaw functions and vertical mouth opening were noticed more in the mandibultomy group compared to the transoral group in 6- weeks after surgery.
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Affiliation(s)
- Mohammed A Q Al-Saleh
- Orthodontic Graduate Program, School of Dentistry, University of Alberta, 476 Edmonton Clinic Health Academy (ECHA), Edmonton, Alberta, T6G 1C9, Canada.
| | - Kumaradevan Punithakumar
- Servier Virtual Cardiac Centre, Mazankowski Alberta Heart Institute and Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, T6G 2B7, Canada.,Department of Computing Science, Faculty of Science, University of Alberta, Athabasca Hall, Room 411, Edmonton, Alberta, T6G 2E8, Canada
| | - Manuel Lagravere
- Orthodontic Graduate Program, School of Dentistry, University of Alberta, 476 Edmonton Clinic Health Academy (ECHA), Edmonton, Alberta, T6G 1C9, Canada
| | - Pierre Boulanger
- Servier Virtual Cardiac Centre, Mazankowski Alberta Heart Institute and Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, T6G 2B7, Canada.,Department of Computing Science, Faculty of Science, University of Alberta, Athabasca Hall, Room 411, Edmonton, Alberta, T6G 2E8, Canada
| | - Jacob L Jaremko
- Department of Radiology and Diagnostic Imaging, Faculty of Medicine and Dentistry, University of Alberta, 2A2.41 WC Mackenzie Health Science Center, Edmonton, Alberta, T6G 2R7, Canada
| | - John Wolfaardt
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, 16940-87 Avenue, Edmonton, Alberta, T5R 4H5, Canada
| | - Paul W Major
- Orthodontic Graduate Program, School of Dentistry, University of Alberta, 476 Edmonton Clinic Health Academy (ECHA), Edmonton, Alberta, T6G 1C9, Canada
| | - Hadi Seikaly
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, 16940-87 Avenue, Edmonton, Alberta, T5R 4H5, Canada
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Grondin F, Hall T. Changes in cervical movement impairment and pain following orofacial treatment in patients with chronic arthralgic temporomandibular disorder with pain: A prospective case series. Physiother Theory Pract 2016; 33:52-61. [PMID: 27911133 DOI: 10.1080/09593985.2016.1247934] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to investigate the influence of isolated temporomandibular joint (TMJ) manual therapy on pain and range of motion (ROM) of the TMJ and cervical spine including flexion-rotation test (FRT) in people suffering chronic pain arising from chronic arthralgic temporomandibular disorder (TMD). An experienced clinician managed a case series of 12 patients with TMD (mean duration 28.6 months +/- 26.9). The intervention comprised four-weekly sessions of transverse medial accessory TMJ mobilization and advice. Patients were examined prior to and one-week following the intervention period. Outcome measures included jaw disability (JFLS-20), jaw pain measured by Visual Analogue Scale (VAS), maximal mouth opening ROM, cervical ROM including FRT, and pain during cervical movement. A paired t-test revealed significant improvement following the intervention in disability (p < 0.001), VAS pain score at rest (p < 0.001) and at maximum mouth opening (p < 0.001), jaw opening ROM (p < 0.001), FRT ROM to the left (p = 0.024) and right (p = 0.001). In contrast, no significant change was identified for total cervical ROM (p = 0.905). After the intervention, five patients (41.66%) had no pain at rest or at maximal mouth opening, and all had a negative FRT. The effect sizes indicate a moderate to strong, clinically significant effect for all variables apart from total cervical ROM. While a case series cannot identify a cause and effect relationship, these results provide preliminary evidence for the influence of TMJ manual therapy on measures of TMD including pain, as well as upper but not whole cervical movement and associated pain in patients with a diagnosis of TMJ arthralgia.
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Affiliation(s)
- Francis Grondin
- a Laboratory of Anatomy , Bordeaux University , Bordeaux Cedex, France
| | - Toby Hall
- b School of Physiotherapy and Exercise Science , Curtin University of Technology , Perth , WA , Australia
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Pasinato F, Santos-Couto-Paz CC, Zeredo JLL, Macedo SB, Corrêa EC. Experimentally induced masseter-pain changes masseter but not sternocleidomastoid muscle-related activity during mastication. J Electromyogr Kinesiol 2016; 31:88-95. [DOI: 10.1016/j.jelekin.2016.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 07/30/2016] [Accepted: 09/26/2016] [Indexed: 11/24/2022] Open
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Gil-Martínez A, Grande-Alonso M, López-de-Uralde-Villanueva I, López-López A, Fernández-Carnero J, La Touche R. Chronic Temporomandibular Disorders: disability, pain intensity and fear of movement. J Headache Pain 2016; 17:103. [PMID: 27812883 PMCID: PMC5095086 DOI: 10.1186/s10194-016-0690-1] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 10/14/2016] [Indexed: 01/12/2023] Open
Abstract
Background The objective was to compare and correlate disability, pain intensity, the impact of headache on daily life and the fear of movement between subgroups of patients with chronic temporomandibular disorder (TMD). Methods A cross-sectional study was conducted in patients diagnosed with chronic painful TMD. Patients were divided into: 1) joint pain (JP); 2) muscle pain (MP); and 3) mixed pain. The following measures were included: Craniomandibular pain and disability (Craniofacial pain and disability inventory), neck disability (Neck Dsiability Index), pain intensity (Visual Analogue Scale), impact of headache (Headache Impact Test 6) and kinesiophobia (Tampa Scale of Kinesiophobia-11). Results A total of 154 patients were recruited. The mixed pain group showed significant differences compared with the JP group or MP group in neck disability (p < 0.001, d = 1.99; and p < 0.001, d = 1.17), craniomandibular pain and disability (p < 0.001, d = 1.34; and p < 0.001, d = 0.9, respectively), and impact of headache (p < 0.001, d = 1.91; and p < 0.001, d = 0.91, respectively). In addition, significant differences were observed between JP group and MP group for impact of headache (p < 0.001, d = 1.08). Neck disability was a significant covariate (37 % of variance) of craniomandibular pain and disability for the MP group (β = 0.62; p < 0.001). In the mixed chronic pain group, neck disability (β = 0.40; p < 0.001) and kinesiophobia (β = 0.30; p = 0.03) were significant covariate (33 % of variance) of craniomandibular pain and disability. Conclusion Mixed chronic pain patients show greater craniomandibular and neck disability than patients diagnosed with chronic JP or MP. Neck disability predicted the variance of craniofacial pain and disability for patients with MP. Neck disability and kinesiophobia predicted the variance of craniofacial pain and disability for those with chronic mixed pain.
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Affiliation(s)
- Alfonso Gil-Martínez
- Hospital La Paz Institute for Health Research, Madrid, Spain. .,Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios, Universidad Autónoma de Madrid, Calle La Salle, 10, 28036, Madrid, Spain.
| | - Mónica Grande-Alonso
- Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios, Universidad Autónoma de Madrid, Calle La Salle, 10, 28036, Madrid, Spain
| | - Ibai López-de-Uralde-Villanueva
- Hospital La Paz Institute for Health Research, Madrid, Spain.,Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios, Universidad Autónoma de Madrid, Calle La Salle, 10, 28036, Madrid, Spain
| | - Almudena López-López
- Multidisciplinary Group on Pain Research and Management, Excellence Research Program URJC-Santander, Universidad Rey Juan Carlos, Alcorcón, Spain.,Departamento de medicina y cirugía, psicología, medicina preventiva y salud pública e inmunología microbiología médica, Universidad Rey Juan Carlos, Avda. Atenas s/n, 28922, Alcorcón, Spain
| | - Josué Fernández-Carnero
- Hospital La Paz Institute for Health Research, Madrid, Spain.,Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios, Universidad Autónoma de Madrid, Calle La Salle, 10, 28036, Madrid, Spain.,Multidisciplinary Group on Pain Research and Management, Excellence Research Program URJC-Santander, Universidad Rey Juan Carlos, Alcorcón, Spain.,Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Avda. Atenas s/n, 28922, Alcorcón, Spain
| | - Roy La Touche
- Hospital La Paz Institute for Health Research, Madrid, Spain.,Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios, Universidad Autónoma de Madrid, Calle La Salle, 10, 28036, Madrid, Spain
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von Piekartz H, Pudelko A, Danzeisen M, Hall T, Ballenberger N. Do subjects with acute/subacute temporomandibular disorder have associated cervical impairments: A cross-sectional study. ACTA ACUST UNITED AC 2016; 26:208-215. [PMID: 27744136 DOI: 10.1016/j.math.2016.09.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Revised: 08/10/2016] [Accepted: 09/05/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND There is preliminary evidence of cervical musculoskeletal impairment in some temporomandibular disorder (TMD) pain states. OBJECTIVES To determine whether people with TMD, classified as either mild or moderate/severe TMD, have more cervical signs of dysfunction than healthy subjects. DESIGN Cross-sectional survey. METHOD Based on the Conti Amnestic Questionnaire and examination of the temporomandibular joint (Axis I classification of the Research Diagnostic Criteria for TMD), of 144 people examined 59 were classified to a mild TMD group, 40 to a moderate/severe TMD group and 45 to an asymptomatic control group without TMD. Subjects were evaluated for signs of cervical musculoskeletal impairment and disability including the Neck Disability Index, active cervical range of motion, the Flexion-Rotation Test, mechanical pain threshold of the upper trapezius and obliquus capitis inferior muscles, Cranio-Cervical Flexion test and passive accessory movements of the upper 3 cervical vertebrae. RESULTS According to cervical musculoskeletal dysfunction, the control group without TMD were consistently the least impaired and the group with moderate/severe TMD were the most impaired. These results suggest, that the more dysfunction and pain is identified in the temporomandibular region, the greater levels of dysfunction is observable on a number of cervical musculoskeletal function tests. The pattern of cervical musculoskeletal dysfunction is distinct to other cervical referred pain phenomenon such as cervicogenic headache. CONCLUSION These findings provide evidence that TMD in an acute/subacute pain state is strongly related with certain cervical spine musculoskeletal impairments which suggests the cervical spine should be examined in patients with TMD as a potential contributing factor.
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Affiliation(s)
- Harry von Piekartz
- Faculty of Business, Management and Social Science, Department Movement and Rehabilitationscience Caprivistrasse 30a, 49076 Osnabrueck, Germany.
| | - Ani Pudelko
- Faculty of Business, Management and Social Science, Department Movement and Rehabilitationscience Caprivistrasse 30a, 49076 Osnabrueck, Germany
| | - Mira Danzeisen
- Faculty of Business, Management and Social Science, Department Movement and Rehabilitationscience Caprivistrasse 30a, 49076 Osnabrueck, Germany
| | - Toby Hall
- School of Physiotherapy and Curtin Health Innovation Research, Curtin University, P.O. Box U1987, Perth, WA 6845, Australia
| | - Nikolaus Ballenberger
- Faculty of Business, Management and Social Science, Department Movement and Rehabilitationscience Caprivistrasse 30a, 49076 Osnabrueck, Germany
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Jayaseelan DJ, Tow NS. Cervicothoracic junction thrust manipulation in the multimodal management of a patient with temporomandibular disorder. J Man Manip Ther 2016; 24:90-7. [PMID: 27559278 DOI: 10.1179/2042618614y.0000000080] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Temporomandibular disorder (TMD) is a common condition that can be difficult to manage in physical therapy. A number of interventions, such as manual therapy, therapeutic exercise, and patient education have typically been used in some combination. However, the evidence regarding thrust manipulation of not only the local but also adjacent segments is sparse. Specifically, the use of cervicothoracic (CT) junction thrust manipulation has not previously been described in the management of individuals with TMD. In this case report, CT junction thrust manipulation, in addition to locally directed manual therapy, exercise, and postural education, was associated with immediate improvements in neck and jaw symptoms and function in a complex patient with TMD. The patient was seen for seven visits over the course of 2 months and demonstrated clinically significant changes in the neck disability index (NDI), the numeric rating of pain scale (NPRS), and the global rating of change (GROC) scale. The purpose of this report is to describe the successful physical therapy management of a patient with TMD utilizing manual therapy, including CT junction thrust manipulation, education, and exercise.
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Affiliation(s)
- Dhinu J Jayaseelan
- Fellowship in Orthopedic Manual Physical Therapy, University of Illinois at Chicago, USA
| | - Nancy S Tow
- Outpatient Physical Therapy Services, University of Illinois Hospital & Health Sciences Systems, Chicago, USA
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Häggman-Henrikson B, Lampa E, Marklund S, Wänman A. Pain and Disability in the Jaw and Neck Region following Whiplash Trauma. J Dent Res 2016; 95:1155-60. [PMID: 27307051 DOI: 10.1177/0022034516653598] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The relationship between whiplash trauma and chronic orofacial pain is unclear, especially with regard to the time elapsed from trauma to development of orofacial pain. The aim was to analyze prevalence of jaw pain and disability, as well as the relationship between pain and disability in the jaw and neck regions in the early nonchronic stage after whiplash trauma. In this case-control study, 70 individuals (40 women, 30 men, mean age 35.5 y) who visited an emergency department with neck pain following a car accident were examined within 3 wk of trauma (group 1) and compared with 70 individuals (42 women, 28 men, mean age 33.8 y), who declined to attend a clinical examination but agreed to fill in questionnaires (group 2). The 2 case groups were compared with a matched control group of 70 individuals (42 women, 28 men, mean age 37.6 y) without a history of neck trauma. All participants completed questionnaires regarding jaw pain and dysfunction, rating pain intensity in jaw and neck regions on the Numerical Rating Scale, the Neck Disability Index, and Jaw Disability Checklist. Compared with controls, individuals with a recent whiplash trauma reported more jaw pain and dysfunction. Furthermore, there was a moderate positive correlation between jaw and neck pain ratings for group 1 (r = 0.61, P < 0.0001) and group 2 (r = 0.59, P < 0.0001). In the logistic regression analysis, cases showed higher odds ratios (range, 6.1 to 40.8) for jaw and neck pain and disability compared with controls. Taken together, the results show that individuals with a recent whiplash trauma report more jaw pain and disability compared with controls without a history of neck trauma. Furthermore, the correlation between jaw and neck pain intensity implies that intensity of neck pain in the acute stage after whiplash trauma might be a possible risk factor also for development of chronic orofacial pain.
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Affiliation(s)
- B Häggman-Henrikson
- Clinical Oral Physiology, Umeå University, Umeå, Sweden Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden
| | - E Lampa
- Clinical Oral Physiology, Umeå University, Umeå, Sweden
| | - S Marklund
- Clinical Oral Physiology, Umeå University, Umeå, Sweden
| | - A Wänman
- Clinical Oral Physiology, Umeå University, Umeå, Sweden
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Diagnosi e terapia delle patologie dell’ATM: Aspetti gnatologici. DENTAL CADMOS 2016. [DOI: 10.1016/s0011-8524(16)30077-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Ishii T, Narita N, Endo H. Evaluation of jaw and neck muscle activities while chewing using EMG-EMG transfer function and EMG-EMG coherence function analyses in healthy subjects. Physiol Behav 2016; 160:35-42. [PMID: 27059322 DOI: 10.1016/j.physbeh.2016.03.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 02/25/2016] [Accepted: 03/17/2016] [Indexed: 02/07/2023]
Abstract
This study aims to quantitatively clarify the physiological features in rhythmically coordinated jaw and neck muscle EMG activities while chewing gum using EMG-EMG transfer function and EMG-EMG coherence function analyses in 20 healthy subjects. The chewing side masseter muscle EMG signal was used as the reference signal, while the other jaw (non-chewing side masseter muscle, bilateral anterior temporal muscles, and bilateral anterior digastric muscles) and neck muscle (bilateral sternocleidomastoid muscles) EMG signals were used as the examined signals in EMG-EMG transfer function and EMG-EMG coherence function analyses. Chewing-related jaw and neck muscle activities were aggregated in the first peak of the power spectrum in rhythmic chewing. The gain in the peak frequency represented the power relationships between jaw and neck muscle activities during rhythmic chewing. The phase in the peak frequency represented the temporal relationships between the jaw and neck muscle activities, while the non-chewing side neck muscle presented a broad range of distributions across jaw closing and opening phases. Coherence in the peak frequency represented the synergistic features in bilateral jaw closing muscles and chewing side neck muscle activities. The coherence and phase in non-chewing side neck muscle activities exhibited a significant negative correlation. From above, the bilateral coordination between the jaw and neck muscle activities is estimated while chewing when the non-chewing side neck muscle is synchronously activated with the jaw closing muscles, while the unilateral coordination is estimated when the non-chewing side neck muscle is irregularly activated in the jaw opening phase. Thus, the occurrence of bilateral or unilateral coordinated features in the jaw and neck muscle activities may correspond to the phase characteristics in the non-chewing side neck muscle activities during rhythmical chewing. Considering these novel findings in healthy subjects, EMG-EMG transfer function and EMG-EMG coherence function analyses may also be useful to diagnose the pathologically in-coordinated features in jaw and neck muscle activities in temporomandibular disorders and whiplash-associated disorders during critical chewing performance.
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Affiliation(s)
- Tomohiro Ishii
- Nihon University School of Dentistry at Matsudo, Department of Removable Prosthodontics, 2-870-1 Sakaecho-Nishi, Matsudo, Chiba 271-8587, Japan.
| | - Noriyuki Narita
- Nihon University School of Dentistry at Matsudo, Department of Removable Prosthodontics, 2-870-1 Sakaecho-Nishi, Matsudo, Chiba 271-8587, Japan.
| | - Hiroshi Endo
- Human Technology Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), 1-1 Higashi, Tsukuba, Ibaraki, 305-8566, Japan.
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Chronic Neck Pain and Cervico-Craniofacial Pain Patients Express Similar Levels of Neck Pain-Related Disability, Pain Catastrophizing, and Cervical Range of Motion. PAIN RESEARCH AND TREATMENT 2016; 2016:7296032. [PMID: 27119020 PMCID: PMC4828545 DOI: 10.1155/2016/7296032] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 03/01/2016] [Accepted: 03/15/2016] [Indexed: 11/29/2022]
Abstract
Background. Neck pain (NP) is strongly associated with cervico-craniofacial pain (CCFP). The primary aim of the present study was to compare the neck pain-related disability, pain catastrophizing, and cervical and mandibular ROM between patients with chronic mechanical NP and patients with CCFP, as well as asymptomatic subjects. Methods. A total of 64 participants formed three groups. All participants underwent a clinical examination evaluating the cervical range of motion and maximum mouth opening, neck disability index (NDI), and psychological factor of Pain Catastrophizing Scale (PCS). Results. There were no statistically significant differences between patients with NP and CCFP for NDI and PCS (P > 0.05). One- way ANOVA revealed significant differences for all ROM measurements. The post hoc analysis showed no statistically significant differences in cervical extension and rotation between the two patient groups (P > 0.05). The Pearson correlation analysis shows a moderate positive association between NDI and the PCS for the group of patients with NP and CCFP. Conclusion. The CCFP and NP patient groups have similar neck disability levels and limitation in cervical ROM in extension and rotation. Both groups had positively correlated the NDI with the PCS.
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Carvalho GF, Chaves TC, Florencio LL, Dach F, Bigal ME, Bevilaqua-Grossi D. Reduced thermal threshold in patients with Temporomandibular Disorders. J Oral Rehabil 2016; 43:401-8. [DOI: 10.1111/joor.12386] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2016] [Indexed: 11/30/2022]
Affiliation(s)
- G. F. Carvalho
- Department of Biomechanics; Medicine and Locomotor Apparatus Rehabilitation - Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto-SP Brazil
| | - T. C. Chaves
- Department of Neurosciences and Behavioral Sciences - Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto-SP Brazil
| | - L. L. Florencio
- Department of Biomechanics; Medicine and Locomotor Apparatus Rehabilitation - Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto-SP Brazil
| | - F. Dach
- Department of Neurosciences and Behavioral Sciences - Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto-SP Brazil
| | - M. E. Bigal
- Migraine & Headache Clinical Development; Global Branded R&D; Pennsylvania PA USA
| | - D. Bevilaqua-Grossi
- Department of Biomechanics; Medicine and Locomotor Apparatus Rehabilitation - Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto-SP Brazil
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