Relationship between cervical musculoskeletal impairments and temporomandibular disorders: clinical and electromyographic variables

  • Author / Creator
    Armijo Olivo, Susan
  • Temporomandibular disorders (TMD) consist of a group of pathologies affecting the masticatory muscles, the temporomandibular joint and related structures. The association between the cervical spine and TMD has been studied from different perspectives; however, the study of cervical muscles and their significance in the development and perpetuation of TMD has not been elucidated. Thus, this project was designed to investigate the association between cervical musculoskeletal impairments and TMD. A sample of subjects who attended the TMD/Orofacial Pain clinic, and students and staff at the University of Alberta participated in this study. All subjects underwent a series of physical tests and electromyographic assessment (i.e. head and neck posture, maximal cervical muscle strength, cervical flexor and extensor muscles endurance, and cervical flexor muscle performance) to determine cervical musculoskeletal impairments. All subjects were asked to complete the Neck disability Index and the Jaw Function Scale, and the Chronic Pain Grade Disability Questionnaire. A strong relationship between neck disability and jaw disability was found (r=0.82). Craniocervical posture (measured using the eye-tragus-horizontal angle) was statistically different between patients with myogenous TMD and healthy subjects. However, the difference was too small (3.3º) to be considered clinically relevant. Maximal cervical flexor muscle strength was not statistically or clinically different between patients with TMD and healthy subjects. No statistically significant differences were found in electromyographic activity of the sternocleidomastoid or the anterior scalene muscles in patients with TMD when compared to healthy subjects while executing the craniocervical flexion test (p=0.07). However, clinically important effect sizes (0.42-0.82) were found. Subjects with TMD presented with reduced cervical flexor as well as extensor muscle endurance while performing the flexor and extensor muscle endurance tests when compared to healthy individuals. Furthermore, patients with mixed TMD presented with steeper negative slopes (although modest) at several times during the neck extensor muscle endurance test than healthy subjects. The results of this research provided an important clinical contribution to the area of physical therapy and TMD. It identified impairments in the cervical spine in patients with TMD that could help guide clinicians in the assessment and prescription of more effective interventions for individuals with TMD.

  • Subjects / Keywords
  • Graduation date
  • Type of Item
  • Degree
    Doctor of Philosophy
  • DOI
  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
  • Language
  • Institution
    University of Alberta
  • Degree level
  • Department
    • Faculty of Rehabilitation Medicine
  • Supervisor / co-supervisor and their department(s)
    • Magee, D (Rehabilitation Medicine)
  • Examining committee members and their departments
    • Warren, Sharon (Rehabilitation Medicine)
    • Major, Paul (Dentistry)
    • Thie, Norman (Dentistry)
    • Syrotuik, Dan (Physical Education and Recreation)
    • Da Fonseca, Sergio (Physical Therapy)