Temporomandibular disorders (TMD) consist of a group of pathologies affecting the masticatory muscles, the temporomandibular joint and related structures. The association between the cervical spine and TMD has been studied from different perspectives; however, the study of cervical muscles and their significance in the development and perpetuation of TMD has not been elucidated. Thus, this project was designed to investigate the association between cervical musculoskeletal impairments and TMD. A sample of subjects who attended the TMD/Orofacial Pain clinic, and students and staff at the University of Alberta participated in this study. All subjects underwent a series of physical tests and electromyographic assessment (i.e. head and neck posture, maximal cervical muscle strength, cervical flexor and extensor muscles endurance, and cervical flexor muscle performance) to determine cervical musculoskeletal impairments. All subjects were asked to complete the Neck disability Index and the Jaw Function Scale, and the Chronic Pain Grade Disability Questionnaire. A strong relationship between neck disability and jaw disability was found (r=0.82). Craniocervical posture (measured using the eye-tragus-horizontal angle) was statistically different between patients with myogenous TMD and healthy subjects. However, the difference was too small (3.3) to be considered clinically relevant. Maximal cervical flexor muscle strength was not statistically or clinically different between patients with TMD and healthy subjects. No statistically significant differences were found in electromyographic activity of the sternocleidomastoid or the anterior scalene muscles in patients with TMD when compared to healthy subjects while executing the craniocervical flexion test (p=0.07). However, clinically important effect sizes (0.42-0.82) were found. Subjects with TMD presented with reduced cervical flexor as well as extensor muscle endurance while performing the flexor and extensor muscle endurance tests when compared to healthy individuals. Furthermore, patients with mixed TMD presented with steeper negative slopes (although modest) at several times during the neck extensor muscle endurance test than healthy subjects. The results of this research provided an important clinical contribution to the area of physical therapy and TMD. It identified impairments in the cervical spine in patients with TMD that could help guide clinicians in the assessment and prescription of more effective interventions for individuals with TMD. / Rehabilitation Science
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:AEU.10048/1125 |
| Date | 06 1900 |
| Creators | Armijo Olivo, Susan |
| Contributors | Magee, D (Rehabilitation Medicine), Warren, Sharon (Rehabilitation Medicine), Major, Paul (Dentistry), Thie, Norman (Dentistry), Syrotuik, Dan (Physical Education and Recreation), Da Fonseca, Sergio (Physical Therapy) |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | 10497912 bytes, application/pdf |
| Relation | 10)Armijo Olivo S, Magee, D, Parfitt M, Major Paul, Thie , N. The cervical spine, the stomatognathic system and Craniofacial pain: what is the connection? A critical review. Journal of Orofacial Pain 2006; 20:271-287, 13)Armijo Olivo S, , Bravo J, Magee D, Paul Major, Norman Thie, Flores-Mir C. Relationship between head and cervical posture and temporomandibular disorders: A systematic review. Journal of Orofacial Pain 20: 9-23, 2006, 1)Armijo Olivo S, Fuentes J, Costa B, Gadotti I, Silvestre R & Magee, DJ. Electromyographic Evaluation of The Performance of Flexor Cervical Muscles In Patients With Myogenous Temporomandibular Disorders, Mixed Temporomandibular disorders, and healthy subjects When Executing The Craniocervical Flexion Test (CCFT) 6th Annual meeting Alberta Provincial CIHR Training Program in Bone and Joint Health. Banff 19-20 October 2007, 1)Armijo-Olivo S, Fuentes J, Silvestre R, Da Costa B, Gadotti I, Magee D Strength and endurance of the cervical flexor muscles in patients with Temporomandibular Disorders (TMD): Preliminary Results. International Society of Orofacial pain, Brazil August 2009., 2)Armijo-Olivo S, Rappoport K, Fuentes J, Magee D. Head and cervical posture in patients with Temporomandibular Disorders (TMD). International Society of Orofacial pain, Brazil August 2009., 6)Armijo Olivo S ,Silvestre R , Fuentes J , da Costa B, Gadotti, I , Magee D.: Electromyographic Evaluation Of The Performance Of Flexor Cervical Muscles In Patients with Mixed Temporomandibular Disorders When Executing The Craniocervical Flexion Test Preliminary Results. 12th World Congress on Pain (IASP). Glasgow August 17-22, 2008, 8)Armijo Olivo S ,Silvestre R , Fuentes J , da Costa B, Gadotti, I , Magee D. Evaluation of the Fatigability of the cervical Extensors muscles while doing the neck extensor endurance Test in patients with myogenous temporomandibular Disorders and healthy subjects: Preliminary results. XVII international Conference of the International Society of electrophysiology and Kinesiology. Niagara Falls June 18-21, 2008, 9)Armijo Olivo S, Fuentes J, Costa B, Gadotti I, Silvestre R & Magee, DJ. Electromyographic Evaluation Of The Performance Of Flexor Cervical Muscles In Patients With Myogenous Temporomandibular Disorders When Executing The Craniocervical Flexion Test (CCFT) AAOP 2008 Annual Conference, April 2008 |
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