Glaros A G
Department of Behavioral Science, University of Missouri-Kansas City 64108, USA.
Biofeedback Self Regul. 1996 Sep;21(3):261-72. doi: 10.1007/BF02214737.
To test the hypothesis that individuals with temporomandibular disorders (TMD) have deficits in proprioceptive awareness, 20 TMD patients were compared with 20 nonpain individuals matched to the TMD patients on age and gender. Left and right frontalis, masseter, and temporalis were monitored, as were forearm extensor, heart rate, and skin conductance while the participants viewed a nonstressful film segment. Following the film segment, participants provided self-reports of these physiological responses. This sequence was repeated for a second, stressful film segment and for a third, non-stressful film segment. Correlations between physiological activity and self-report were used as measures of proprioceptive awareness. The results indicated that TMD subjects were most accurate in their awareness of facial muscle activity during the stress condition and least accurate in the two nonstress periods. Control subjects increased their accuracy of awareness at each time period, showing significantly greater accuracy than the TMD group in the last, nonstress period. TMD subjects more accurately perceived activity of the nonfacial muscle variables in the two nonstress periods than during the stress period. These findings may provide a mechanism for understanding clinical observations showing that TMD patients with myofascial pain engage in high levels of parafunctional oral activity without awareness.
为了验证颞下颌关节紊乱症（TMD）患者存在本体感觉意识缺陷这一假设，将20名TMD患者与20名在年龄和性别上与TMD患者匹配的无疼痛个体进行比较。在参与者观看一段无压力的电影片段时，对左右额肌、咬肌和颞肌进行监测，同时监测前臂伸肌、心率和皮肤电导率。在电影片段播放后，参与者对这些生理反应进行自我报告。对第二个有压力的电影片段和第三个无压力的电影片段重复此过程。生理活动与自我报告之间的相关性被用作本体感觉意识的指标。结果表明，TMD受试者在压力状态下对面部肌肉活动的感知最为准确，而在两个无压力阶段则最不准确。对照组受试者在每个时间段的感知准确性都有所提高，在最后一个无压力阶段显示出比TMD组明显更高的准确性。TMD受试者在两个无压力阶段比在压力阶段更准确地感知非面部肌肉变量的活动。这些发现可能为理解临床观察结果提供一种机制，即患有肌筋膜疼痛的TMD患者在无意识的情况下会进行高水平的副功能口腔活动。
