ABSTRACT
BACKGROUND: The association between body postural changes and temporomandibular disorders (TMD) has been widely discussed in the literature, however, there is little evidence to support this association. OBJECTIVES: The aim of the present study was to conduct a systematic review to assess the evidence concerning the association between static body postural misalignment and TMD. METHOD: A search was conducted in the PubMed/Medline, Embase, Lilacs, Scielo, Cochrane, and Scopus databases including studies published in English between 1950 and March 2012. Cross-sectional, cohort, case control, and survey studies that assessed body posture in TMD patients were selected. Two reviewers performed each step independently. A methodological checklist was used to evaluate the quality of the selected articles. RESULTS: Twenty studies were analyzed for their methodological quality. Only one study was classified as a moderate quality study and two were classified as strong quality studies. Among all studies considered, only 12 included craniocervical postural assessment, 2 included assessment of craniocervical and shoulder postures,, and 6 included global assessment of body posture. CONCLUSION: There is strong evidence of craniocervical postural changes in myogenous TMD, moderate evidence of cervical postural misalignment in arthrogenous TMD, and no evidence of absence of craniocervical postural misalignment in mixed TMD patients or of global body postural misalignment in patients with TMD. It is important to note the poor methodological quality of the studies, particularly those regarding global body postural misalignment in TMD patients. .
Subject(s)
Heparin/pharmacology , Poly dA-dT/antagonists & inhibitors , Polydeoxyribonucleotides/antagonists & inhibitors , RNA Polymerase II/antagonists & inhibitors , Sarcosine/analogs & derivatives , Transcription, Genetic , Catalysis , Detergents/pharmacology , Poly dA-dT/metabolism , RNA Polymerase II/metabolism , Sarcosine/pharmacology , TriticumABSTRACT
Background: Migraine and temporomandibular disorders (TMDs) are reported to be associated. However, there are no reports on the association among migraines, TMDs and changes in body posture. Objectives : To assess changes in body posture in women suffering migraines with or without TMD compared with a control group. Method: Sixty-six women with a mean age of 18 to 45 years participated in this study. The groups were composed of 22 volunteers with migraine and TMD (MTMD), 22 volunteers with migraines without TMD (MG) and 22 women in the control group (CG). Static posture was assessed by photogrammetry, and 19 angles were measured. Results: Postural asymmetry was observed in the face for 4 angles measured on the frontal plane in the MG group and for 4 angles of the trunk in the MG and MTMD groups with respect to CG. However, for comparisons between MTMD and CG, clinical relevance was identified for two angles of the sagittal plane (Cervical and Lumbar Lordosis, Effect Size - ES - moderate: 0.53 and 0.60). For comparisons between the MG and CG, the clinical relevance/potential was verified for three angles with moderate ES (ES>0.42). The clinical relevance when comparing MTMD and CG was identified for four angles of facial symmetry head inclination (ES>0.54) and for two angles between MG and CG (ES>0.48). Conclusion : The results demonstrated the presence of postural changes compared with a control group in women with migraines with or without TMD, and there were similar clinically relevant postural changes among the patients with migraines with and without TMD. .
Contextualização: Há relatos na literatura sobre associações entre migrânea e disfunção temporomandibular (DTM). Entretanto, não há relatos sobre a associação entre migrânea, DTM e alterações da postura corporal. Objetivos: Avaliar a presença de alterações da postura corporal em mulheres com migrânea com e sem DTM em relação a um grupo controle. Método: Foram avaliados três grupos de 22 integrantes cada, na faixa etária de 18 a 50 anos, sexo feminino, compostos de voluntárias com migrânea e DTM (GMDTM), migranosas sem DTM (GM) e grupo controle (GC). As voluntárias foram submetidas à avaliação da postura estática por meio da fotogrametria, e foram mensurados 19 ângulos. Resultados: Foram observadas assimetrias posturais em quatro ângulos mensurados no plano frontal na face no GM e em quatro ângulos do tronco no GM e no GMDTM em relação ao GC. Entretanto, foi verificada relevância clínica para dois ângulos posturais no plano sagital (GM vs. GMDTM - lordose cervical e lombar, Effect size - ES moderados: 0,53 e 0,60) e, para comparação entre o GM e o GC, foi observada relevância clínica/potencial para três ângulos (ES>0,42). Foi verificada relevância clínica para quatro ângulos de simetria facial/inclinação da cabeça na comparação GMDTM e GM (ES>0,54) e para dois ângulos entre o GM e o GC (ES>0,48). Conclusão: Os resultados do presente trabalho demonstraram a presença de alterações de postura corporal em mulheres com migrânea com e sem DTM em relação ao grupo controle, e as alterações de postura foram similares entre os GM e GMDTM na análise de relevância clínica. .
Subject(s)
Adolescent , Adult , Female , Humans , Middle Aged , Young Adult , Migraine Disorders/physiopathology , Posture , Temporomandibular Joint Disorders/physiopathology , Cross-Sectional Studies , Migraine Disorders/complications , Temporomandibular Joint Disorders/complicationsABSTRACT
OBJECTIVES: The aim of this study was to assess the prevalence of Temporomandibular Disorders (TMD), using the Research Diagnostic Criteria for TMD (RDC/TMD) in women with episodic and chronic migraine (M and CM), as well as in asymptomatic women. METHOD: Sample consisted of 61 women, being 38 with M and 23 with CM, identified from a headache outpatient center; we also investigated 30 women without headaches for at least 3 months (women without headache group - WHG). Assessment of TMD was conducted by a physical therapist who was blind to the headache status. RESULTS: The prevalence of TMD, assessed through the RDC, was 33.3% in the WHG, 86.8% in the M group and 91.3% of the CM group. Differences were significant when comparing M and CM groups with WHG (p<0.001), but not when comparing M and CM (p>0.05) as well as higher risk for TMD [odds ratio (OR)=3.15, 95% confidence interval (CI) 1.73-5.71 and OR=3.97, 95%CI 1.76-8.94]. CONCLUSION: Women with migraine are more likely to have muscular and articular TMD, suggesting that both disorders might be clinically associated, which demonstrate the importance of physical therapy assessment in the multidisciplinary team.
OBJETIVOS: Avaliar a presença de disfunção temporomandibular (DTM) usando o Critério Diagnóstico em pesquisa para disfunção temporomandibular (RDC/TMD) em mulheres com migrânea episódica e migrânea crônica (M e MC), bem como em mulheres sem nenhuma cefaleia. MÉTODO: A amostra foi composta por 61 mulheres, 38 com M e 23 com MC, selecionadas em um centro terciário de saúde; também foram avaliadas 30 mulheres sem nenhuma cefaleia nos últimos três meses (grupo de mulheres sem cefaleia - MSC). A avaliação da DTM foi realizada por um fisioterapeuta que não tinha conhecimento do diagnóstico das pacientes. RESULTADOS: Por meio do RDC/TMD, a frequência de DTM foi de 33.3% no grupo MSC, 86.8% no grupo M e 91.3% no grupo MC. A diferença foi significativa entre os grupos com migrânea e o grupo MSC (p<0.001), porém não houve diferença entre os grupos M e MC (p>0,05), bem como maior fator de risco de DTM [odds ratio (OR)=3,15, intervalo de confiança (IC) de 95% 1,73-5,71 e OR=3,97, IC95% 1,76-8,94]. CONCLUSÃO: Mulheres com migrânea têm maior frequência de DTM muscular e articular, sugerindo que essas condições estão clinicamente associadas, evidenciando a importância do fisioterapeuta na equipe de avaliação multidisciplinar.