Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden.
Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden; Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; Rehabilitation Research Chair, King Saud University, Riyadh, Saudi Arabia.
Arch Oral Biol. 2019 Jan;97:109-115. doi: 10.1016/j.archoralbio.2018.10.018. Epub 2018 Oct 19.
This study tested the hypothesis that modulation of jaw sensorimotor control by intraoral dental appliance can reduce postural sway during quiet standing and hence improve standing balance, in patients with whiplash associated disorders (WAD) and non-trauma neck pain.
Postural sway during quiet standing with feet together was examined in 54 WAD patients (40 females) and 10 non-trauma patients (8 females) using wireless 3D movement recording technique. Recordings were performed alternating without and with intraoral dental appliance, and with closed eyes and open eyes, respectively. In this protocol the participants served as their own controls. A reference group of 30 healthy subjects (17 females) was also recorded. Each recording lasted 120 s, followed by 3-5 min of rest. Speed, acceleration and perimeter of postural sway area were documented.
In the patients, but not in the healthy group, the intraoral dental appliance instantly and significantly reduced standing postural sway in recordings with closed and open eyes.
The prompt reduction in standing postural sway from intervention by intraoral dental appliance i.e. improved standing balance, suggests a potent effect on the postural control system by modulation of the jaw sensorimotor system, probably involving reflex transmission. The result opens for new insight into mechanisms behind postural control and the pathophysiology of balance disorders, and adds to the knowledge on plasticity of the nervous system. It may help developing new procedures for assessment and management of impaired balance in WAD and non-trauma neck pain patients.
本研究旨在验证以下假设，即通过口腔内牙具对咀嚼肌感觉运动控制的调节，能否减少因挥鞭样损伤所致疾患（WAD）和非创伤性颈痛患者的静息站立时姿势摆动，从而改善其平衡能力。
采用无线三维运动记录技术，对 54 例 WAD 患者（40 例女性）和 10 例非创伤性颈痛患者（8 例女性）进行了双脚并拢的静息站立时姿势摆动检查。记录时分别交替进行无牙具、牙具和闭眼睁眼的口腔内牙具置入操作，每种状态下的记录持续 120s，随后休息 3-5min。记录速度、加速度和姿势摆动面积的周长。
仅在患者中，而不是在健康对照组中，口腔内牙具即刻显著减小了闭眼和睁眼时的站立姿势摆动。
口腔内牙具干预可即刻显著减小站立姿势摆动，即平衡能力改善，提示咀嚼肌感觉运动系统的调节对姿势控制系统具有强大作用，可能涉及反射传递。这一结果为姿势控制机制和平衡障碍的病理生理学提供了新的见解，并增加了对神经系统可塑性的认识。这可能有助于为 WAD 和非创伤性颈痛患者的平衡障碍评估和管理提供新的方法。
