Effects of Therapeutic and Aerobic Exercise Programs on Pain, Neuromuscular Activation, and Bite Force in Patients with Temporomandibular Disorders.

Pain in masticatory muscles is one of the most frequent symptoms in patients with temporomandibular disorders (TMD) and can lead to changes in the patterns of neuromuscular activity of masticatory muscles and decrease in bite force. This study assesses the effects of three eight-week exercise programs on pain intensity, neuromuscular activation, and bite force of masticatory muscles in patients with TMD. Forty-five patients were divided into three groups: a therapeutic exercise program (G1), a therapeutic and aerobic exercise program (G2), and an aerobic exercise program (G3). The masticatory muscles' pain was evaluated using the numeric pain rating scale (NPRS), surface electromyographic (sEMG) activity of the masseter was recorded during maximum voluntary contraction and at rest, and bite force was evaluated using a dynamometer. These parameters were evaluated twice at baseline (A01/A02), at the end of the eight-week intervention period (A1), and 8-12 weeks after the end of the intervention (A2). After intervention, G2 showed the best results, with a significantly decrease in masticatory muscles' pain and increase in bite force. These results suggest that interventions to reduce pain in patients with TMD should be multimodal.

Effects of therapeutic and aerobic exercise programs in temporomandibular disorder-associated headaches.

OBJECTIVE: To assess the effects of three 8-week exercise programs on the frequency, intensity, and impact of headaches in patients with headache attributed to temporomandibular disorder (TMD). METHODOLOGY: Thirty-six patients diagnosed with headache attributed to TMD participated in the study and were divided into three groups of 12 patients: a therapeutic exercise program (G1, mean age: 26.3±5.6 years), a therapeutic and aerobic exercise program (G2, mean age: 26.0±4.6 years), and an aerobic exercise program (G3, 25.8±2.94 years). Headache frequency and intensity were evaluated using a headache diary, and the adverse headache impact was evaluated using the Headache Impact Test (HIT-6). The intensity was reported using the numerical pain rating scale. These parameters were evaluated twice at baseline (A01/A02), at the end of the 8-week intervention period (A1), and 8-12 weeks after the end of the intervention (A2). RESULTS: At A1, none of the G2 patients reported having headaches, in G1, only two patients reported headaches, and in G3, ten patients reported headache. The headache intensity scores (0.3 [95% CI: -0.401, 1.068]), (0.0 [95% CI: -0.734, 0.734]) and HIT-6 (50.7 [95% CI: 38.008, 63.459]), (49.5 [95% CI: 36.808, 62.259]), significantly decreased in G1 and G2 at A1. At A2 headache intensity scores (0.5 [95% CI: -0.256, 1.256]), (0.0 [95% CI: -0.756, 0.756]) and HIT-6 (55.1 [95% CI: 42.998, 67.268]), (51.7 [95% CI: 39.532, 63.802]) in G1 and G2 haven't change significantly. The effects obtained immediately after the completion of the intervention programs were maintained until the final follow-up in all groups. CONCLUSION: The programs conducted by G1 (therapeutic exercises) and G2 (therapeutic and aerobic exercise) had significant results at A1 and A2.

Effects of therapeutic exercise and aerobic exercise programmes on pain, anxiety and oral health-related quality of life in patients with temporomandibular disorders.

BACKGROUND: Pain and anxiety contribute to decreasing quality of life related to oral health in patients with temporomandibular disorders (TMD). Evidence-based practice has shown that therapeutic and aerobic exercise programmes are adequate strategies for modifying these factors. OBJECTIVE: To assess the effects of aerobic exercise on pain, anxiety and quality of life related to oral health in patients with TMD. METHODS: Forty-five patients diagnosed with TMD were divided into three groups of 15 participants: a therapeutic exercise programme (G1, mean 26.9 ± 5.5 years), a therapeutic and aerobic exercise programme (G2, mean 26 ± 4.4 years) and an aerobic exercise programme (G3, mean 24.9 ± 3.4 years). Pain intensity was assessed using a numerical rating scale (NRS), anxiety level and quality of life related to oral health through GAD-7 and OHIP-14, respectively. These parameters were evaluated twice at baseline (T0a/T0b), ending 8-week intervention period (T1) and 8-12 weeks after ending intervention (T2). RESULTS: NRS significantly decreased in G1 (mean difference T0a/T1 = 5.2, p Ë‚ .001), G2 (mean difference T0a/T1 = 6.0, p Ë‚ .001) and G3 (mean difference T0a/T1 = 2.2, p = 0.001). OHIP-14 significantly decreased in G1 (mean difference T0a/T1 = 13.5, p Ë‚ .001) and G2 (mean difference T0a/T1 = 15.8, p ˂ 0.001) but not in G3 (mean difference T0a/T1 = 1.2, p = 0.55). There were no significant differences between groups regarding GAD-7. Between T1 and T2, there were no significant differences in variables. CONCLUSION: Therapeutic exercises and therapeutic excercises combined with aerobic exercise groups had a significant decrease in pain and oral health-related quality of life at 8 and 12 weeks. These decreases were not seen for the aerobic exercise group.

Effects of therapeutic and aerobic exercise programs in temporomandibular disorder-associated headaches

Abstract Objective To assess the effects of three 8-week exercise programs on the frequency, intensity, and impact of headaches in patients with headache attributed to temporomandibular disorder (TMD). Methodology Thirty-six patients diagnosed with headache attributed to TMD participated in the study and were divided into three groups of 12 patients: a therapeutic exercise program (G1, mean age: 26.3±5.6 years), a therapeutic and aerobic exercise program (G2, mean age: 26.0±4.6 years), and an aerobic exercise program (G3, 25.8±2.94 years). Headache frequency and intensity were evaluated using a headache diary, and the adverse headache impact was evaluated using the Headache Impact Test (HIT-6). The intensity was reported using the numerical pain rating scale. These parameters were evaluated twice at baseline (A01/A02), at the end of the 8-week intervention period (A1), and 8-12 weeks after the end of the intervention (A2). Results At A1, none of the G2 patients reported having headaches, in G1, only two patients reported headaches, and in G3, ten patients reported headache. The headache intensity scores (0.3 [95% CI: -0.401, 1.068]), (0.0 [95% CI: -0.734, 0.734]) and HIT-6 (50.7 [95% CI: 38.008, 63.459]), (49.5 [95% CI: 36.808, 62.259]), significantly decreased in G1 and G2 at A1. At A2 headache intensity scores (0.5 [95% CI: -0.256, 1.256]), (0.0 [95% CI: -0.756, 0.756]) and HIT-6 (55.1 [95% CI: 42.998, 67.268]), (51.7 [95% CI: 39.532, 63.802]) in G1 and G2 haven't change significantly. The effects obtained immediately after the completion of the intervention programs were maintained until the final follow-up in all groups. Conclusion The programs conducted by G1 (therapeutic exercises) and G2 (therapeutic and aerobic exercise) had significant results at A1 and A2.

Functional activities habits in chronic stroke patients: A perspective based on ICF framework.

BACKGROUND: Functional autonomy and social inclusion are of key importance for stroke patient's rehabilitation. OBJECTIVE: To evaluate activity and participation of chronic stroke patients by means of basic (BADL), instrumental (IADL) and social (SADL) activities of daily living. METHODS: Forty individuals, 24 patients and 16 healthy individuals fill in a functional activities habits questionnaire. RESULTS: Regarding BADL, 25% of the patients did not get out of bed and 70.8% did not use toilet by themselves. Considering IADL, 29.2% of the patients did not dial the telephone, 70.8% did not wash dishes and clothes, 58.3% did not cook, 100% did not sew, 87.5% did not carry out repairs, 41.7% did not go to the bank, 54.2% did not shop and 45.8% did not write (all p < 0.05). Regarding SADL, 87.5% of the patients were not working professionally, 41.7% did not visit friends or relatives, 75% did not travel and go to the beach and 95.8% did not dance (all p < 0.05). CONCLUSIONS: Chronic stroke patients have limitations in activity and restrictions to participation, even after few years of stroke onset, particularly regarding applying knowledge, use of communication devices, domestic life, major life areas and community, social and civic life.

Questionnaire on body awareness of postural habits in young people: construction and validation / Questionário de percepção corporal dos hábitos posturais de jovens: construção e validação

Abstract Introduction: The postural deviations associated with the changes in the habits of young people have increased over the last decades. Investigating the subject by way of a self-perception questionnaire allows one to understand the level of awareness the individual has concerning his/her postural habits. Objective: Designing a self-perception evaluation questionnaire about the postural habits of young people and to validate, pre-test, verify the reliability and the internal consistency of this instrument. Methods: The validity of the content was determined by 10 judges. The study involved young people (15 - 18 years old) from Florianopolis/Brazil. The questionnaire was pre-tested, applied to 15 youthful who provided qualitative information about it. The reproducibility was analyzed by way of a test-retest with 40 students, in a one-week gap, and was analyzed by interclass correlation coefficient. The internal consistency was analyzed by Cronbach's alpha with 679 students. A 5% significance level was adopted. Results: Concerning to the validation of content, the questionnaire presented a total coefficient of 0.28 and 72% concordance was observed amongst the reviewers. The interclass correlation coefficient (test-retest) indicated acceptable reproducibility values (R = 0.66, 0.74 and 0.59; p < 0.001), with a decrease in the object-carrying dimension (R = 0.32; p = 0.04). The questionnaire was considered suitable, quick and easy to fill in. The internal consistency presented a value of 0.80. Conclusion: The questionnaire on body awareness of postural habits in young people is a valid instrument with good repeatability and reliability, its use can be recommended with teenagers showing the same profile as those used in this study.

Resumo Introdução: Os desvios posturais associados às mudanças de hábitos em adolescentes vêm aumentando nas últimas décadas. Investigar por meio de questionário de autopercepção permite entender o nível de consciência que o indivíduo tem dos hábitos posturais. Objetivo: Construir um questionário de avaliação da autopercepção dos hábitos posturais de jovens, validar, pré-testar, verificar a confiabilidade e a consistência interna do instrumento. Métodos: A validade de conteúdo foi analisada por 10 juízes. O estudo envolveu jovens (15 - 18 anos) de Florianópolis/Brasil. O questionário foi pré-testado, aplicado a 15 jovens que forneceram informações qualitativas sobre ele. A reprodutibilidade foi analisada através do teste-reteste com 40 alunos, em um intervalo de 1 semana, os dados foram analisados por meio do coeficiente de correlação intraclasse. A consistência interna foi analisada por meio do Alpha de Cronbach com 679 jovens. Adotou-se nível de significância de 5%. Resultados: Na validação de conteúdo o questionário apresentou um coeficiente total de 0.28, observou-se uma concordância de 72% entre os avaliadores. O questionário foi considerado adequado, de rápido e fácil preenchimento. Os coeficientes de correlação intraclasse (teste-reteste) indicaram valores de reprodutibilidade aceitáveis (R = 0.66; 0.74 e 0.59; p < 0,001), com baixa na dimensão carregando objetos (R = 0.32; p = 0.04). A consistência interna apresentou um valor de 0.80. Conclusão: O questionário de percepção corporal dos hábitos posturais de jovens é um instrumento válido, com boa repetibilidade, confiabilidade e seu uso pode ser recomendado para adolescentes com o mesmo perfil deste estudo.