Caroline M. Speksnijder

Mixing ability test compared with a comminution test in persons with normal and compromised masticatory performance

A mastication test was needed with a material that forms a bolus and is soft enough to be chewed by persons with compromised oral function, in particular patients confronted with oral cancer. We therefore developed a wax-mixing ability test and compared it with a comminution test using Optocal as test food. We hypothesized that the mixing ability test would be better at differentiating between groups of persons with compromised masticatory performance than the comminution test. Sixty healthy subjects were recruited in three groups of 20, matched for age and gender: a group with natural dentition; a group with full dentures; and a group with maxillary denture and implant-supported mandibular overdenture. The mixing ability test was found to discriminate better between the two full-denture groups than the comminution test.

Masticatory function in subacute TMD patients before and after treatment

Masticatory function can be impaired in temporomandibular disorders (TMDs) patients. We investigated whether treatment of subacute non-specific TMD patients may influence oral function and clinical outcome measures. Fifteen patients with subacute TMD participated in the study. We quantified masticatory performance, maximum voluntary bite force, muscle activity and chewing cycle duration before and after treatment. Masticatory performance and bite force of patients were compared with the results obtained for an age- and gender-matched group of subjects without TMD complaints. Furthermore, we determined possible changes in anamnestic and clinical scores from questionnaires (mandibular function impairment questionnaire; MFIQ), pain scores and clinical outcome measures. Maximum bite force significantly increased, although the values after treatment were still significantly lower than those of the subjects without TMD complaints. The corresponding electromyography values did not show significant change after treatment. The masticatory performance of the patients remained unaltered; patients chewed significantly less efficient than controls. The average duration of chewing cycles significantly decreased after treatment. We observed a significant improvement in MFIQ scores. During the clenching and chewing tasks, the visual analogue scale scores were significantly higher than before these tasks. We may conclude that subacute temporomandibular joint disorders negatively influence chewing behaviour. Bite force, chewing cycle duration and also perceived mandibular function significantly improved after treatment, although the masticatory performance remained unaltered.

The effect of thoracic spine manipulation on pain and disability in patients with non-specific neck pain: a systematic review

Abstract Purpose: The aim of this systematic review was to determine the efficacy of thoracic spine manipulation (TSM) in reducing pain and disability in patients diagnosed with non-specific neck pain. Methods: An extensive literature search of PubMed, The Cochrane Library, CINAHL and EMBASE was conducted in February 2012. Randomized controlled trials (RCTs) or controlled clinical trials evaluating the effect of TSM in patients aged 18 to 65 years with non-specific neck pain were eligible. Methodological quality of the studies was assessed according to the Physiotherapy Evidence Database scale (PEDro). Qualitative analyses were conducted by means of the best evidence synthesis of van Peppen et al. Results: The methodological quality of the 10 included RCTs (677 patients) varied between four and eight points. Eight studies reported significant reduction in pain and/or disability by TSM. Overall, according to the best evidence synthesis, there is insufficient evidence that TSM is more effective than control interventions in reducing pain and disability in patients with non-specific neck pain. Conclusions: TSM has a therapeutic benefit to some patients with neck pain, when compared to the effect of interventions such as electrotherapy/thermal programme, infrared radiation therapy, spinal mobilization and exercises. However, in comparison to cervical spine manipulation, no evidence is found that TSM is more effective in reducing pain and disability. Implications for Rehabilitation TSM is often used in the treatment of non-specific neck pain, which is a major health problem in the Western society. There is insufficient evidence that TSM is more effective in reducing pain and disability than control treatments in patients with non-specific neck pain. Despite the insufficient evidence that TSM is more effective than control treatments, TSM has a therapeutic benefit to some patients with neck pain. Therefore, TSM alone or in combination with other interventions is a suitable intervention to use in the treatment of non-specific neck pain.

Oral Function After Oncological Intervention in the Oral Cavity: A Retrospective Study

PURPOSE To assess self-perceived oral function of patients with oral cavity cancer at different stages of treatment, ie, before oncologic intervention, 5 weeks after intervention, and 5 years after intervention. PATIENTS AND METHODS A cohort of 158 patients with malignancy in the oral cavity treated by surgery in 1999 or 2000 was included. From this cohort we interviewed 69 patients by telephone in 2005 and collected data on dental status, disorders of chewing and swallowing, xerostomia, preference of food consistency, tube nutrition, weight loss, and speech for different stages of treatment. RESULTS For patients treated in the maxilla region we observed a significant (P < .05) recovery of perceived chewing ability after 5 years to the level experienced before oncologic intervention. Patients treated in the mandible region reported a deteriorated dental state, chewing ability, lip competence, and xerostomia after 5 years. Patients treated in the tongue and mouth-floor region experienced deterioration for dental state, chewing ability, and xerostomia after 5 years compared with the level before the oncologic intervention. CONCLUSIONS Our telephone interview on oral function provided supplementary information on how patients experienced their problems with oral function during various phases of oncologic treatment. A retrospective interview may thus help to add information to incomplete retrospective data.

Digital image processing versus visual assessment of chewed two‐colour wax in mixing ability tests

Two-colour chewing gum and wax have been widely used as test foods to evaluate the ability to mix and knead a food bolus. The mixing of the colours has been assessed by computer analysis or by visual inspection. Reports contradict each other about whether computer analysis and visual assessment could equally well discriminate between the masticatory performances of groups of participants with different dental status. This study compares the results of computer analysis of digital images of chewed two-colour wax with the results of visual assessment of these images. Sixty healthy subjects participated and chewed on red-blue wax for 5, 10, 15 and 20 chewing strokes. The subjects were divided into three groups of 20, matched for age and gender, according to their dental status: natural dentition, full dentures and maxillary denture plus implant-supported mandibular overdenture. Mixing of the chewed wax was determined by computer analysis of images of the wax and by visual assessment of the images by five examiners. Both the computer method and the observers were able to distinguish the mixing abilities of the dentate subjects from the two denture wearer groups. Computer analysis could also discriminate the mixing abilities of the two denture groups. However, observers were not able to distinguish the mixing abilities of the two denture groups after 5, 10 and 15 chewing strokes. Only after 20 chewing strokes, they could detect a significant difference in mixing ability.

MASTICATION IN PATIENTS TREATED FOR MALIGNANCIES IN TONGUE AND/OR FLOOR OF MOUTH: A 1-YEAR PROSPECTIVE STUDY

People confronted with oral cancer run a high risk of deteriorated masticatory performance. Reduced masticatory function may affect quality of life and food choice. An altered food choice may result in lower intakes for key nutrients and weight loss.

Neck and shoulder function in patients treated for oral malignancies: A 1-year prospective cohort study

Neck and shoulder complaints can be a direct result of a neck dissection.

Maximum mouth opening and trismus in 143 patients treated for oral cancer: a 1-year prospective study.

Patients with oral cancer can develop restricted mouth opening (trismus) because of the oncologic treatment.

Tongue function in patients treated for malignancies in tongue and/or floor of mouth; a one year prospective study

Progress in (reconstructive) surgery and radiotherapy tends to improve survival and reduce oral functional deficits. Despite the growing sophistication of cancer treatment, patients still report deterioration in tongue function. Sensory function, mobility, and force of the tongue were determined in 45 patients with a carcinoma of tongue and/or floor of mouth. Measurements were performed before surgery, shortly after surgery, shortly after radiotherapy, 6, and 12 months after surgery. Surgery had a negative impact on tongue sensory function and mobility. Post-surgery radiotherapy did not further deteriorate sensory function, mobility, or force of the tongue. Patients in the surgery-radiotherapy group (SRG) had significantly worse tongue sensory function and mobility than patients in the surgery group (SG), probably caused by more advanced tumour stage and more extensive reconstructions and related scar tissue. The tongue force in patients in both groups significantly increased in the first 6 months after surgery, but this increase disappeared in the next 6 months. The authors conclude that surgery had a significant negative influence on tongue function, especially in the group of patients treated with radiotherapy. No further deterioration of tongue function was observed after post-surgical radiotherapy within the first year after surgery.

Measurement properties of the Quebec back pain disability scale in patients with nonspecific low back pain : Systematic review

Background The Quebec Back Pain Disability Scale (QBPDS) has been translated into different languages, and several studies on its measurement properties have been done. Purpose The purpose of this review was to critically appraise and compare the measurement properties, when possible, of all language versions of the QBPDS by systematically reviewing the methodological quality and results of the available studies. Method Bibliographic databases (PubMed, Embase, CINAHL, and PsycINFO) were searched for articles with the key words “Quebec,” “back,” “pain,” and “disability” in combination with a methodological search filter for finding studies on measurement properties concerning the development or evaluation of the measurement properties of the QBPDS in patients with nonspecific low back pain. Assessment of the methodological quality was carried out by the reviewers using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist for both the original language version of the QBPDS in English and French and all translated versions. The results of the measurement properties were rated based on criteria proposed by Terwee et al. Results The search strategy resulted in identification of 1,436 publications, and 27 articles were included in the systematic review. There was limited-to-moderate evidence of good reliability, validity, and responsiveness of the QBPDS for the different language versions, but for no language version was evidence available for all measurement properties. Conclusion For research and clinical practice, caution is advised when using the QBPDS to measure disability in patients with nonspecific low back pain. Strong evidence is lacking on all measurement properties for each language version of the QBPDS.