ABSTRACT
Objective: The present study aimed to compare the clinical characteristics of volunteers with temporomandibular dysfunction before and after performing exercises with those of volunteers who only followed self-care guidelines.Methods: A parallel randomized controlled trial was performed. Individuals included underwent the intervention twice a week for one month, while the control group only followed self-care guidelines.Results: Twenty-three volunteers participated; however, during the study, four dropped out. At the end of the study, the degree of depression decreased in the volunteers in the intervention group.Conclusion: The level of pain decreased, but the improvement was not statistically significant and, therefore, could not be attributed to the intervention. It can be concluded that the strategies used to reduce pain in this study were not sufficient for clinical improvement in volunteers with temporomandibular dysfunction.
Subject(s)
Temporomandibular Joint Dysfunction Syndrome , Exercise Therapy/methods , Humans , Pain , Pain Measurement , Temporomandibular Joint Dysfunction Syndrome/therapy , Treatment OutcomeABSTRACT
PURPOSE: The aim of the study was to investigate the electroneurophysiological aspects of volunteers with temporomandibular disorders before and after performing isotonic exercises for pain relief and self-care guidelines. METHODS: The study was a parallel controlled randomized controlled trial under protocol 1,680,920. The inclusion criteria were age between 18 and 60 years, muscle temporomandibular dysfunction with or without limitation of mouth opening and self-reported pain with scores between 4 and 10. The individuals were randomized into experimental group and control. Twenty-three volunteers participated in the study, most of then were female. Control group had 11 and experimental group 12 individuals. Dropouts occurred in both groups, two in the experimental group and three in the control group. Since there were an intergroup imbalance the power density was analysed just in experimental group. Electroencephalographic recording was performed before and after the interventions, using the 32-channel apparatus, with sample frequency of 600 Hz and impedance of 5 kΩ. The data were processed through the MATLAB computer program. The individual records filtered off-line, using bandpass between 0.5 and 50 Hz. Epochs of 1,710 ms were created and the calculation of the absolute power density calculated by means of the fast Fourier transform. The statistical approach was inferential and quantitative. RESULTS: The alpha power density analyzed presented a difference, but not significant, when compared in the two moments. CONCLUSION: According to this study, isotonic exercises performed to reduce pain provided a small increase in alpha power density in the left temporal, parietal and occipital regions.
Subject(s)
Temporomandibular Joint Disorders , Temporomandibular Joint Dysfunction Syndrome , Adolescent , Adult , Exercise Therapy , Female , Humans , Male , Middle Aged , Pain , Temporomandibular Joint , Temporomandibular Joint Disorders/therapy , Treatment Outcome , Young AdultABSTRACT
RESUMO Objetivo Analisar os gastos públicos em saúde destinados aos serviços ambulatoriais em Fonoaudiologia nas cinco Regiões Federativas do Brasil. Métodos Trata-se de um estudo ecológico realizado por meio da busca de dados secundários disponíveis em uma plataforma virtual de domínio público, DATASUS (Departamento de Informática do Sistema Único de Saúde). Os dados coletados referiram-se aos valores aprovados para os procedimentos da Fonoaudiologia no período de 2009 a 2018 nas cinco Regiões Federativas. Adotou-se análise descritiva dos dados e exposição dos resultados em valores absolutos, relativos e taxas de crescimento. Resultados Verificou-se que o investimento médio em reais (R$), por ano, nos serviços de Fonoaudiologia no Brasil foi de, aproximadamente, R$ 223.952.639.232,00; sendo 47,2% dos recursos destinados à Região Sudeste. Dentre as grandes áreas de especialização, a Audiologia foi responsável por 95,4% do investimento, seguida pelas áreas da Linguagem (4,0%), Motricidade Orofacial (0,5%) e Voz (0,1%). Conclusão Os serviços fonoaudiológicos demandam considerável parcela dos recursos públicos, sendo a área da Audiologia responsável por quase metade desses gastos, seguida pelas grandes áreas da Linguagem, Motricidade Orofacial e Voz.
ABSTRACT Purpose To analyze public spending on health services to outpatient services in Speech Therapy in the five federative regions of Brazil. Methods This is an ecological study carried out through the search for secondary data available on a public domain virtual platform, DATASUS. The collected data refer to the values approved for the Speech Therapy procedures in the period from 2009 to 2018 in the five federative regions. Descriptive analysis of data and exposure of results in absolute and relative values and growth rates were adopted. Results It was found that the average investment in reais, per year, in speech therapy services in Brazil was approximately R$ 223,952,639,232.00, with 47.2% of the resources destined for the Southeast region. Among the major areas of specialization, Audiology accounted for 95.4% of the investment, followed by Language (4.0%), Orofacial Motricity (0.5%) and Voice (0.1%). Conclusion The findings indicate that speech therapy services demand a considerable portion of public resources, with the area of Audiology being responsible for almost half of these expenses, followed by the large area of Language, Orofacial Motricity and Voice.
Subject(s)
Quality of Health Care , Unified Health System , Ecological Studies , Speech, Language and Hearing Sciences , Public Expenditures on Health/statistics & numerical data , Health Services Research/economics , BrazilABSTRACT
BACKGROUND: Temporomandibular disorders are a group of orofacial pain conditions that are commonly identified in the general population. Like many other chronic pain conditions, they can be associated with anxiety/depression, which can be related to changes in the activity of the dorsolateral prefrontal cortex. Some studies have demonstrated clinical improvement in subjects with chronic pain who are given therapeutic neuromodulation. Transcranial direct current stimulation is a noninvasive brain stimulation technique that allows the modulation of neuronal membranes. This therapy can enhance or inhibit action potential generation in cortical neurons. In some instances, medications acting in the central nervous system may be helpful despite their adverse side effects. It is important to determine if cathodal transcranial direct current stimulation over the dorsolateral prefrontal cortex, an area that modulates emotion and motor cortex excitability, has an analgesic effect on chronic temporomandibular disorders pain. METHOD/DESIGN: The investigators will run a randomized, controlled crossover double blind study with 15 chronic muscular temporomandibular disorder subjects. Each subject will undergo active (1 mA and 2 mA) and sham transcranial direct current stimulation. Inclusion criteria will be determined by the Research Diagnostic Criteria for Temporomandibular Disorders questionnaire, with subjects who have a pain visual analogic scale score of greater than 4/10 and whose pain has been present for the previous 6 months, and with a State-Trait Anxiety Inventory score of more than 42. The influence of transcranial direct current stimulation will be assessed through a visual analogic scale, quantitative sensory testing, quantitative electroencephalogram, and the State-Trait Anxiety Inventory score. DISCUSSION: Some studies have demonstrated a strong association between anxiety/depression and chronic pain, where one may be the cause of the other. This is especially true in chronic temporomandibular disorders, and breaking this cycle may have an effect over the symptoms and associated dysfunction. We believe that by inhibiting activity of the dorsolateral prefrontal cortex though cathodal transcranial direct current stimulation, there may be a change in both anxiety/depression and pain level. Transcranial direct current stimulation may emerge as a new tool to be considered for managing these patients. We envision that the information obtained from this study will provide a better understanding of the management of chronic temporomandibular disorders. TRIAL REGISTRATION: This trial was registered at clinicaltrials.gov on 24 May 2014 (Identifier: NCT02152267 ).
Subject(s)
Masticatory Muscles/innervation , Prefrontal Cortex/physiopathology , Temporomandibular Joint Disorders/therapy , Transcranial Direct Current Stimulation/methods , Adolescent , Adult , Brazil , Clinical Protocols , Cross-Over Studies , Double-Blind Method , Electroencephalography , Female , Humans , Male , Middle Aged , Pain Measurement , Research Design , Surveys and Questionnaires , Temporomandibular Joint Disorders/diagnosis , Temporomandibular Joint Disorders/physiopathology , Time Factors , Treatment Outcome , Young AdultABSTRACT
A utilização de questionários pode assegurar oacesso a informações importantes na mudança decomportamentos. Objetivo: Descrever e discutir ametodologia e os instrumentos utilizados em pesquisas comprofissionais da área de Saúde. Material e Métodos: A partirde listas fornecidas por entidades de classe, profissionaisda área de saúde foram contatados pessoalmente e pelainternet para preenchimento do questionário de avaliação doconhecimento sobre procedimentos diagnósticos deneuroimagem e eletroneurofisiologia cortical em pacientescom distúrbios de linguagem. Resultados: não conseguimosacesso a 635 profissionais (97%) e, dos contatados comsucesso, 23 (3%) responderam o questionário utilizado.Dentre os que não participaram, 369 (56%) trabalhavam emhospitais, 66 (10%) não foram acessados, 66 (10%) oendereço se encontrava desatualizado, 41 (6%) tinhamnúmero de telefone errado, 37 (6%) atuavam em outraespecialidade, 30 (5%) estavam indisponíveis, 18 (3%)receberam e não responderam, 9 (1%) negaram opreenchimento. Conclusão: As dificuldades encontradasdurante a execução deste estudo proporcionam uma reflexãoacerca da construção de novos conhecimentos, uma vezque os profissionais envolvidos na prática clínica, e atémesmo na formação acadêmica, não se disponibilizam quandosolicitados a serem voluntários de pesquisa...
The use of questionnaires can ensure accessto important information concerning changing behavior.Objective: In this study we aimed to describe and discussthe methods and tools used in research involving healthprofessionals. Material and Methods: Health careprofessionals were contacted in person or through theinternet to fill out a questionnaire about their knowledge ondiagnostic procedures of neuroimaging and corticalelectroneurophysiology in children with language disorder.Results: A total of 635 professionals (97%) were nonrespondents,and 23 (3%) completed the questionnaires.Among those who did not participate, 369 (56%) worked inhospitals, 66 (10%) could not be reached, 66 (10%) had anoutdated address, 41 (6%) had the wrong phone number, 37(6%) worked with another specialty, 30 (5%) wereunavailable, 18 (3%) received the questionnaire but did notanswer it, and 9 (1%) declined. Conclusion: The difficultiesencountered during the execution of this study provide areflection on the production of new knowledge, sinceprofessionals involved in clinical practice and even inacademic education were not available when asked to beresearch subjects...
