Cervical and scapular instability in subjects with temporomandibular disorder
Maryllian de Albuquerque Vieira; Maria das Graças Rodrigues de Araújo; Gabriel Barreto Antonino; Angélica da Silva Tenório; Maria das Graças Paiva; Ana Paula de Lima Ferreira
Background: Temporomandibular disorder (TMD) is a set of disorders involving the masticatory muscles, the temporomandibular joint (TMJ) and/or the associated structures. Objectives: To evaluate the occurrence of cervical and scapular instability in subjects with TMD. Methods: A total of 22 patients participated in the study, being 11 of them with TMD, selected using the RDC/TMD criteria, and 11 in the control group. The stabilization capacity of the neck muscles was evaluated through StabilizerTM and the muscles of the shoulder girdle through specific tests. Cervical mobility data from both groups were provided using the accelerometer while for cervical disability was used the Neck Disability Index (NDI) questionnaire. Results: Cervical instability was higher in the TMD group (20.36 ± 3.2) than in the control group (28.54 ± 0.8), revealing significant difference (p= 0.03). The highest percentages of scapular stabilization tests were found in subjects with TMD, (n= 9; 81.81%) when compared with control subjects (n= 5; 45.45%). The NDI results showed that the TMD group presented mild cervical incapacity (11.18 ± 2) and the control presented no disability (2.27 ± 0.4; p= 0.001). Conclusion: Cervical disability, and cervical and scapular instability were more frequent in subjects with TMD.
1. Robert L. Gauer, MD, Michael J. Semidey, DMD. Diagnosis and treatment of Temporomandibular disorders. Am Fam Physician. 2015;91(6):378–86.
2. Scheers, Isabelle, et al. “NCBINCBI Logo Skip to main content Skip to navigation Resources How To About NCBI Accesskeys Sign in to NCBI PubMed US National Library of Medicine National Institutes of Health Search database Search term Clear input Advanced Help Result Filters Format: Abstract Send to J Pediatr Gastroenterol Nutr. 2018 May 9.” Journal of Pediatric Gastroenterology and Nutrition (2018).
3. Leeuw R. Dor orofacial: guia de avaliação, diagnóstico e tratamento. 4. ed. São Paulo: Quintessence, 2010.
4. Wadhwa S, Kapila S. TMJ Disorders: future innovations in diagnostics and therapeutics. J Dent Educ. 2008; 72(8):930–47.
5. Costa da DR, Lima APF, Pereira TA, Porporatti AL, Conti PC, Costa YM et al. Neck disability is associated with masticatory myofascial pain and regional muscle sensitivity. Arch Oral Biol. 2015;60(5):745-52.
6. Jull GA, Sterling M, Falla D, et al. Whiplash, Headache, and Neck Pain: Research-Based Directions for Physical Therapies. Philadelphia, PA: Elsevier; 2008:41–58.
7. Soares JC, Weber P, Trevisan ML, Mota CB, Rossi AG. Influence of pain on postural control in women with neck pain. Rev Bras Cineantropom Desempenho Hum 2013, 15(3):371-381.
8. Saavedra FJ, Cordeiro MT, Alves JV, Fernandes HM, Reis VM, Alverne DG. The influence of positional release therapy on the myofascial tension of the upper trapezius muscle. Rev Bras Cineantropom Desempenho Hum 2014, 16(2):191-199.
9. Armijo-Olivo S, Silvestre R, Fuentes J, Costa da BR, Gadotti IC, Warren S. et al. Electromyographic Activity of the Cervical Flexor Muscles in Patients With Temporomandibular Disorders While Performing the Craniocervical Flexion Test: A Cross-Sectional Study. Phys Ther. 2011; 91(8): 1184–1197.
10. Vierola A, Suominen AL, Ikavalko T, Lintu N, Lindi V, Lakka HM. et al. Clinical signs of temporomandibular disorders and various pain conditions among children 6 to 8 years of age: the PANIC study. J Orofac Pain. 2012;26(1):17-2.
11. Chaves TC, Turci AM, Pinheiro CF, Sousa LM, Grossi DB. Static body postural misalignment in individuals with temporomandibular disorders: a systematic review. Braz J Phys Ther. 2014. 18(6):481-501.
12. Schiffman EL, Ohrbach R, Trulove EL, Feng T, Anderson GC, Pan W et al. The research diagnostic criteria for temporomandibular disorders. V: methods used to estabilish and validate revised axis I diagnostic algoritms. J. Orofacial Pain, 2010. 24(1): 63-78.
13. Dworkin SF, Leresche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord, 1992. 6(4):301-355.
14. Pereira FJ. Critérios de Diagnóstico para a pesquisa das disfunções temporomandibulares (RDC/TDM): tradução oficial para Língua Portuguesa. J. Bras. Clin. Odontol. 2004. 8:384-395.
15. Jull G, Barrett C, Magee R, Ho P. Further clinical clarification of the muscle dysfunction in cervical headache. Cephalalgia. 1999; 19(3):179-85.
16. Sforza C, Rosati R, De Meneses M, Musto F, Toma M. EMG analysis of trapezius and masticatory muscles: experimental protocol and data reproducibility. J Oral Rehabil. 2011;38(9):648-54.
17. Kisner C, Colby LA. Exercícios terapêuticos: fundamentos e técnicas. 5.ed. Barueri, SP: Manole, 2009.
18. Magee DJ. Avaliação Musculoesquelética. Ed. Manole, 2010.
19. Vernon H.; Mior S. The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther. 1991;14(7):409-15.
20. Cook C, Richardson JK, Braga L, Menezes A, Soler X, Kume P et al. Crosscultural adaptation and validation of the Brazilian Portuguese version of the Neck Disability Index and Neck Pain and Disability Scale. Spine. 2006;31 (14):1621-7.
21. Dancey C, Reidy J. Estatística sem matemática para psicologia: usando SPSS para Windows. Porto Alegre: Artmed, 2006.
22. García-Orea PG, Heredia JR, Sanotos MS, Grigoletto ME. Acute effects of the use of external instability generating devices on neuromuscular performance. Rev Bras Cineantropom Desempenho Hum 2016, 18(6):722- 730.
23. Amatéa DV, Novaes AP, Campolongo GD, Barros de TP. A importância da avaliação postural no paciente com disfunção da articulação temporomandibular. Acta Ortop. Bra. 2004;12(3).
24. Armijo-Olivo S, Magee D. Cervical Musculoskeletal Impairments and Temporomandibular Disorders. J Oral Maxillofac Res. 2012; 3(4):1.
25. Wiesinger B, Malker H, Englund E, Wänman A. Does a dose-response relation exist between spinal pain and temporomandibular disorders? BMC Musculoskelet Disord. 2009;10:28.
26. Ferão MIB, Traebert J. Prevalence of temporomandibular dysfunction in patients with cervical pain under physiotherapy treatment. Fisioter. Mov. 2008;21(4):63-70.
27. Farias ACR, Alves VCR, Gandelman H. Estudo da relação entre disfunção da articulação temporomandibular e as alterações posturais. Rev Odontol UNICID. 2001;13(2):125 – 133.
28. Silveira A, Gadotti IC, Armijo-Olivo S, Biasotto-Gonzalez DA, Magee D. Jaw Dysfunction Is Associated with Neck Disability and Muscle Tenderness in Subjects with and without Chronic Temporomandibular Disorders. Biomed Res Int. 2015:512-792.
29. Armijo-Olivo S, Fuentes J, Major PW, Warren S, Thie NMR, Magee DJ. “The association between neck disability and jaw disability,” J. of Oral Rehabilitation. 2010; 37(9): 670–679.