scholarly journals Temporomandibular Joint and Cervical Spine Mobility Assessment in the Prevention of Temporomandibular Disorders in Children with Osteogenesis Imperfecta: A Pilot Study

Author(s):  
Kulesa-Mrowiecka Małgorzata ◽  
Pihut Małgorzata ◽  
Słojewska Kinga ◽  
Sułko Jerzy

Osteogenesis imperfecta is a heterogeneous group of hereditary disorders of connective tissue diseases characterized by increased bone fragility, low growth, sometimes accompanied by abnormalities within the dentine, blue sclera, and partial or total hearing impairment. The changes may affect all joints, including the cervical spine and temporomandibular joints in the future, resulting in pain. The aim of the present study was to assess whether there is a relationship between the active range of motion of the cervical spine and the mobility of temporomandibular joints due to differential diagnosis in children with osteogenesis imperfecta, and to present a prevention algorithm for temporomandibular disorders. The study involved a group of 34 children with osteogenesis imperfecta, and the control group included 23 children (age 9.1 ± 3.8 years). Data were collected through an interview based on the author’s questionnaire, and the physical examination consisted in measuring the mobility of the cervical spine using an inclinometer (Cervical Range of Motion Instrument), the Helkimo scale, and linear measurements. In children with congenital bone fragility, there were acoustic symptoms from the temporomandibular joints more often than in healthy children. A correlation was found between the mobility of the cervical spine and temporomandibular joints in the study group. In the case of detecting irregularities in the temporomandibular joints, children were ordered to perform jaw-tongue coordination exercises.

2021 ◽  
pp. 20-33
Author(s):  
V. O. Belash ◽  
A. E. Vorobyova ◽  
D. A. Vasyukovich

Introduction. Back pain is not only a high prevalence, but also a costly health problem. That is why the search for new and the optimization of existing methods of dorsopathies treatment acquire an important clinical and medico-social significance. In recent years, the medical community has increased the interest in non-drug methods of treatment, including osteopathy. Previous studies have substantiated the possibility of effective application of osteopathic correction methods in the treatment of patients with dorsopathies. A specific object of the osteopath′s work is somatic dysfunction (SD). And if earlier SD was perceived from the standpoint of purely biomechanical disorders, then in recent years there have been serious changes in understanding the heterogeneity of this state nature. The biomechanical, rhythmogenic and neurodynamic components are conventionally distinguished in the structure of SD. One of the neurodynamic disorders types is the violation of motor stereotypes, the so-called static-dynamic disorders, revealed through special dynamic tests and manifested in the functional impossibility of building of active movement at various levels. At the same time, the generally accepted biomechanical approaches do not allow to completely eliminate violations of the statodynamic stereotype.The goal of research — the study was to research the effectiveness of the osteopathic approach using in combination with kinesitherapy for correction of the statodynamic stereotype violations in patients with dorsopathy at the cervicothoracic level.Materials and methods. A controlled randomized prospective study was conducted on the basis of a private rehabilitation center «Ezramed-Clinic» in Omsk in the period from February 2019 to December 2019. 52 patients with a diagnosis of dorsopathy at the cervicothoracic level were observed. 12 people were knocked out during the study in accordance with the exclusion criteria. As a result, 40 patients participated in the study. Depending on the applied treatment method, the patients were divided by simple randomization into two groups (main and control), each of which consisted of 20 people. Both groups of patients received osteopathic correction three times with a frequency of receptions 1 time in 7–10 days. The main group of patients additionally independently performed daily for 10 minutes a set of exercises aimed to restore the disturbed motor stereotypes (normal synkinesis). The control group of patients additionally independently performed a set of exercise therapy for the cervical spine every day for 10 minutes. All patients, regardless of the group, underwent an osteopathic examination before and after treatment with the formation of an osteopathic conclusion; the severity of pain syndrome and the volume of active movements in the cervical spine were assessed. The severity of the pain syndrome and the range of active movements were assessed before and immediately after treatment, as well as 3 months after the first session.Results. The use of osteopathic correction in conjunction with kinesitherapy (both special exercises and a complex of exercise therapy) in patients with a diagnosis of dorsopathy at the cervicothoracic level leads to a statistically significant increase in the range of motion in the cervical spine in the sagittal and frontal planes (p<0,05). The combination of osteopathic correction together with exercise therapy in patients of the control group led to a statistically more significant increase (p<0,05) in the range of motion in the cervical spine in the frontal plane after treatment compared with the results of the main group. However, 3 months after treatment, the indicators in patients of both groups did not have statistically significant differences.The combination of osteopathic correction in conjunction with kinesiotherapy in the form of special exercises for the motor stereotype correction in the main group of patients with diagnosed dorsopathy at the cervicothoracic level led to a statistically significant (p<0,05) decrease in the intensity of the pain syndrome at the 2nd session.Conclusion. In order to increase the effectiveness of treatment, osteopathic correction of somatic dysfunctions in patients with dorsopathy at the cervicothoracic level can be supplemented with complex kinesitherapy, both in the form of traditional exercise therapy, and in the form of special exercises for correction of altered motor stereotype.


Author(s):  
Jingheng Shu ◽  
Xin Xiong ◽  
Desmond YR Chong ◽  
Yang Liu ◽  
Zhan Liu

The study aimed to compare the difference of stress distributions in temporomandibular joints (TMJs) between the patients with mandibular asymmetry and asymptomatic subjects and find the relations between deviated distance and biomechanical stress using three-dimensional finite element method, to give guidance to dentists for correction of mandibular asymmetry. Ten facial symmetric subjects without symptoms of temporomandibular disorders (TMD) and 10 mandibular asymmetric patients were recruited and assigned as the Control and Case group respectively. The FE models of the mandible and maxilla were reconstructed from cone-beam computed tomography (CBCT) images. Muscle forces and boundary conditions were applied to the two groups corresponding to centric and anterior occlusions. The simulation manifested significant differences in stresses of the TMJs between the non-deviated and deviated sides in the Case group under the centric and anterior occlusions. The stresses in the Case group were significantly greater than those in the Control group, especially on the non-deviated side. Besides, there were weak and moderate correlations between the third principal stresses and deviated distances for the patients under centric and anterior occlusions. The excessive stresses in the TMJ of patients with mandibular asymmetry were associated with temporomandibular disorders.


2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Erika Giannotti ◽  
Konstantinos Koutsikos ◽  
Maurizia Pigatto ◽  
Maria Elisa Rampudda ◽  
Andrea Doria ◽  
...  

Objective. To propose a rehabilitation protocol able to produce immediate and long-term beneficial effects on level of disability and overall performance in ADLs.Materials and Methods. Forty-one FM patients were randomized to an exercise and educational-behavioral programme group (experimental group, EG = 21) or to a control group (CG = 20). Each subject was evaluated before, at the end (T1), and after 6 months (T6) from the conclusion of the rehabilitation treatment using the Fibromyalgia Impact Questionnaire (FIQ), the visual analogue scale (VAS), the Health Assessment Questionnaire (HAQ), the fatigue severity scale (FSS), the 6-minute walking test (6MWT), tender points count (TPC), and spinal active range of motion. The exercise protocol included 20 sessions consisting in self-awareness, stretching, strengthening, spine flexibility, and aerobic exercises, which patients were subsequently educated to perform at home.Results. The two groups were comparable at baseline. At T1, the EG showed a positive trend in FIQ, VAS, HAQ, and FSS scales and significant improvement in 6MWT and in most spinal active range of motion measurements (Pbetween 0.001 and 0.04). The positive results were maintained at the follow-up.Conclusion. The proposed programme was well tolerated and produced immediate and medium-term beneficial effects improving function and strain endurance. This trial is registered withDRKS00005071on DRKS.


2020 ◽  
Vol 22 (2) ◽  
pp. 131-141
Author(s):  
Karolina Wiaderna ◽  
Monika Selegrat ◽  
Anna Hadamus

Background. The prevalence of neck pain is on the increase. A sedentary life style, poor ergonomics in the workplace and in daily life, and stress all contribute to neck overload. The aim of this study was to assess the efficacy of a single session of a Fascial Distortion Model (FDM) intervention combined with foam rolling in patients with cervical spine overload. Material and methods. The study enrolled 90 patients, who were randomized to an FDM group, a foam rolling group (who exercised with a Duoball against a wall) and a control group, of 30 patients each. Mobility was measured with a digital inclinometer, pain intensity was assessed with a VAS scale and (upper and middle) trapezius tone was evaluated by sEMG. These measurements were carried out twice in each group and analysed in Matlab and Statistica 13. Results. Both groups subjected to a therapeutic intervention (FDM and foam rolling) reported a significant reduction in neck pain intensity and improved cervical spine mobility (p<0.01). The control group did not demonstrate changes in mobility or pain intensity. The resting trapezius tone did not change in any of the groups. Conclusions, 1. A single session of FDM therapy can effectively reduce and eliminate cervical spine pain, which may be of use in work-site rehabilitation. 2. Single sessions of FDM and foam rolling can effectively improve neck mobility in patients with cervical spine overload. 3. There is a rationale for conducting further prospective randomized studies of larger samples to assess the duration of the beneficial effects of both therapies and determine an optimum session frequency.


2021 ◽  
Author(s):  
Rabia Sohail ◽  
Huma Riaz ◽  
Muhammad Akhtar ◽  
Asim Raza ◽  
Kinza Shabbir ◽  
...  

Abstract Background: Tension type headache is claimed to be one of top ten disabling conditions in the world. The purpose of the study was to determine the effects of muscle energy technique on pain, range of motion at cervical spine and disability related to tension type headache. Methods: A randomized control trial was conducted on 48 participants of both genders whose age was 18 to 40 years with complain of tension type at Rehabilitation and Injury Management Department of Medcare International Hospital Gujranwala, from July to December 2019. Participants were randomly selected and allocated into two groups (experimental and control group). The experimental group received both muscle energy technique and myofascial release technique on trapezius and sternocleidomastoid of both sides. The intervention was applied for 6 weeks (3 sessions per week). Assessments were done at baseline, 4th week and 6th week. Numeric pain rating scale (NPRS), Headache disability inventory (HDI), headache impact test (HIT) and cervical range of motion with the help of Inclinometer were tools for assessment. Data analysis was done using SPSS (version 21). Results: The mean age of experimental group was 26.5±5.42 and control group was 27.7±5.70. The experimental group was shown significant improvement in terms of pain and flexion and side flexion range of motion with p-value ≤0.05. Conclusion: It is concluded that muscle energy technique is effective treatment for tension type headache; it is associated to decreased range of motion at cervical spine and disability related to TTH. Trial registration: IRCT20190121042445N2, Registered 07-02-2021.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Juhani Multanen ◽  
Arja Häkkinen ◽  
Hannu Kautiainen ◽  
Jari Ylinen

Abstract Background Neck pain has been associated with weaker neck muscle strength and decreased cervical spine range of motion. However, whether neck muscle strength or cervical spine mobility predict later neck disability has not been demonstrated. In this 16-year prospective study, we investigated whether neck muscle strength and cervical spine mobility are associated with future neck pain and related disability in women pain-free at baseline. Methods Maximal isometric neck muscle strength and passive range of motion (PROM) of the cervical spine of 220 women (mean age 40, standard deviation (SD) 12 years) were measured at baseline between 2000 and 2002. We conducted a postal survey 16 years later to determine whether any subjects had experienced neck pain and related disability. Linear regression analysis adjusted for age and body mass index was used to determine to what extent baseline neck strength and PROM values were associated with future neck pain and related disability assessed using the Neck Disability Index (NDI). Results The regression analysis Beta coefficient remained below 0.1 for all the neck strength and PROM values, indicating no association between neck pain and related disability. Of the 149 (68%) responders, mean NDI was lowest (3.3, SD 3.8) in participants who had experienced no neck pain (n = 50), second lowest (7.7, SD 7.1) in those who had experienced occasional neck pain (n = 94), and highest (19.6, SD 22.0) in those who had experienced chronic neck pain (n = 5). Conclusions This 16-year prospective study found no evidence for an association between either neck muscle strength or mobility and the occurrence in later life of neck pain and disability. Therefore, screening healthy subjects for weaker neck muscle strength or poorer cervical spine mobility cannot be recommended for preventive purposes.


2016 ◽  
Vol 4 (4) ◽  
pp. 12-20
Author(s):  
Nellya K. Bakhteeva ◽  
Tat'yana A. Ionova ◽  
Valeriy N. Belonogov ◽  
Sergej P. Bazhanov ◽  
Vladimir V. Ostrovskij

Background. Interpretation of cervical pain syndrome in children is complicated, resulting in delayed diagnosis of developmental juvenile osteochondrosis. Thus, updating the diagnostic methods of this pathology is particularly important.Aim. To improve methods of cervical spine diagnostics in children with cervical pain syndrome at the base of vertebral and basilar arteries using duplex ultrasound.Material and methods. The study cohort included 148 pediatric patients aged 4–18 years who were divided into two groups: a treatment group of 108 children with cervical pain syndrome and a control group of 40 healthy children. Clinical, radiological (ultrasound, X-ray, and MRI), and statistical methods were used for comparisons.Results. Duplex ultrasound of 108 patients revealed pathological changes of qualitative and quantitative features of C- or S-shaped, corner bend, mesh, excessive, and wave-shaped tortuosity deformities, as well as a reduction or expanse in diameter of one or two of the spinal arteries (SAs). The absence of an influence of osseous cervical spine structures on SAs was considered a sign of congenital genesis of SA deformity, while segmental instability of C2-C3 and/or C3-C4, atlanto-axial subluxation, and a Kimmerle anomaly were considered signs of extravascular compression of SAs. Regardless of the deformity genesis, blood flow was deficit in the vertebral basilar basin because of local hemodynamic disorders at the site of the deformity, particularly in older children. MRI revealed signs of intervertebral disc hypohydration at C2-C3 and/or C3-C4.Conclusion. Pathological changes in SAs of both congenital and acquired genesis resulted in hemodynamic disorders in the vertebral basilar basin in children with cervical pain syndrome, particularly older children.


Author(s):  
Д.А. Петухова ◽  
Е.Е. Гуринова ◽  
А.Л. Сухомясова ◽  
Н.Р. Максимова

В статье представлены клинические, молекулярно-генетические характеристики 6-летнего пациента с клиническими признаками SOPH-синдрома, печеночной недостаточностью, а также хрупкостью костей по типу несовершенного остеогенеза. В результате массового параллельного секвенирования были обнаружены описанная мутация с.5741G>A (p.Arg1914His) и ранее не описанный миссенс-вариант c.2535G>T (p.Trp845Cys) гена NBAS в компаунд-гетерозиготном состоянии. Here, we describe a case of a 6-year-old Yakut girl who presented with clinical signs of SOPH syndrome, acute liver failure (ALF) and bone fragility by the type of osteogenesis imperfecta. Targeted panel sequencing for 494 genes of connective tissue diseases of the patient revealed that he carried novel compound heterozygous missense mutation in NBAS, c.2535G>T (p.Trp845Cys), с.5741G>A (p.Arg1914His).


2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Karolina Walczyńska-Dragon ◽  
Stefan Baron ◽  
Aleksandra Nitecka-Buchta ◽  
Ewaryst Tkacz

Temporomandibular dysfunction (TMD) is considered to be associated with imbalance of the whole body. This study aimed to evaluate the influence of TMD therapy on cervical spine range of movement (ROM) and reduction of spinal pain. The study group consisted of 60 patients with TMD, cervical spine pain, and limited cervical spine range of movements. Subjects were interviewed by a questionnaire about symptoms of TMD and neck pain and had also masticatory motor system physically examined (according to RDC-TMD) and analysed by JMA ultrasound device. The cervical spine motion was analysed using an MCS device. Subjects were randomly admitted to two groups, treated and control. Patients from the treated group were treated with an occlusal splint. Patients from control group were ordered to self-control parafunctional habits. Subsequent examinations were planned in both groups 3 weeks and 3 months after treatment was introduced. The results of tests performed 3 months after the beginning of occlusal splint therapy showed a significant improvement in TMJ function(P>0.05), cervical spine ROM, and a reduction of spinal pain. The conclusion is that there is a significant association between TMD treatment and reduction of cervical spine pain, as far as improvement of cervical spine mobility.


2018 ◽  
Vol 22 (5) ◽  
pp. 45-50
Author(s):  
A. M. Mambetova ◽  
A. M. Inarokova ◽  
N. N. Shabalova ◽  
D. V. Bizheva ◽  
A. T. Mahiyeva

THE AIM. To determine the concentration of natriuretic peptide in the blood serum in children with congenital malformations of the urinary system (CM US) and to compare with the activity of renin-angiotensin-aldosterone system (RAAS).MATERIALS AND METHODS.119 patients with CM US aged 3 to 18 years were examined. A control group of 10 clinically healthy children. 3 groups were assigned: group I – 55 children with  congenital vesicoureteral reflux, and group II – 34 children with  congenital hydronephrosis and ureterohydronephrosis, III group – 30 children with other forms of dysembryogenesis of the US. Following indicators were identified by ELISA in the blood: renin, aldosterone,  N – terminal propeptide natriuretic hormone (NT-рroВNР). RESULTS.NT-рroВNР, renin and aldosterone hyperproduction were diagnosed in 59,6%, 69,7%, 54.6 % of sick children relatively. Concentrations were higher in all variants of  malformations in comparison with the control group. Significant  differences were revealed in obstructive species, where arterial  hypertension (AH) was diagnosed more often. Patients with AH  recorded significantly higher concentrations of NT-proВNР and renin.CONCLUSION.The key point in pathological processes developmentand progression in the cardiovascular system and kidneys is the  activation of RAAS. The system of natriuretic factors is important in maintaining the compensated state of patients due to the blockade of RAAS.


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