Jaw Kinematics and Muscle Activation in Patients With Non-specific Chronic Neck Pain

National Yang Ming Chiao Tung University

Status: Completed

Conditions: Temporomandibular Disorder; Biomechanical Phenomena; Nonspecific Chronic Neck Pain

Treatments: Other: Muscle activation; Other: Pressure pain threshold (PPT); Other: Cranial-cervical angle (CCA); Other: Cervical range of motion (CROM); Other: Jaw kinematics

Study type: Observational

Funder types: Other

Identifiers

NCT04041271

(717)108A-33

Details and patient eligibility

About

Temporomandibular disorder (TMD) is a collective term for pain and dysfunction of the masticatory muscles and temporomandibular joint (TMJ). Typical signs and symptoms of TMD includes regional pain, noises from the TMJs and limitations in jaw movements. Altered jaw kinematics and muscle activity have also been reported. TMD may be related to neck problems. Over 50% of patients with TMD suffer from nonspecific neck pain. Patients with TMD often have symptoms over neck, including upper cervical spine movement impairment and reduced cervical muscles endurance. Conversely, TMD may also develop in patients with neck pain. Twenty to thirty-three percent of patients with neck pain also have TMD. Subjects with neck pain present with a twofold higher prevalence of TMD than those without neck pain. In patients with neck pain, the development or perpetuation of TMD may be due to the anatomical connection between TMJ and neck: neck posture affects the mandible position and sensory inputs from the cervical-mandibular region converge at the trigemino-cervical nucleus. Early identification of TMD is essential but to our knowledge, no study has investigated whether patients with neck pain demonstrate altered jaw movement and muscle activity, which is associated with TMD. The purposes of this proposal are to compare the jaw kinematics, muscle activity and muscle sensitivity in healthy individuals and patients with non-specific chronic neck pain (NCNP). This study also aimed to investigate the relationship between forward-head posture and the jaw kinematics, muscle activity as well as muscle sensitivity. With a cross-sectional exploratory study design, 30 healthy control subjects and 30 subjects with NCNP will be recruited. Clinical assessments will include cervical range of motion (CROM), pressure pain threshold (PPT) over the cervical-mandibular region and the cranial-cervical angle (CCA). Jaw kinematics will be measured by Ultrasonic Jaw Motion Analyzer (Zebris GmbH) during functional jaw movements. Muscle activities are record from bilateral anterior temporalis, masseter, sternocleidomastoid muscle and upper trapezius by surface electromyography during resting and clenching.

Enrollment: 44 patients

Sex: All

Ages: 20 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria (nonspecific chronic neck pain group):

• Aged between 20 to 65 years old
• Mechanical pain that provoked by sustained neck postures or specific neck movements without any identifiable diseases or structure anomalies
• Chronic or recurrent neck pain of at least 3 months duration
• Minimum of 3 points on the numerical pain rating scale (NPRS) over cervical region
• Without any pain, clicking or range of motion limitation over TMJ

Inclusion Criteria (healthy control group):

• Age (± 5 years) and gender match to NCNP group
• No pain or clinical pathology involving the masticatory system or cervical spine for at least one year prior to the start of the study

Exclusion Criteria (both groups):

• Serious injury, tumor, infection
• Recent cervical-cranial surgery
• Neurologic involvement
• Inflammatory rheumatic diseases
• Pregnancy
• Nonmechanical cause of neck pain (e.g. herniated disk, spinal fractures)
• Had been diagnosed with spinal conditions (e.g. spondylolisthesis)
• Shoulder pain within 1 years
• Loss of posterior tooth
• Dental pain or periodontal problems
• Orthodontic, orofacial myofunctional or TMD treatment within 3 months
• Use of analgesic or anti-inflammatory drugs within 3 days

Trial design

44 participants in 2 patient groups

Nonspecific chronic neck pain (NCNP) group

Description:

Subjects with nonspecific chronic neck pain will be included to perform clinical test and assess their jaw kinematics and muscle activation.

Treatment:

Other: Muscle activation

Other: Cranial-cervical angle (CCA)

Other: Jaw kinematics

Other: Pressure pain threshold (PPT)

Other: Cervical range of motion (CROM)

Control group

Description:

Healthy control subjects will be included to compare the differences in jaw kinematics, muscle activation and clinical tests between healthy subjects and subjects with nonspecific chronic neck pain. Subjects in this group will received the same assessment as the NCNP group.

Treatment:

Other: Muscle activation

Other: Cranial-cervical angle (CCA)

Other: Jaw kinematics

Other: Pressure pain threshold (PPT)

Other: Cervical range of motion (CROM)