PNF and Movement

Korea Proprioceptive Neuromuscular Facilitation Association (대한고유수용성신경근촉진법학회)
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Changes of Cervical Range of Motion and Pelvic Mobility during Gait in Subjects with Pain-related Temporomandibular Disorders

관자 아래턱 장애에 따른 목뼈 가동 범위 제한과 보행 시 골반 가동성의 변화 연구

  • Yeo, Sang-Seok (Department of Physical Therapy, College of Health Science, Dankook University)
  • 여상석 (단국대학교 공공.보건과학대학 물리치료학과)
  • Received : 2022.11.22
  • Accepted : 2022.12.08
  • Published : 2022.12.31
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Abstract

Purpose: Temporomandibular disorder (TMD) is a common musculoskeletal problem that causes pain in and disability of masticatory muscles, the temporo-mandibular joint (TMJ), and related structures. The purpose of this study was to compare pressure pain thresholds (PPTs) of masticatory muscles, cervical ranges of motion (ROM), and pelvic mobility during gait of subjects with or without TMD. Methods: In this study, pain thresholds and changes in the mobility of the cervical vertebrae and pelvis were measured in 25 patients with TMD and 25 healthy controls. Using a pressure algometer, the pressure pain thresholds (PPTs) of the masseter and temporalis muscles were measured in both groups. A gyroscope sensor with a mobile application was used to determine cervical ROM in the frontal and sagittal planes. A 3D-motion analysis system was used to evaluate pelvic mobility in the sagittal, frontal, and transverse planes during gait. Results: The TMD group showed significantly decreased PPTs of masseter and temporalis muscles compared with the control group (p < 0.05). Cervical ROM in flexion, extension, and lateral bending were significantly decreased in the TMD group compared with the control group (p < 0.05). In addition, antero-posterior pelvic tilt was significantly decreased in the TMD group (p < 0.05). Conclusion: The results of the current study suggest that there are close anatomical and functional relationships between TMD and muscle chains related to the cervical spine and pelvis. Therefore, more comprehensive body posture assessments, especially of painful areas, should be undertaken when studying TMD patients.

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References

  1. Armijo-Olivo S, Silvestre R, Fuentes J, et al. electromyographic activity of the cervical flexor muscles in patients with temporomandibular disorders while performing the craniocervical flexion test: a cross-sectional study. Physical Therapy. 2011;91(8):1184-1197. https://doi.org/10.2522/ptj.20100233
  2. Bogduk N. The neck and headaches. Neurologic Clinics. 2004;22(1):151-171. https://doi.org/10.1016/S0733-8619(03)00100-2
  3. Catanzariti JF, Debuse T, Duquesnoy B. Chronic neck pain and masticatory dysfunction. Joint Bone Spine. 2005;72(6):515-519. https://doi.org/10.1016/j.jbspin.2004.10.007
  4. Cha YJ, Yoon HS, Jung DH, et al. The best lumbothoracic-cervical chain stabilization exercise for longus colli activation. J Med Imag Health Inform. 2018;8(1):84-87. https://doi.org/10.1166/jmihi.2018.2237
  5. Chisnoiu AM, Picos AM, Popa S, et al. Factors involved in the etiology of temporomandibular disorders - a literature review. Clujul Medical. 2015;88(4):473-478. https://doi.org/10.15386/cjmed-485
  6. da Costa DRA, Ferreira APD, Pereira TAB, et al. Neck disability is associated with masticatory myofascial pain and regional muscle sensitivity. Archives of Oral Biology. 2015;60(5):745-752. https://doi.org/10.1016/j.archoralbio.2015.02.009
  7. de Farias Neto JP, de Santana JM, de Santana-Filho VJ, et al. Radiographic measurement of the cervical spine in patients with temporomandibular dysfunction. Archives of Oral Biology. 2010;55(9):670-678. https://doi.org/10.1016/j.archoralbio.2010.06.002
  8. Eriksson PO, Haggman-Henrikson B, Nordh E, et al. Co-ordinated mandibular and head-neck movements during rhythmic jaw activities in man. Journal of Dental Research. 2000;79(6):1378-1384. https://doi.org/10.1177/00220345000790060501
  9. Fernandez-de-las-Penas C, Galan-del-Rio F, Alonso-Blanco C, et al. Referred pain from muscle trigger points in the masticatory and neck-shoulder musculature in women with temporomandibular disoders. Journal of Pain. 2010;11(12):1295-1304. https://doi.org/10.1016/j.jpain.2010.03.005
  10. Ferreira MC, Bevilaqua-Grossi D, Dach FE, et al. Body posture changes in women with migraine with or without temporomandibular disorders. Brazilian Journal of Physical Therapy. 2014;18(1):19-29. https://doi.org/10.1590/S1413-35552012005000137
  11. Fink M, Wahling K, Stiesch-Scholz M, et al. The functional relationship between the craniomandibular system, cervical spine, and the sacroiliac joint: a preliminary investigation. Cranio-the Journal of Craniomandibular & Sleep Practice. 2003;21(3):202-208.
  12. Fiorentino NM, Kutschke MJ, Atkins PR, et al. Accuracy of functional and predictive methods to calculate the hip joint center in young non-pathologic asymptomatic adults with dual fluoroscopy as a reference standard. Annals of biomedical engineering. 2016;44(7):2168-2180. https://doi.org/10.1007/s10439-015-1522-1
  13. Flores HF, Ottone NE, Fuentes, R. Analysis of the morphometric characteristics of the cervical spine and its association with the development of temporomandibular disorders. Cranio. 2017;35(2):79-85. https://doi.org/10.1080/08869634.2016.1162950
  14. Gomes PKA, Silva RBC, de Freitas IMD, et al. evaluation of postural balance and articular mobility of the lower limbs in chronic neck pain patients by means of low-cost clinical tests. Journal Manipulative Physiological Therapeutics. 2018;41(8):658-664. https://doi.org/10.1016/j.jmpt.2018.03.006
  15. Grondin F, Hall T, Laurentjoye M, et al. Upper cervical range of motion is impaired in patients with temporomandibular disorders. Cranio-the Journal of raniomandibular & Sleep Practice. 2015;33(2):91-99.
  16. Jorgensen MB, Skotte JH, Holtermann A, et al. Neck pain and postural balance among workers with high postural demands - a cross-sectional study. Bmc Musculoskeletal Disorders. 2011;12(1):1-7. https://doi.org/10.1186/1471-2474-12-1
  17. La Touche R, Fernandez-De-Las-Penas C, Fernandez-Carnero J, et al. The effects of manual therapy and exercise directed at the cervical spine on pain and pressure pain sensitivity in patients with myofascial temporomandibular disorders. Journal of Oral Rehabilitation. 2009;36(9):644-652. https://doi.org/10.1111/j.1365-2842.2009.01980.x
  18. La Touche, R, Paris-Alemany, A, von Piekartz H, et al. The influence of cranio-cervical posture on maximal mouth opening and pressure pain threshold in patients with myofascial temporomandibular pain disorders. Clinical Journal of Pain. 2011;27(1):48-55. https://doi.org/10.1097/AJP.0b013e3181edc157
  19. Leeuw Rd, Klasser GD, American Academy of Orofacial P. Orofacial pain : guidelines for assessment, diagnosis, and management. 6th ed. Berlin. Quintessence Publishing. 2018.
  20. McGinley JL, Baker R, Wolfe R, et al. The reliability of three-dimensional kinematic gait measurements: A systematic review. Gait Posture. 2009;29(93):360-369. https://doi.org/10.1016/j.gaitpost.2008.09.003
  21. Mense S, Simons DG, Russell IJ. Muscle pain : understanding its nature, diagnosis, and treatment. Philadelphia. Lippincott Williams & Wilkins. 2001
  22. Munhoz WC, Hsing WT. The inconclusiveness of research on functional pathologies of the temporomandibular system and body posture: paths followed, paths ahead: a critical review. Cranio. 2021;39(3):254-265. https://doi.org/10.1080/08869634.2019.1603585
  23. Munhoz WC, Marques AP. Body posture evaluations in subjects with internal temporomandibular joint derangement. Cranio. 2009;27(4):231-242. https://doi.org/10.1179/crn.2009.034
  24. Najafi B, Horn D, Marclay S, et al. Assessing postural control and postural control strategy in diabetes patients using innovative and wearable technology. Journal of Diabetes Science and Technology. 2010;4(4):780-791. https://doi.org/10.1177/193229681000400403
  25. Nicolakis P, Nicolakis M, Piehslinger E, et al. Relationship between craniomandibular disorders and poor posture. Cranio-the Journal of Craniomandibular & Sleep Practice. 2000;18(2):106-112.
  26. Okeson JP. Management of temporomandibular disorders and occlusion. 3rd ed. St. Louis. Mosby-Year Book. 1993.
  27. O'Sullivan K, Clifford A, Hughes L. The reliability of the CODA motion analysis system for lumbar spine analysis: A pilot study. Physiotherapy Pract Res. 2010;31(1):16-22. https://doi.org/10.3233/PPR-2010-31104
  28. Pallegama RW, Ranasinghe AW, Weerasinghe VS, et al. Influence of masticatory muscle pain on electromyographic activities of cervical muscles in patients with myogenous temporomandibular disorders. Journal of Oral Rehabilitation. 2004;31(5):423-429. https://doi.org/10.1111/j.1365-2842.2004.01266.x
  29. Park GB, Kim CW, Park SB. et al. Reliability and Usefulness of the Pressure Pain Threshold Measurement in Patients with Myofascial Pain. Ann Rehabil Med. 2011;35(3):412-417. https://doi.org/10.5535/arm.2011.35.3.412
  30. Perry J, Burnfield JM, Cabico LM, et al. Gait analysis : normal and pathological function. 2nd ed. California. Slack. 2010.
  31. Prieto TE, Myklebust JB, Hoffmann RG, et al. Measures of postural steadiness: differences between healthy young and elderly adults. IEEE Transactions on biomedical engineering. 1996;43(9):956-966. https://doi.org/10.1109/10.532130
  32. Quek J, Brauer SG, Clark R, et al. New insights into neck-pain-related postural control using measures of signal frequency and complexity in older adults. Gait & Posture. 2014;39(4):1069-1073. https://doi.org/10.1016/j.gaitpost.2014.01.009
  33. Ries LGK, Berzin F. Analysis of the postural stability in individuals with or without signs and symptoms of temporomandibular disorder. Brazilian oral research. 2008;22:378-383. https://doi.org/10.1590/S1806-83242008000400016
  34. Rodriguez-Blanco C, Cocera-Morata FM, Heredia-Rizo AM, et al. Immediate effects of combining local techniques in the craniomandibular area and hamstring muscle stretching in subjects with temporomandibular disorders: a randomized controlled study. Journal of Alternative and Complementary Medicine. 2015;21(8):451-459. https://doi.org/10.1089/acm.2014.0332
  35. Saito ET, Akashi PMH, Sacco, IDN. Global body posture evaluation in patients with temporomandibular joint disorder. Clinics. 2009;64(1):35-39 https://doi.org/10.1590/S1807-59322009000100007
  36. Sessle BJ, Hu JW, Amano N, et al. Convergence of cutaneous, tooth pulp, visceral, neck and muscle afferents onto nociceptive and non-nociceptive neurones in trigeminal subnucleus caudalis (medullary dorsal horn) and its implications for referred pain. Pain. 1986;27(2):219-235. https://doi.org/10.1016/0304-3959(86)90213-7
  37. Silveira A, Armijo-Olivo S, Gadotti IC, et al. Masticatory and cervical muscle tenderness and pain sensitivity in a remote area in subjects with a temporomandibular disorder and neck disability. Journal of Oral Facial Pain Headache. 2014;28(2):138-146. https://doi.org/10.11607/ofph.1112
  38. Tanuja S. Assessment of craniocervical posture in tmj disorders using lateral view: a cross sectional study. The Tamil Nadu Dr. M. G. R. Medical University. Master's Degree. 2019.
  39. Turp JC, Turp JC, Sommer C, et al. The puzzle of orofacial pain: integrating research into clinical management. New York. Karger. 2007.
  40. Valentino B, Melito F. Functional relationships between the muscles of mastication and the muscles of the leg. Surgical and Radiologic Anatomy. 1991;13(1):33-37. https://doi.org/10.1007/BF01623138
  41. Walczynska-Dragon K, Baron S. The biomechanical and functional relationship between temporomandibular dysfunction and cervical spine pain. Acta of Bioengineering and Biomechanics. 2011;13(4):93-98.
  42. Weber P, Correa EC, Ferreira Fdos S, et al. Cervical spine dysfunction signs and symptoms in individuals with temporomandibular disorder. Journal da Sociedade Brasileira de Fonoaudiologia. 2012;24(2):134-139. https://doi.org/10.1590/S2179-64912012000200008
  43. Whittle MW, Levine, D. Three-dimensional relationships between the movements of the pelvis and lumbar spine during normal gait. Human Movement Science. 1999;18(5):681-692. https://doi.org/10.1016/S0167-9457(99)00032-9
  44. Williams K, Tarmizi A, Treleaven, J. Use of neck torsion as a specific test of neck related postural instability. Musculoskeletal Science and Practice. 2017;29:115-119. https://doi.org/10.1016/j.msksp.2017.03.012