Immediate effect of a motor control exercise target to the neck muscles on upper cervical range of motion and motor control in patients with temporomandibular disorder
DOI:
https://doi.org/10.48208/HeadacheMed.2021.18Palavras-chave:
Desordem temporomandibular; Amplitude de movimento articular; dor facialResumo
Objective
To 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.
Methods
This 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.
Results
A 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.
Conclusion
A 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.
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Referências
Pereira KNF, de Andrade LLS, da Costa MLG and Portal TF. Sinais e sintomas de pacientes com disfunção
temporomandibular. Rev CEFAC 2005;7(2):221-228
Okeson JP and de Kanter RJ. Temporomandibular disorders in the medical practice. J Fam Pract 1996;43(4):347-356
Tuncer AB, Ergun N, Tuncer AH and Karahan S. Effectiveness of manual therapy and home physical therapy in patients with temporomandibular disorders: A randomized controlled trial. J Bodyw Mov Ther 2013;17(3):302-308 Doi:10.1016/j.jbmt.2012.10.006 DOI: https://doi.org/10.1016/j.jbmt.2012.10.006
Leeuw R and Klasser GD. Orofacial pain: guidelines for assessment, diagnosis, and management. Am J Orthod
Dentofacial Orthop 2008;134(1):171 Doi:10.1016/j.ajodo.2008.05.001 DOI: https://doi.org/10.1016/j.ajodo.2008.05.001
Milanesi JDM, Corrêa ECR, Borin GS, Souza JA and Pasinato F. Atividade elétrica dos músculos cervicais e amplitude de movimento da coluna cervical em indivíduos com e sem DTM. Fisioter e Pesq 2011;18(4):317-322 Doi:10.1590/s1809-29502011000400004 DOI: https://doi.org/10.1590/S1809-29502011000400004
Ogince M, Hall T, Robinson K and Blackmore AM. The diagnostic validity of the cervical flexionrotation test in C1/2-related cervicogenic headache. Man Ther 2007;12(3):256-262 Doi:10.1016/j.math.2006.06.016 DOI: https://doi.org/10.1016/j.math.2006.06.016
Soares JC, Weber P, Trevisan ME, Trevisan CM and Rossi AG. Correlação entre postura da cabeça, intensidade da
dor e índice de incapacidade cervical em mulheres com queixa de dor cervical. Fisioter Pesq 2012;19(1):68-72
Doi:10.1590/S1809-29502012000100013 DOI: https://doi.org/10.1590/S1809-29502012000100013
Costa DR, Lima Ferreira AP, Pereira TA, Porporatti AL, Conti PC, Costa YM and Bonjardim LR. Neck disability is
associated with masticatory myofascial pain and regional muscle sensitivity. Arch Oral Biol 2015;60(5):745-752
Doi:10.1016/j.archoralbio.2015.02.009 DOI: https://doi.org/10.1016/j.archoralbio.2015.02.009
Menezes Kinote APB, Monteiro LT, Vieira AAC, Ferreira NMN and Vasconcellos Abdon APJ. Perfil funcional de pacientes com disfunção temporomandibular em tratamento fisioterápico. Rev Bras Promoç Saúde 2011;24(4):306-312 Doi:10.5020/2087
Armijo-Olivo S and Magee D. Cervical musculoskeletal impairments and temporomandibular disorders. J Oral Maxillofac Res 2013;3(4):e4 Doi:10.5037/jomr.2012.3404 DOI: https://doi.org/10.5037/jomr.2012.3404
Kraus S. Temporomandibular disorders, head and orofacial pain: cervical spine considerations. Dent Clin North Am 2007;51(1):161-193, vii Doi:10.1016/j.cden.2006.10.001 DOI: https://doi.org/10.1016/j.cden.2006.10.001
Bogduk N. The neck and headaches. Neurol Clin 2004;22(1):151-171, vii Doi:10.1016/s0733-8619(03)00100-2 DOI: https://doi.org/10.1016/S0733-8619(03)00100-2
Armijo-Olivo S, Pitance L, Singh V, Neto F, Thie N and Michelotti A. Effectiveness of Manual Therapy and
Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis. Phys Ther 2016;96(1):9-25 Doi:10.2522/ptj.20140548 DOI: https://doi.org/10.2522/ptj.20140548
Medlicott MS and Harris SR. A systematic review of the effectiveness of exercise, manual therapy, electrotherapy, relaxation training, and biofeedback in the management of temporomandibular disorder. Phys Ther 2006;86(7):955-973 DOI: https://doi.org/10.1093/ptj/86.7.955
McNeely ML, Armijo Olivo S and Magee DJ. A systematic review of the effectiveness of physical therapy interventions for temporomandibular disorders. Phys Ther 2006;86(5):710-725 DOI: https://doi.org/10.1093/ptj/86.5.710
Miller J, Gross A, D'Sylva J, Burnie SJ, Goldsmith CH, Graham N, . . . Hoving JL. Manual therapy and exercise for neck pain: A systematic review. Man Ther 2010;Doi:10.1016/j.math.2010.02.007 DOI: https://doi.org/10.1016/j.math.2010.02.007
Falla D, Lindstrøm R, Rechter L, Boudreau S and Petzke F. Effectiveness of an 8-week exercise programme on pain
and specificity of neck muscle activity in patients with chronic neck pain: a randomized controlled study. Eur
J Pain 2013;17(10):1517-1528 Doi:10.1002/j.1532-2149.2013.00321.x DOI: https://doi.org/10.1002/j.1532-2149.2013.00321.x
Jull GA, Falla D, Vicenzino B and Hodges PW. The effect of therapeutic exercise on activation of the deep
cervical flexor muscles in people with chronic neck pain. Man Ther 2009;14(6):696-701 Doi:10.1016/j. DOI: https://doi.org/10.1016/j.math.2009.05.004
math.2009.05.004 DOI: https://doi.org/10.1088/1475-7516/2009/05/004
Bronfort G, Evans R, Nelson B, Aker PD, Goldsmith CH and Vernon H. A randomized clinical trial of exercise
and spinal manipulation for patients with chronic neck pain. Spine (Phila Pa 1976) 2001;26(7):788-797 Doi:10.1097/00007632-200104010-00020 DOI: https://doi.org/10.1097/00007632-200104010-00020
Ylinen J, Takala EP, Nykänen M, Häkkinen A, Mälkiä E, Pohjolainen T, . . . Airaksinen O. Active neck muscle
training in the treatment of chronic neck pain in women: a randomized controlled trial. Jama 2003;289(19):2509-
Doi:10.1001/jama.289.19.2509 DOI: https://doi.org/10.1001/jama.289.19.2509
Slepian P, Bernier E, Scott W, Niederstrasser NG, Wideman T and Sullivan M. Changes in pain catastrophizing following physical therapy for musculoskeletal injury: the influence of depressive and post-traumatic stress symptoms. J Occup Rehabil 2014;24(1):22-31 Doi:10.1007/s10926-013-9432-2 DOI: https://doi.org/10.1007/s10926-013-9432-2
Falla D, Jull G, Dall'Alba P, Rainoldi A and Merletti R. An electromyographic analysis of the deep cervical flexor
muscles in performance of craniocervical flexion. Phys Ther 2003;83(10):899-906 DOI: https://doi.org/10.1093/ptj/83.10.899
O'Leary S, Cagnie B, Reeve A, Jull G and Elliott JM. Is there altered activity of the extensor muscles in chronic
mechanical neck pain? A functional magnetic resonance imaging study. Arch Phys Med Rehabil 2011;92(6):929-
Doi:10.1016/j.apmr.2010.12.021 DOI: https://doi.org/10.1016/j.apmr.2010.12.021
Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, . . . Dworkin SF. Diagnostic Criteria for
Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the
International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group†. J Oral Facial Pain
Headache 2014;28(1):6-27 Doi:10.11607/jop.1151 DOI: https://doi.org/10.11607/jop.1151
Audette I, Dumas JP, Côté JN and De Serres SJ. Validity and between-day reliability of the cervical range of
motion (CROM) device. J Orthop Sports Phys Ther 2010;40(5):318-323 Doi:10.2519/jospt.2010.3180 DOI: https://doi.org/10.2519/jospt.2010.3180
Oliveira-Souza AIS, Florencio LL, Carvalho GF, Fernández-De-Las-Peñas C, Dach F and Bevilaqua-Grossi
D. Reduced flexion rotation test in women with chronic and episodic migraine. Braz J Phys Ther 2019;23(5):387-
Doi:10.1016/j.bjpt.2019.01.001 DOI: https://doi.org/10.1016/j.bjpt.2019.01.001
Armijo-Olivo S, Silvestre R, Fuentes J, da Costa BR, Gadotti IC, Warren S, . . . Magee DJ. 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 Doi:10.2522/ptj.20100233 DOI: https://doi.org/10.2522/ptj.20100233
Shimada A, Ishigaki S, Matsuka Y, Komiyama O, Torisu T, Oono Y, . . . Sasaki K. Effects of exercise therapy on
painful temporomandibular disorders. J Oral Rehabil 2019;46(5):475-481 Doi:10.1111/joor.12770 DOI: https://doi.org/10.1111/joor.12770
Garrigós-Pedrón M, La Touche R, Navarro-Desentre P, Gracia-Naya M and Segura-Ortí E. Effects of a Physical
Therapy Protocol in Patients with Chronic Migraine and T emporomandibular Disorders: A Randomized, Single-
Blinded, Clinical Trial. J Oral Facial Pain Headache 2018;32(2):137-150 Doi:10.11607/ofph.1912 DOI: https://doi.org/10.11607/ofph.1912
Delgado de la Serna P, Plaza-Manzano G, Cleland J, Fernández-de-Las-Peñas C, Martín-Casas P and Díaz-Arribas MJ. Effects of Cervico-Mandibular Manual Therapy in Patients with Temporomandibular Pain Disorders and Associated Somatic Tinnitus: A Randomized Clinical Trial. Pain Med 2020;21(3):613-624 Doi:10.1093/pm/pnz278 DOI: https://doi.org/10.1093/pm/pnz278
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Copyright (c) 2021 Alexandra Daniele de Fontes Coutinho, Ana Izabela Sobral de Oliveira-Souza, Lais Ribeiro Sales, Daniella Araújo de Oliveira
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
Grant numbers 001