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颈椎康复对颈椎和咀嚼系统肌肉生物电活动(sEMG)的影响。

The influence of cervical spine rehabilitation on bioelectrical activity (sEMG) of cervical and masticatory system muscles.

机构信息

Institute of Health Sciences, Medical College of Rzeszow University, Rzeszów, Poland.

Institute of Clinical Rehabilitation, University of Physical Education in Krakow, Krakow, Poland.

出版信息

PLoS One. 2021 Apr 26;16(4):e0250746. doi: 10.1371/journal.pone.0250746. eCollection 2021.

Abstract

BACKGROUND

Coexistence of temporomandibular joint discomfort along with cervical spine disorders is quite common, and is associated with many limitations and adverse symptoms for the patient. Both diagnostics and treatment of these ailments are difficult, and in many cases, the effects of therapy are not satisfactory. This study assessed the impact of a 3-week neck-only rehabilitation programme without direct intervention in the craniofacial area on the bioelectric activity of both the cervical spine and muscles in the craniofacial area among patients with idiopathic neck pain who do not report TMJ pain.

DESIGN

A parallel group trial with follow-up; Setting: Rehabilitation Clinic.

METHODS

Twenty five patients experiencing idiopathic neck pain underwent the 3-week rehabilitation programme. Thirty five age-matched subjects with no cervical spine and temporomandibular joint (TMJ) dysfunctions were control group. At baseline and after 3 weeks the cervical and craniofacial area muscles' bioelectrical activity (sEMG) was evaluated.

RESULTS

In the experimental group during cervical flexion, a significant decrease of sEMG amplitude was noted in the right (mean 25.1 μV; 95% CI: 21.5-28.6 vs mean 16.8 μV; 95% CI: 13.8-19.7) and left (mean 25.9 μV; 95% CI: 21.7-30.0 vs mean 17.2 μV; 95% CI: 13.6-20.7) Sternocleidomastoid as well as a significant increase in sEMG amplitude of the right (mean 11.1 μV; 95% CI: 7.9-14.2 vs mean 15.7 μV; 95% CI: 12.1-19.2) and left (mean 15.3 μV; 95% CI: 11.9-18.6 vs mean 20.2 μV; 95% CI: 15.7-24.2) Upper Trapezius muscles. In the experimental group, after therapy right and left Sternocleidomastoid, Temporalis Anterior and Masseter muscles presented lower fatigue levels.

CONCLUSIONS

Three weeks of rehabilitation without any therapeutic intervention in temporomandibular joint significantly decreased the bioelectrical activity of the neck and craniofacial muscles while improving the muscle pattern of coactivation in participants with idiopathic neck pain who do not report temporomandibular joint pain. These observations could be helpful in the physiotherapeutic treatment of neck and craniofacial area dysfunctions.

TRIAL REGISTRATION

ID ISRCTN14511735-retrospectively registered.

摘要

背景

颞下颌关节不适与颈椎疾病同时存在的情况相当常见,会给患者带来许多限制和不良反应。这些疾病的诊断和治疗都很困难,而且在许多情况下,治疗效果并不理想。本研究评估了为期 3 周的仅针对颈部的康复方案对无 TMJ 疼痛的特发性颈痛患者颈椎和颅面区域肌肉生物电活动的影响,该方案不直接干预颅面区域。

设计

随访的平行组试验;设置:康复诊所。

方法

25 例特发性颈痛患者接受了 3 周的康复方案。35 名年龄匹配的无颈椎和颞下颌关节(TMJ)功能障碍的受试者为对照组。在基线和 3 周后,评估颈椎和颅面区域肌肉的生物电活动(sEMG)。

结果

在实验组中,颈椎前屈时,右侧(平均 25.1 μV;95%置信区间:21.5-28.6 与平均 16.8 μV;95%置信区间:13.8-19.7)和左侧(平均 25.9 μV;95%置信区间:21.7-30.0 与平均 17.2 μV;95%置信区间:13.6-20.7)胸锁乳突肌的 sEMG 振幅显著降低,右侧(平均 11.1 μV;95%置信区间:7.9-14.2 与平均 15.7 μV;95%置信区间:12.1-19.2)和左侧(平均 15.3 μV;95%置信区间:11.9-18.6 与平均 20.2 μV;95%置信区间:15.7-24.2)斜方肌上肌的 sEMG 振幅显著增加。实验组中,治疗后右侧和左侧胸锁乳突肌、颞肌和咬肌的疲劳程度较低。

结论

3 周的颈部康复治疗,不包括对颞下颌关节的任何治疗干预,可显著降低特发性颈痛患者(无 TMJ 疼痛)的颈部和颅面肌肉的生物电活动,同时改善这些患者的协同激活肌肉模式。这些观察结果可能有助于治疗颈部和颅面区域的功能障碍。

试验注册

ID ISRCTN8275070。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a637/8075221/d33c3291feb7/pone.0250746.g001.jpg

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