Abstract
ObjectiveTo evaluate whether a single specific motor control training session for the neck flexor and deep extensor muscles improves upper cervical range of motion and neck motor control in patients with temporomandibular disorder (TMD) and compare them to a group without TMD. MethodsThis is a before and after, controlled study. The TMD group included women aged between 18-45 years old, complaining of pain in the orofacial region in the last 6 months and diagnosed with masticatory myofascial pain according to Research Diagnostic Criteria (RDC/MD). The control group included match-controls without TMD. The participants were evaluated to global and upper (Flexion Rotation Test - FRT) neck range of motion (ROM) and to neck motor control (Cranio-Cervical Flexion Test - CCFT). They were treated with a protocol of specific motor control exercises targeted to flexor and extensor neck muscles for 30 minutes. One day after the protocol the patients were reevaluated. ResultsA total of 23 volunteers were evaluated. The TMD group showed immediate improvement in left cervical rotation (p=0.043) and right FRT (p=0.036), while the control group did not show any improvement. There was no difference between the groups before and after treatment in relation to cervical movements. Regarding cervical motor control in both groups, the highest prevalence was of results between 24 and 26 mmHg after treatment, different from before the intervention (20 and 22 mmHg) in both groups.ConclusionA single session of specific neck motor control training only improved the left cervical rotation and upper right rotation in the TMD group, but not in the control group. There is no difference at the end of treatment between the groups. Volunteers with TMD showed improvement in the pattern of motor control of the neck when compared to volunteers without TMD.
Highlights
Temporomandibular joint (TMJ) is an element of the stomatognathic system formed by several internal and external structures, it is located anteriorly to the external acoustic meatus, inferiorly to the temporal bone and superiorly to the mandible and contains an intra-articular disk within the articular capsule that divides it into superior and inferior
Questionnaire reported by several authors as a reliable tool for evaluating myogenic, arthrogenic, and mixed Temporomandibular disorder (TMD), and is widely used as diagnostic criteria in clinical TMD research.[24]
This questionnaire model was based on the biopsychosocial model of pain. This classification system was based on the biopsychosocial model of pain that included an Axis I which is composed of the physical assessment that includes pain assessment, mouth range of motion, presence, or absence of otologic noises and symptoms, and muscle palpation, using reliable and well operationalized diagnostic criteria and an Axis II assessment of psychosocial status and pain-related disability
Summary
Temporomandibular joint (TMJ) is an element of the stomatognathic system formed by several internal and external structures, it is located anteriorly to the external acoustic meatus, inferiorly to the temporal bone and superiorly to the mandible and contains an intra-articular disk within the articular capsule that divides it into superior and inferior. Temporomandibular disorder (TMD), in turn, is a collective term for structural and functional disorders involving the TMJ and/or masticatory muscles, head and neck muscles, and contiguous tissue components.[2] Biological, anatomical, biomechanical, behavioral, environmental, and emotional factors affect the masticatory system, causing the development of signs and symptoms and/or perpetuation of TMD.[3] TMD can be considered a multifactorial disease entity.[4] It is primarily characterized by pain and restricted jaw movement, with pain being the most common symptom and the most frequent reason for seeking treatment.[4]
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