Proprioceptive ability at the lips and jaw measured using the same psychophysical discrimination task.

Abstract

In the human face, the muscles and joints that generate movement have different properties. Whereas the jaw is a conventional condyle joint, the facial musculature has neither distinct origin nor insertion points, and the muscles do not contain muscle spindle proprioceptors. This current study aims to compare the proprioceptive ability at the orofacial muscles with that of the temporomandibular joint (TMJ) in 21 neuro-typical people aged between 18 and 65years. A novel psychophysical task was devised for use with both structures that involved a fixed 30.5mm start separation followed by closure onto stimuli of 5, 6, 7, 8mm diameter. The mean proprioceptive score when using the lips was 0.84 compared to 0.79 at the jaw (p<0.001), and response error was lower by 0.1mm. The greater accuracy in discrimination of lip movement is significant because, unlike the muscles controlling the TMJ, the orbicularis oris muscle controlling the lips inserts on to connective tissue and other muscle, and contains no muscle spindles, implying a different more effective, proprioceptive mechanism. Additionally, unlike the lack of correlation previously observed between joints in the upper and lower limbs, at the face the scores from performing the task with the two different structures were significantly correlated (r=0.5, p=0.018). These data extend the understanding of proprioception being correlated for the same left and right joints and correlated within the same structure (e.g. ankle dorsiflexion and inversion), to include use-dependant proprioception, with performance in different structures being correlated through extended coordinated use. At the lips and jaw, it is likely that this arises from extensive coordinated use. This informs clinical assessment and suggests a potential for coordinated post-injury training of the lips and jaw, as well as having the potential to predict premorbid function via measurement of the uninjured structure, when monitoring progress and setting clinical rehabilitation goals.