The Department of Physical Therapy, Tel Aviv University, Tel Aviv, Israel.
The School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Eur J Oral Sci. 2020 Aug;128(4):292-298. doi: 10.1111/eos.12718. Epub 2020 Jul 6.
Upper neck impairments are more prevalent in patients with temporomandibular disorders (TMDs) but the differences between specific types of TMDs are unclear. This study evaluated the distribution of such impairments among different forms of TMD. In total, 116 participants (86 women and 30 men, age range 21-75 yr) were investigated. Forty-two individuals had no TMDs and were assigned to the control group. The remaining 74 patients were assigned to one of three groups based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) findings: pain-related (n = 37); intra-articular (n = 17); or mixed (combined pain-related and intra-articular) (n = 20). Analyses of impairments included between-group comparisons of key parameters of upper neck performance (active/passive mobility and muscular capabilities) and pain (subjective neck disability and pain sensitivity). Patients in the pain-related and mixed TMD groups were found to have decreased upper neck mobility in the cervical flexion-rotation test compared with patients in intra-articular and control groups, as well as poorer capabilities of the deep neck flexor muscles in the cranio-cervical flexion test compared to the control group. It was concluded that patients with pain-related TMD diagnoses are more likely to experience significant upper-neck hypomobility and poor muscular capabilities than patients with intra-articular diagnoses of TMD.
上颈部功能障碍在患有颞下颌关节紊乱症(TMD)的患者中更为常见,但不同类型的 TMD 之间的差异尚不清楚。本研究评估了这些功能障碍在不同类型的 TMD 中的分布情况。共有 116 名参与者(86 名女性和 30 名男性,年龄 21-75 岁)接受了调查。42 名无 TMD 患者被分配到对照组。其余 74 名患者根据颞下颌关节紊乱症的诊断标准(DC/TMD)分为三组:疼痛相关组(n=37);关节内组(n=17);或混合组(疼痛相关和关节内混合组,n=20)。上颈部功能障碍的分析包括对各组之间上颈部运动(主动/被动活动度和肌肉功能)和疼痛(主观颈部障碍和疼痛敏感性)的关键参数进行组间比较。与关节内组和对照组相比,疼痛相关组和混合组的 TMD 患者在颈椎屈伸旋转试验中颈部活动度降低,与对照组相比,在颅颈屈伸试验中深层颈屈肌的功能也较差。研究结果表明,与关节内诊断的 TMD 患者相比,疼痛相关 TMD 诊断的患者更有可能出现显著的上颈部活动受限和肌肉功能障碍。