Priscila Weber

Cervical spine dysfunction signs and symptoms in individuals with temporomandibular disorder

PURPOSE To study the frequency of cervical spine dysfunction (CCD) signs and symptoms in subjects with and without temporomandibular disorder (TMD) and to assess the craniocervical posture influence on TMD and CCD coexistence. METHODS Participants were 71 women (19 to 35 years), assessed about TMD presence; 34 constituted the TMD group (G1) and 37 comprised the group without TMD (G2). The CCD was evaluated through the Craniocervical Dysfunction Index and the Cervical Mobility Index. Subjects were also questioned about cervical pain. Craniocervical posture was assessed by cephalometric analysis. RESULTS There was no difference in the craniocervical posture between groups. G2 presented more mild CCD frequency and less moderate and severe CCD frequency (p=0.01). G1 presented higher percentage of pain during movements (p=0.03) and pain during cervical muscles palpation (p=0.01) compared to G2. Most of the TMD patients (88.24%) related cervical pain with significant difference when compared to G2 (p=0.00). CONCLUSION Craniocervical posture assessment showed no difference between groups, suggesting that postural alterations could be more related to the CCD. Presence of TMD resulted in higher frequency of cervical pain symptom. Thus the coexistence of CCD and TMD signs and symptoms appear to be more related to the common innervations of the trigeminocervical complex and hyperalgesia of the TMD patients than to craniocervical posture deviations.

Mastigação e deglutição em mulheres jovens com desordem temporomandibular

PURPOSE To evaluate chewing and swallowing functions in women with and without temporomandibular disorder (TMD) and investigate the position of the mandible and the hyoid bone as they are important structures in the development of these functions. METHODS Seventy women were evaluated in relation to TMD diagnosis according to the Research Diagnostic Criteria, among them, 34 composed the study group (SG) with TMD and 36 took part in the control group (CG). Evaluation of the masticatory and swallowing functions was performed according to the Protocol of Orofacial Myofunctional Evaluation with Scores. Mandibular and hyoid bone position variables were measured by cephalometric analysis. RESULTS TMD subjects showed a significant difference on tongue (p=0.03) and lip (p=0.04) posture during swallowing function, and a more frequent adoption of a chronic unilateral chewing pattern as well (p=0.03). Moreover, they presented a lower position of the hyoid bone in relation to the mandible (p=0,00). CONCLUSION TMD presence resulted on a higher frequency of myofunctional alterations during masticatory and swallowing functions. A greater distance from hyoid bone to the mandible in addition with the presence of painful symptom can justify, partly, the atypical behaviors of the tongue and lips observed on TMD group. The TMD repercussion on alimentaires functions in a young age group justifies the importance of an earlier diagnosis and therapeutic intervention in these individuals.

Childhood mouth-breathing consequences at adult age: ventilatory function and quality of life

Introduction Mouth breathing can affect the functions of the respiratory systems and quality of life. For this reason, children who grow up with this stimulus may have implications on physical and psychological aspects at adult age.Objective To evaluate childhood mouth-breathing consequences for the ventilatory function and quality of life at adult age.Materials and methods Prospective, observational and cross-sectional study with 24 adults, between 18 and 30 years old, mouth breathers during childhood, comprised the childhood mouth-breathing group (CMB). The childhood nasal-breathing (CNB) group was composed of 20 adults of the same age, without history of respiratory disease during all their lives. Measurements of maximal respiratory pressures, peak expiratory flow and 6-minute walk test were assessed. In addition, all the volunteers answered the Short Form-36 questionnaire (SF-36).Results The maximal inspiratory (p = 0.001) and expiratory (p = 0.000) pressures as well as the distance in the walk test (p = 0.003) were lower in the COB. The COB also presented lower score in the General Health domain of the SF-36 Questionnaire (p = 0.002).Conclusion Childhood mouth-breathing yields consequences for the ventilatory function at adult age, with lower respiratory muscle strength and functional exercise capacity. Conversely, the quality of life was little affected by the mouth breathing in this study.

Correlação entre postura da cabeça, intensidade da dor e índice de incapacidade cervical em mulheres com queixa de dor cervical

Neck pain is the most common symptom of cervical dysfunctions often being related to the maintenance of postures. Postural changes of the head are often associated with the occurrence of neck pain with an anterior approach was the most frequent. The purpose was to investigate the correlation between head posture, pain intensity and neck disability index. The study group (SG) was composed of women, aged between 20 and 50 years who complained of neck pain for more than three months, and the control group (CG) for asymptomatic women. Pain intensity was assessed by visual analogue scale (VAS), disability by neck disability index (NDI) and the head posture by the craniovertebral angle (CV). Normality of the data was verified by the Lilliefors test and the comparison between groups by the Students t-test for independent samples, and the association between variables by Spearman correlation test. Significance level was 5%. The SG had lower average CV for the angle (p=0.02). The CV angle was negatively correlated with the VAS (r=-0.48) and NDI (r=-0.15) suggesting that the smaller the angle, the greater the intensity of neck pain and disability. The NDI and VAS showed a positive correlation (r=0.59). The angle CV in subjects with neck pain was significantly lower than in healthy individuals association with the neck disability index and pain.

Efeito da fisioterapia sobre os parâmetros ventilatórios e a dinâmica tóraco-abdominal de crianças respiradoras bucais

This study aimed to evaluate the effects of the physiotherapy on the ventilatory parameters and thoracoabdominal dynamics of mouth breathing children. Ten mouth breathing children were undergone to 20 sessions of respiratory reeducation and postural correction through stretching and strengthening exercises on Swiss ball, diaphragmatic stimulation and stretching of the inspiratory accessory muscles. The data collected were measurements of the maximum inspiratory and expiratory pressures (MIP and MEP), inspiratory capacity (IC), peak expiratory flow (PEF), the chest wall mobility measured by the respiratory coefficient (Rc) at the levels of the axillary (RcA), xiphosternal (RcX) and umbilical (RcU) regions and biophotogrametry analysis of the Charpy angle. These were measured before and after 10 and 20 sessions. A 1-way repeated measures analysis of variance (ANOVA) was used to determine differences in variables among the three evaluations. Post-hoc comparisons were conducted with the Tukeys Test. It was considered a significance level of 5% (p<0.05). There were improvements on Charpy angle (p=0.048), IC (p=0.037), PEF (0.002), MIP (p=0.007), RcA (p=0.008) and RcX (p=0.041) measures. Although MEP and RcU improved their absolute values, the results were not statistically significant. The program of respiratory physiotherapy and postural correction produced positive effects on the ventilatory function of mouth breathing children.

Análise da postura craniocervical de crianças respiradoras bucais após tratamento postural em bola suíça

O estudo teve como objetivo avaliar a postura craniocervical de criancas respiradoras bucais apos tratamento postural em bola suica. Doze criancas respiradoras bucais foram submetidas a um protocolo de reeducacao postural constituido por exercicios de alongamento e fortalecimento muscular sobre a bola suica, estimulacao diafragmatica e alongamento dos musculos acessorios da inspiracao. A postura craniocervical foi avaliada atraves da analise biofotogrametrica. A posicao da anteriorizacao da cabeca foi aferida por meio do ângulo formado pelos pontos localizados no tragus direito e no processo espinhoso da setima vertebra cervical com a linha horizontal. A curvatura cervical foi avaliada pela distância horizontal de uma linha vertical tangenciando o apice da cifose toracica e o ponto de maior concavidade da curvatura cervical. As fotografias foram obtidas antes e apos dez atendimentos. A normalidade das variaveis foi verificada a partir do teste Shapiro-Wilk. Para as comparacoes entre as medias foi utilizado o teste t de Student para amostras dependentes admitindo-se nivel de significância de 5% (p<0,05). Verificou-se uma melhora na postura craniocervical, atraves da diminuicao da anteriorizacao da cabeca (p=0,00) e do restabelecimento da curvatura fisiologica da coluna cervical (p=0,01). O tratamento postural em bola suica proporcionou um melhor alinhamento da postura craniocervical, provavelmente pelo equilibrio dos musculos cervicais e maior acao diafragmatica.

RELAÇÃO DA ATIVIDADE ELÉTRICA DOS MÚSCULOS SUPRA E INFRA-HIÓIDEOS DURANTE A DEGLUTIÇÃO E CEFALOMETRIA

ABSTRACTPurpose: to investigate the influence of the habitual head posture, jaw and hyoid bone position on the supra and infrahyoid muscles activity of the muscles during swallowing of different food textures. Method: an observational, cross-sectional study, with women between 19 and 35 years, without myofunctional swallowing disorders. The craniocervical posture, position of the mandible and hyoid bone were evaluated by cephalometry. The electromyographic activity of the supra and infrahyoid muscles was collected during swallowing water, gelatin and cookie. Results: sample of 16 women, mean age 24.19 ± 2.66 years. At rest, there were negative/moderate correlations between the electrical activity of the suprahyoid muscles with NSL/CVT (head position in relation to the cervical vertebrae) and NSL/OPT (head position in relation to the cervical spine) postural variables, and positive/moderate with the CVA angle (position of flexion/extension of the head). During swallowing the cookie, the activity of infrahyoid muscles showed a negative/moderate correlation with NSL/OPT angle. It was found higher electrical activity of the suprahyoid muscles during swallowing of all foods tested, and of the infrahyoid muscles at rest. There was difference on the muscle activity during swallowing of foods with different consistencies, which was higher with cookie compared to water and gelatin.

Severidade da desordem temporomandibular e sua relação com medidas cefalométricas craniocervicais

Abstract Introduction : It is known that there is a relationship between the Temporomandibular Disorder (TMD) and craniocervical posture, but, besides the studies showed inconclusive results, the severity of signs and symp-toms of TMD is not considered. Objective : To correlate the severity of TMD index to craniocervical cephalo-metric measurements. Materials and methods : Thirty-two women, from 19 to 35 years old with a diagnosis of TMD (RDC/TMD), took part in the study. The severity of signs and symptoms of TMD was assessed by the Temoromandibular Index proposed by Pehling and calculated according to the physical examination findings of the RDC/TMD (Axis I). The craniocervical posture was evaluated by cephalometry through 11 measures related to the head, cervical spine, jaw and the hyoid bone position. Data normality was tested by Lilliefors test and correlations were performed by Spearman coefficient. Results : Moderate negative correlation was found between the CVT/Hor angle and Muscular (p = 0.0288) and Temporomandibular (p = 0.0394) Indices; between the CPL/Hor angle (anterior) when correlated with Functional (p = 0.0482) and Muscle indices (p = 0.0086) and between distance from the hyoid to the third cervical vertebra (Hy/C3) and Functional Index (p = 0.0155).