Efeito da massoterapia e da estimulação elétrica nervosa transcutânea na dor e atividade eletromiográfica de pacientes com disfunção temporomandibular

This study aimed at assessing the effect of two physical therapy resources in the treatment of temporomandibular disorders (TMD) – massage therapy and transcutaneous electrical nerve stimulation (TENS) on masseter and temporal muscles – in view of reducing painful sensitivity response in TMD patients. Twenty female volunteers with myogenous TMD signs and symptoms were randomly divided into two groups (n-10): group 1 was submitted to one session of massage on the face, and group 2 received TENS on the face. Before and after the treatment, volunteers underwent an electromyographic exam in isotonic and isometric contractions of masseter and temporal muscles, and answered the Visual Analog Scale of pain (VAS). Results show that the muscles examined had greater electromyographic activity (p=0.02) after the session in both groups, pointing to improvement in muscle contraction pattern; and a reduction in VAS scores (p<0.01). Both therapeutic resources were thus found to be equally effective in reducing pain sensitivity in TMD patients.Este estudo visou avaliar o efeito de dois recursos fisioterapêuticos para o tratamento da disfunção temporomandibular (DTM), a massoterapia e aestimulação nervosa elétrica transcutânea (TENS) nos músculos masseter e temporal, tendo em vista o alívio da sensibilidade dolorosa de pacientes com DTM. Participaram 20 mulheres com sinais e sintomas de DTM miogênica, distribuídas por sorteio em dois grupos (n=10): as do grupo 1 foram submetidas a uma sessão de massoterapia na face, as do grupo 2, a uma sessão de TENS na face. Antes e após o tratamento, as participantes foram avaliadas por exame eletromiográfico em contrações isotônica e isométrica bilateralmente e responderam à Escala Visual Analógica de dor (EVA). Os resultados mostram que os músculos avaliados manifestaram maior atividade eletromiográfica imediatamente após as terapias propostas (p=0,02), demonstrando melhora no padrão de contração muscular, e diminuição dos valores marcados na EVA (p<0,01). Ambos os tratamentos propostos, pois, foram recursos igualmente favoráveis à redução do quadro álgico em voluntárias com DTM

Correlation between temporomandibular dysfunction, cervical posture and quality of life

INTRODUÇÃO: As disfunções temporomandibulares apresentam manifestações clínicas variadas, porém com alta prevalência de alterações posturais e impacto na qualidade de vida destes indivíduos. OBJETIVO: Caracterizar o grau de disfunção temporomandibular (DTM) e relacionar com a postura cervical e com a qualidade de vida em universitários. Método: Foram selecionados 98 indivíduos, de ambos os gêneros, com faixa etária entre 18 a 33 anos, através dos questionários, Índice Anamnético de Fonseca, que gradua a severidade da DTM e a versão brasileira do questionário de qualidade de Vida SF-36. A análise da postura de cabeça e pescoço foi realizada pelo software AlcimagemÒ, que oferece uma análise quantitativa dos ângulos. RESULTADOS: 68,36% apresentaram DTM Leve, 23,47% Moderada e 8,16% Severa;os mesmos apresentaram prejuízo principalmente nos domínios Vitalidade e Dor (X²= 0,03), sendo que Aspectos Emocionais e Sociais foram os domínios mais preservados. A média do ângulo cervical em indivíduos com DTM foi 90,76°(±7,72), sendo que há um aumento do ângulo cervical relacionado ao aumento do grau de severidade da DTM, porém não significante estatisticamente (r= 0,09). CONCLUSÃO: Houve uma prevalência maior de Disfunção Temporomandibular (DTM) leve, sendo que em relação ao ângulo cervical, houve um aumento com a severidade do grau de DTM, com piora da qualidade de vida nesta população.INTRODUCTION: Temporomandibular dysfunction (TMD) presents several clinical manifestations, with high prevalence of postural changes and impacts on the individual's quality of life. Objective: To characterize the degree of temporomandibular dysfunction (TMD) and to correlate it with cervical posture and the quality of life of undergraduate students. Materials and METHODS: Ninety-eight individuals between 18 and 33 years old of both sexes were selected by means of the questionnaires Fonseca's Anamnesis Index, which graduates TMD severity, and the Brazilian version of the SF-36 Quality of Life Questionnaire. Analysis of the head and neck posture was performed with the Alcimagem software, which offers a quantitative analysis of the angles. RESULTS: The data collected demonstrated that 68.36% of the subjects presented mild TMD, 23.47% presented moderate TMD and 8.16% presented severe TMD; the participants presented distortions in the Vitality and Pain domains (X²= 0.03), while the domains of Emotional and Social Aspects remained preserved. The average of cervical angle in individuals with TMD was 90.76°(±7.72), and an increase in cervical angle was observed related to the increase in TMD severity degree; however, this data was not statistically significant (r=0.09). CONCLUSION: TMD influenced the quality of life of the sample utilized. A possible increase in cervical angle related to an increased TMD severity degree is suggested

Effectiveness of phototherapy incorporated into an exercise program for osteoarthritis of the knee: study protocol for a randomized controlled trial

BACKGROUND: Osteoarthritis is a chronic disease with a multifactor etiology involving changes in bone alignment, cartilage, and other structures necessary to joint stability. There is a need to investigate therapeutic resources that combine different wavelengths as well as different light sources (low-level laser therapy and light-emitting diode therapy) in the same apparatus for the treatment of osteoarthritis. The aim of the proposed study is to analyze the effect of the incorporation of phototherapy into a therapeutic exercise program for individuals with osteoarthritis of the knee. METHODS/DESIGN: A double-blind, controlled, randomized clinical trial will be conducted involving patients with osteoarthritis of the knee. Evaluations will be performed using functional questionnaires before and after the treatment protocols, in a reserved room with only the evaluator and participant present, and no time constraints placed on the answers or evaluations. The following functional tests will also be performed: stabilometry (balance assessment), dynamometry (muscle strength of gluteus medius and quadriceps), algometry (pain threshold), fleximeter (range of motion), timed up-and-go test (functional mobility), and the functional reach test. The participants will then be allocated to three groups through a randomization process using opaque envelopes: exercise program, exercise program + phototherapy, or exercise program + placebo phototherapy, all of which will last for eight weeks. DISCUSSION: The purpose of this randomized clinical trial is to analyze the effect of the incorporation of phototherapy into a therapeutic exercise program for osteoarthritis of the knee. The study will support the practice based on evidence to the use of phototherapy in individuals with a diagnosis of osteoarthritis of the knee. Data will be published after the study is completed. TRIAL REGISTRATION: The protocol for this study has been submitted to Clinical Trials, registration number NCT02102347, on 29 March 2014

Effect of Facial Massage on Static Balance in Individuals with Temporomandibular Disorder – a Pilot Study

Introduction: The influence of the neuromuscular system on the cervical region and mastication is directly associated with mandibular movements and neck posture. Normal occlusal homeostasis depends on complex sensory feedback mechanisms of the periodontal ligament, temporomandibular joint and other structures of the stomatognathic system. This feedback serves as a regulatory mechanism that helps determine the force and nature of muscle contractions. Alterations in the muscles of mastication, neck muscles, and occlusal characteristics constitute causal factors of imbalances in the postural muscle chains, leading to alterations in the center of pressure (CoP) of the feet. Thus, therapies that seek occlusal reestablishment, such as muscle relaxation techniques, may lead to a restructuring of the global equilibrium of the neuromuscular system and an improvement in body posture. Purpose: The aim of the present pilot study was to investigate the immediate effect of facial massage on the CoP in the anteroposterior (CoPAP) and mediolateral (CoPML) directions in individuals with temporomandibular disorder (TMD). Methods: Twenty individuals with a diagnosis of TMD based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were submitted to a facial massage technique. CoPAP and CoPML were evaluated using a force plate. Evaluations were performed under two visual conditions (eyes open and eyes closed) prior to resting in dorsal decubitus (baseline), after 10 minutes of rest (premassage) and after the administration of the massage technique (postmassage). Results: No significant differences were found regarding CoPAP velocity with eyes open or the following aspects under either visual condition (eyes open or closed): CoPML velocity, RMS of CoPAP, RMS of CoPML, and sway area. The only significant difference was found for mean CoPAP velocity with eyes closed. Conclusions: While the results of the present study demonstrate the reliability of the reproduction of the data, facial massage had no immediate influence on postural control in individuals with TMD

[presence Of Temporomandibular Joint Discomfort Related To Pacifier Use].

The goal of the present study was to analyze if the duration of pacifier use influenced the stomatognathic system in children that did not present any other parafunctional habits. Transversal cohort study. To collect data, a questionnaire was used and answered by the mothers of 90 children aged three to seven years old. The children were divided into three groups: did not use pacifier; used pacifier until 2 years old; and used pacifier for more than 2 years. Greater prevalence of pain or discomfort in the stomatognathic system was observed among the children who had not used pacifier and the children who had used it for more than 2 years. The prevalence was smaller among the children who used pacifier until 2 years of age. Thus, it is concluded that pacifier is important to induce children to perform suction movements, preparing them to the introduction of solid foods. However, if used for a prolonged period of time, it may damage the joint and consequently the child's quality of life.71365-

Correlation between headache and temporomandibular joint dysfunction

A relação entre disfunções temporomandibulares (DTM) e os diferentes tipos de cefaléias ainda não está bem compreendida, mas a dor de cabeça é provavelmente o sintoma mais comum da DTM. O objetivo deste estudo foi correlacionar cefaléia com o índice clínico de Fonseca de avaliação da DTM. Participaram 160 voluntários estudantes da Universidade Nove de Julho na faixa dos 18 aos 36 anos, sendo 80 mulheres e 80 homens. Foram aplicados dois questionários: o índice clínico de Fonseca e um questionário sobre cefaléia. Os dados foram analisados estatisticamente e o nível de significância fixado em pThe relationship between temporomandibular joint disorders (TMD) and different kinds of headaches is still not well understood, though headache is probably the most common symptom of TMD. The aim of this study was to correlate headache with Fonseca's TMD clinical index. A total of 160 university students aged 18 to 36 years old were selected, half women, half men. Two questionnaires were applied to them: the Fonseca clinical questionnaire and one on headache. Data were statistically analysed and significance level set at

Correlação entre cefaléia e disfunção temporomandibular

A relação entre disfunções temporomandibulares (DTM) e os diferentes tipos de cefaléias ainda não está bem compreendida, mas a dor de cabeça é provavelmente o sintoma mais comum da DTM. O objetivo deste estudo foi correlacionar cefaléia com o índice clínico de Fonseca de avaliação da DTM. Participaram 160 voluntários estudantes da Universidade Nove de Julho na faixa dos 18 aos 36 anos, sendo 80 mulheres e 80 homens. Foram aplicados dois questionários: o índice clínico de Fonseca e um questionário sobre cefaléia. Os dados foram analisados estatisticamente e o nível de significância fixado em p<0,05. Os resultados mostram maior prevalência de DTM entre as mulheres com cefaléia, mas não foi possível verificar uma relação direta entre cefaléia e nível de gravidade da disfunção da articulação temporomandibular