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턱관절장애 환자의 목뼈 뒤굽음 각과 통증 및 기능장애 수준 간에 상관성 연구

Correlation Among the Cervical Kyphotic Angle, Pain, and Disability Level in Patients With Temporomandibular Disorders

  • 이인수 (대전대학교 보건의료대학원 물리치료학과) ;
  • 김선엽 (대전대학교 보건의료과학대학 물리치료학과)
  • Lee, In-su (Department of Physical Therapy, Graduate School of Health and Medicine, Daejeon University) ;
  • Kim, Suhn-yeop (Department of Physical Therapy, College of Health and Medical Science, Daejeon University)
  • 투고 : 2020.03.16
  • 심사 : 2020.04.28
  • 발행 : 2020.05.20

초록

Background: There is an opinion that improper postures of the head and cervical spine are associated with temporomandibular joint (TMJ) disorders (TMDs). Objects: The aim of this study was to investigate the proportions among the cervical kyphotic angle, physical symptoms including the pain intensity level of the TMJ, and severity of TMD disability in patients diagnosed with TMD. Methods: Sixty-two subjects participated in the study. The evaluation tools included measurements of the cervical kyphotic angle based on the Ishihara index, pressure pain threshold (PPT) on the TMJ, maximal mouth opening (MMO) without pain, current pain intensity level of the TMJ measured using the Quadruple Visual Analogue Scale (QVAS), Korean TMD (KTMD) disability index, KTMD Symptom Frequency/Intensity Scales (SFS/SIS), and Korean Headache Impact Test-6. Correlation analysis was conducted to investigate the correlations between the cervical kyphotic angle and parameters related to TMJ symptoms. Results: Variables that were significantly correlated with the cervical kyphotic angle were the PPT around the TMJ (r = 0.259, p < 0.05), current pain intensity level of the TMJ based on the QVAS (r = -0.601, p< 0.01), and usual pain intensity level based on the SIS (r = -0.379, p < 0.01). The level of TMD functional disability was significantly correlated with the degree of headache (r = 0.551, p < 0.01), level of PPT of the TMJ (r = -0.383, p < 0.01), pain-free MMO (r = -0.515, p < 0.01), pain intensity level of the TMJ based on the QVAS (r = 0.393, p < 0.01), TMD symptom frequency (r = 0.739, p < 0.01), usual pain intensity of the TMJ (r = 0.624, p < 0.01), and most severe pain intensity of the TMJ (r = 0.757, p < 0.01). Conclusion: There is a positive correlation between the cervical kyphotic angle and PPT and a negative correlation between the current and usual pain intensity levels of the TMJ. The cervical kyphotic angle was a predictor of the pain level, tenderness threshold, and intensity of pain in the TMJ.

키워드

참고문헌

  1. Carroll LJ, Hogg-Johnson S, van der Velde G, Haldeman S, Holm LW, Carragee EJ, et al.; Bone and Joint Decade 2000- 2010 Task Force on Neck Pain and Its Associated Disorders. Course and prognostic factors for neck pain in the general population: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine (Phila Pa 1976) 2008;33(4 Suppl):S75-82. https://doi.org/10.1097/BRS.0b013e31816445be
  2. Saal JA. The new back school prescription: stabilization training. Part II. Occup Med 1992;7(1):33-42.
  3. Helliwell PS, Evans PF, Wright V. The straight cervical spine: does it indicate muscle spasm? J Bone Joint Surg Br 1994;76(1):103-6. https://doi.org/10.1302/0301-620X.76B1.8300650
  4. Okeson JP. Orofacial pain: guidelines for assessment, diagnosis, and management. Chicago: Quintessence Publishing Co.; 1996;113-84.
  5. Ries LG, Alves MC, Berzin F. Asymmetric activation of temporalis, masseter, and sternocleidomastoid muscles in temporomandibular disorder patients. Cranio 2008;26(1):59-64. https://doi.org/10.1179/crn.2008.008
  6. Suvinen TI, Kemppainen P. Review of clinical EMG studies related to muscle and occlusal factors in healthy and TMD subjects. J Oral Rehabil 2007;34(9):631-44. https://doi.org/10.1111/j.1365-2842.2007.01769.x
  7. Manfredini D, Guarda-Nardini L, Winocur E, Piccotti F, Ahlberg J, Lobbezoo F. Research diagnostic criteria for temporomandibular disorders: a systematic review of axis I epidemiologic findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112(4):453-62. https://doi.org/10.1016/j.tripleo.2011.04.021
  8. Ioi H, Matsumoto R, Nishioka M, Goto TK, Nakata S, Nakasima A, et al. Relationship of TMJ osteoarthritis/osteoarthrosis to head posture and dentofacial morphology. Orthod Craniofac Res 2008;11(1):8-16. https://doi.org/10.1111/j.1601-6343.2008.00406.x
  9. Clark GT. Examining temporomandibular disorder patients for cranio-cervical dysfunction. J Craniomandibular Pract 1983;2(1):55-63. https://doi.org/10.1080/07345410.1983.11677853
  10. de Wijer A, Steenks MH, de Leeuw JR, Bosman F, Helders PJ. Symptoms of the cervical spine in temporomandibular and cervical spine disorders. J Oral Rehabil 1996;23(11):742-50. https://doi.org/10.1046/j.1365-2842.1996.d01-187.x
  11. Eriksson PO, Haggman-Henrikson B, Nordh E, Zafar H. Coordinated mandibular and head-neck movements during rhythmic jaw activities in man. J Dent Res 2000;79(6):1378-84. https://doi.org/10.1177/00220345000790060501
  12. Miernik M, Wieckiewicz M, Paradowska A, Wieckiewicz W. Massage therapy in myofascial TMD pain management. Adv Clin Exp Med 2012;21(5):681-5.
  13. Visscher CM, Huddleston Slater JJ, Lobbezoo F, Naeije M. Kinematics of the human mandible for different head postures. J Oral Rehabil 2000;27(4):299-305. https://doi.org/10.1046/j.1365-2842.2000.00518.x
  14. Zafar H, Eriksson PO, Nordh E, Haggman-Henrikson B. Wireless optoelectronic recordings of mandibular and associated head-neck movements in man: a methodological study. J Oral Rehabil 2000;27(3):227-38. https://doi.org/10.1046/j.1365-2842.2000.00505.x
  15. Moya H, Miralles R, Zuniga C, Carvajal R, Rocabado M, Santander H. Influence of stabilization occlusal splint on craniocervical relationships. Part I: Cephalometric analysis. Cranio 1994;12(1):47-51. https://doi.org/10.1080/08869634.1994.11677993
  16. Kalamir A, Pollard H, Vitiello AL, Bonello R. Manual therapy for temporomandibular disorders: a review of the literature. J Bodyw Mov Ther 2007;11(1):84-90. https://doi.org/10.1016/j.jbmt.2006.07.003
  17. Walczynska-Dragon K, Baron S, Nitecka-Buchta A, Tkacz E. Correlation between TMD and cervical spine pain and mobility: is the whole body balance TMJ related? Biomed Res Int 2014;2014:582414. https://doi.org/10.1155/2014/582414
  18. Todd AG. Cervical spine: degenerative conditions. Curr Rev Musculoskelet Med 2011;4(4):168-74. https://doi.org/10.1007/s12178-011-9099-2
  19. Alanen PJ, Kirveskari PK. Occupational cervicobrachial disorder and temporomandibular joint dysfunction. Cranio 1984;3(1):69-72. https://doi.org/10.1080/08869634.1984.11678088
  20. Garcia R Jr, Arrington JA. The relationship between cervical whiplash and temporomandibular joint injuries: an MRI study. Cranio 1996;14(3):233-9. https://doi.org/10.1080/08869634.1996.11745973
  21. Gonzalez-Iglesias J, Cleland JA, Neto F, Hall T, Fernandez-delas-Penas C. Mobilization with movement, thoracic spine manipulation, and dry needling for the management of temporomandibular disorder: a prospective case series. Physiother Theory Pract 2013;29(8):586-95. https://doi.org/10.3109/09593985.2013.783895
  22. Kang DK. Relationship between temporomandibular disorder and cervical kyphosis. Seoul, Yonsei University, Master's Thesis. 2018.
  23. Darlow LA, Pesco J, Greenberg MS. The relationship of posture to myofascial pain dysfunction syndrome. J Am Dent Assoc 1987;114(1):73-5. https://doi.org/10.14219/jada.archive.1987.0053
  24. Hackney J, Bade D, Clawson A. Relationship between forward head posture and diagnosed internal derangement of the temporomandibular joint. J Orofac Pain 1993;7(4):386-90.
  25. Olivo SA, Bravo J, Magee DJ, Thie NM, Major PW, Flores-Mir C. The association between head and cervical posture and temporomandibular disorders: a systematic review. J Orofac Pain 2006;20(1):9-23.
  26. De Laat A, Meuleman H, Stevens A, Verbeke G. Correlation between cervical spine and temporomandibular disorders. Clin Oral Investig 1998;2(2):54-7. https://doi.org/10.1007/s007840050045
  27. Von Korff M, Le Resche L, Dworkin SF. First onset of common pain symptoms: a prospective study of depression as a risk factor. Pain 1993;55(2):251-8. https://doi.org/10.1016/0304-3959(93)90154-H
  28. Grafton KV, Foster NE, Wright CC. Test-retest reliability of the Short-Form McGill Pain Questionnaire: assessment of intraclass correlation coefficients and limits of agreement in patients with osteoarthritis. Clin J Pain 2005;21(1):73-82. https://doi.org/10.1097/00002508-200501000-00009
  29. Boonstra MC, De Waal Malefijt MC, Verdonschot N. How to quantify knee function after total knee arthroplasty? Knee 2008;15(5):390-5. https://doi.org/10.1016/j.knee.2008.05.006
  30. Hoglund LT, Scott BW. Automobilization intervention and exercise for temporomandibular joint open lock. J Man Manip Ther 2012;20(4):182-91. https://doi.org/10.1179/2042618612Y.0000000008
  31. Rodriguez-Recio O, Junquera LM, Calvo N. Mandibular fracture after wire suspension reduction technique in patient with HIV. Br J Oral Maxillofac Surg 2000;38(4):397. https://doi.org/10.1054/bjom.1999.0050
  32. Chesterton LS, Sim J, Wright CC, Foster NE. Interrater reliability of algometry in measuring pressure pain thresholds in healthy humans, using multiple raters. Clin J Pain 2007;23(9):760-6. https://doi.org/10.1097/AJP.0b013e318154b6ae
  33. Fischer AA. Pressure algometry over normal muscles. Standard values, validity and reproducibility of pressure threshold. Pain 1987;30(1):115-26. https://doi.org/10.1016/0304-3959(87)90089-3
  34. Zhao H, Zhao Y, Qiu GX. Relationship between cervical curvature index and cervical spine angle. Chin J Clin Rehabil 2005;9(10):252-3. https://doi.org/10.3321/j.issn:1673-8225.2005.10.040
  35. Chu MK, Im HJ, Ju YS, Yu KH, Ma HI, Kim YJ, et al. Validity and reliability assessment of Korean headache impact test-6 (HIT- 6). J Korean Neurol Assoc 2009;27(1):1-6.
  36. Kosinski M, Bayliss MS, Bjorner JB, Ware JE Jr, Garber WH, Batenhorst A, et al. A six-item short-form survey for measuring headache impact: the HIT-6. Qual Life Res 2003;12(8):963-74. https://doi.org/10.1023/A:1026119331193
  37. Resende CM, Alves AC, Coelho LT, Alchieri JC, Roncalli AG, Barbosa GA. Quality of life and general health in patients with temporomandibular disorders. Braz Oral Res 2013;27(2):116-21. https://doi.org/10.1590/S1806-83242013005000006
  38. Pimenta e Silva Machado L, de Macedo Nery MB, de Gois Nery C, Leles CR. Profiling the clinical presentation of diagnostic characteristics of a sample of symptomatic TMD patients. BMC Oral Health 2012;12:26. https://doi.org/10.1186/1472-6831-12-26
  39. Bovim G, Schrader H, Sand T. Neck pain in the general population. Spine (Phila Pa 1976) 1994;19(12):1307-9. https://doi.org/10.1097/00007632-199406000-00001
  40. Munhoz WC, Marques AP, Siqueira JT. Radiographic evaluation of cervical spine of subjects with temporomandibular joint internal disorder. Braz Oral Res 2004;18(4):283-9. https://doi.org/10.1590/S1806-83242004000400002
  41. Sessle BJ, Hu JW, Amano N, Zhong G. Convergence of cutaneous, tooth pulp, visceral, neck and muscle afferents onto nociceptive and non-nociceptive neurones in trigeminal subnucleus caudalis (medullary dorsal horn) and its implications for referred pain. Pain 1986;27(2):219-35. https://doi.org/10.1016/0304-3959(86)90213-7
  42. Song EM, Kim EJ, Cho YJ, Cho JH, Chung SH, Song MY. The correlation among cervical curvature, neck pain and headache in patients with chronic neck pain. J Korean Med Rehabil 2011;21(4):97-109.
  43. Jung DY, Chung SH, Lee JS. An analysis of relationship among cervical spine curvature measurement methods. J Oriental Rehab Med 2005:15(4):65-76.
  44. Harrison DE, Harrison DD, Cailliet R, Troyanovich SJ, Janik TJ, Holland B. Cobb method or Harrison posterior tangent method: which to choose for lateral cervical radiographic analysis. Spine (Phila Pa 1976) 2000;25(16):2072-8. https://doi.org/10.1097/00007632-200008150-00011
  45. Cho DI, Yoon J, Kim SJ, Park DS. Radiologic analysis of cervical lordosis for university students. J Korean Med Rehabil 2015;25(4):83-92. https://doi.org/10.18325/jkmr.2015.25.4.83

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