Jaw dysfunction is associated with neck disability and muscle tenderness in subjects with and without chronic temporomandibular disorders.

PURPOSE: Tender points in the neck are common in patients with temporomandibular disorders (TMD). However, the correlation among neck disability, jaw dysfunction, and muscle tenderness in subjects with TMD still needs further investigation. This study investigated the correlation among neck disability, jaw dysfunction, and muscle tenderness in subjects with and without chronic TMD. Participants. Forty females between 19 and 49 years old were included in this study. There were 20 healthy controls and 20 subjects who had chronic TMD and neck disability. METHODS: Subjects completed the neck disability index and the limitations of daily functions in TMD questionnaires. Tenderness of the masticatory and cervical muscles was measured using an algometer. RESULTS: The correlation between jaw disability and neck disability was significantly high (r = 0.915, P < 0.05). The correlation between level of muscle tenderness in the masticatory and cervical muscles with jaw dysfunction and neck disability showed fair to moderate correlations (r = 0.32-0.65). CONCLUSION: High levels of muscle tenderness in upper trapezius and temporalis muscles correlated with high levels of jaw and neck dysfunction. Moreover, high levels of neck disability correlated with high levels of jaw disability. These findings emphasize the importance of considering the neck and its structures when evaluating and treating patients with TMD.

Validity of surface markers placement on the cervical spine for craniocervical posture assessment.

The objective of this study was to evaluate the ability of a physical therapist to place surface markers on the skin over spinous process of C2, C4, C6, and C7 by evaluating the markers positioning using radiographs. A total of 39 healthy female subjects participated. From 39 subjects, 22 had 2 radiographs taken and 17 had 1 radiograph taken. This study presents the results from the 22 subjects and from all 39 subjects together. The markers used were visible on the radiographs. The surface markers placement was tested by using percentage agreement. The criteria used were based on the direction of palpation. Only the markers placed that presented the center of the markers tip aligned to the tip of the spinous process was considered an acceptable placement. Only one level of agreement was considered. A misplaced marker was measured by its relation with the vertebra above or below. From the 22 subjects, the total percentage of agreement was 87.5%. Of the 12.5% error, 1.7% (3) occurred attempting to find C2; 4.5% (8) for C4; 3.4% (6) for C6; and 2.8% (5) for C7. From the total of 39 subjects, the total percentage of agreement was 87.8%. Of the 12.2% error 1.3% (2) occurred attempting to find C2; 2.6% (4) for C4; 3.2% (5) for C6; and 5.2% (8) for C7. Based on the results from this study, clinicians and researchers should take into account possible errors on surface markers placement on the cervical spine when measuring craniocervical posture using photographs.

Importance and clarification of measurement properties in rehabilitation

OBJETIVO: O objetivo do presente artigo foi revisar criticamente os conceitos e tipos de confiabilidade, validade e responsividade de medidas, e discutir suas implicações para a pesquisa em reabilitação e para a prática clínica de qualidade.MÉTODO: Uma revisão crítica da literatura foi realizada considerando as vantagens, as limitações e o uso adequado das propriedades de medida em reabilitação.RESULTADOS E DISCUSSÃO: A qualidade das medidas é avaliada por critérios tais como confiabilidade, validade e responsividade. Muitos estudos publicados não apresentam estas propriedades de medida as quais estão relacionadas e algumas vezes sobrepõe-se sendo freqüentemente confundidas. Este artigo de revisão esclareceu os conceitos e tipos de confiabilidade, validade e responsividade. Exemplos relevantes para a área de reabilitação foram apresentados. Discutiu-se como as propriedades de medida interagem entre si e influenciam o tamanho do efeito e o poder dos estudos. CONCLUSÕES: Medidas são essenciais na pesquisa em reabilitação e na avaliação clínica. As propriedades de medida devem ser apresentadas para permitir que o leitor possa avaliar a qualidade dos resultados apresentados. Os esclarecimentos das propriedades de medida apresentados neste artigo podem contribuir para a padronização das definições e para a melhoria da qualidade da pesquisa em reabilitação e da prática clínica.

Preliminary rapport on head posture and muscle activity in subjects with class I and II.

Forward head posture may cause alterations in the stomatognathic system, including changes in the muscle activity of the masticatory muscles and dental occlusion alterations. Considering the need for further understanding of the relationship between the stomatognathic system and the cervical region, the purpose of this study was to analyse the head posture and the electromyographic (EMG) activity of the anterior portion of temporal and masseter muscles bilaterally among bruxist's subjects with different dental occlusion classifications using the Angle method. The study consisted of 20 female volunteers, between the ages of 17 and 27 years. They were separated into two groups (class I and class II occlusions) according to a dentist-performed evaluation. An assessment of forward head posture was conducted using a photographic technique (angular calculus) combined with a clinical analysis. In the EMG analyses, active differential surface electrodes (Ag) were utilized and were placed bilaterally on the belly of masseter and temporal muscles, perpendicular to the muscles fibres. The EMG signal recorded during bilateral isotonic mastication, was presented using the Root Mean Square and was processed by Matlab software. The results indicated that the EMG responses of temporal and masseter muscles tend to be modified by occlusion alteration class II. Subjects with class II occlusion tended to present more occurrence of forward head posture with alterations in the muscle activity pattern between masseter and temporal muscles.