【論文摘要】Kinematics and Muscle Activity of Temporomandibular Joint in Patients With Non-specific Chronic Neck Pain

【論文摘要】非特定性慢性頸部疼痛患者的顳顎關節動作學及肌肉活性

蕭泳心(Weng-Sam Siu) ； 魏敏如(Min-Ju Wei) ； 許至瑜(Chih-Yu Hsu) ； 李士元(Shyh-Yuan Lee) ； 林吟亮(Yin-Liang Lin)

《物理治療》 45卷4期 (2020/12) Pp. 296-297

https://doi.org/10.6215/FJPT.202012.O03

摘要

Background and Purpose: Non-specific chronic neck pain (NCNP) is highly prevalent, affecting 16.7-75.1% of population. Over one-fifth of patients with NCNP suffer from temporomandibular disorder (TMD), and those with neck pain has higher prevalence of TMD than those without neck pain. The comorbidity between NCNP and TMD could be explained by forward-head posture or neuronal convergence. Patients with TMD have showed changes in TMJ kinematics during movement, and altered muscle activation during resting and clenching. Although neck problems are highly associated with TMD, no study has investigated whether patients with NCNP demonstrate altered TMJ kinematics and muscle activation before they show any symptoms of TMD. Therefore, this study aimed to compare kinematics and muscle activity in patients with NCNP to those in healthy subjects. Methods: This is a cross-sectional exploratory study. We recruited 15 healthy subjects (8 males and 7 females, 20-30 years old) and 20 subjects, who had NCNP but no TMD symptom (10 males and 10 females, 20-34 years old). Zebris Jaw Motion Analyzer was used to measure TMJ kinematics data during mouth opening, closing, protrusion and lateral deviation. Surface electromyography was used to assess muscle activity of anterior temporalis, masseter, sternocleidomastoid and upper trapezius during clenching. Three-way ANOVA was used to compare condylar movements in different phases. Two-way ANOVA and independent t test were used to analyze other parameters. The significant level set at 0.05. Results: As compared to the healthy, NCNP group showed increased condylar path length during mouth opening (p = 0.019) and increased condylar translation during mouth opening and closing (p ＜ 0.003). No significant difference was found in muscle activity. Conclusion: Patients with NCNP demonstrate altered TMJ kinematics during movement. These changes might be early signs of the potential development of TMD. Clinical Relevance: In patients with mild NCNP, clinician may evaluate any increased condylar translation in their TMJs.