Effects of upper cervical manipulation on the electromyographic activity of the masticatory muscles and the opening range of motion of the mouth in women with temporomandibular disorder: randomized and blind clinical trial
DOI:
https://doi.org/10.590/1809-2950/15568322042015Abstract
We evaluated the effects of upper cervical manipulation on the surface electromyographic activity (sEMG) of masticatory muscles and range of motion of the opening movement of the mouth in women with temporomandibular disorders (TMD). We evaluated 10 women with myogenic a TMD diagnosis, according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and divided randomly into an experimental group (EG) n=5, which received upper cervical manipulation, and a placebo group (PG) n=5, which received maneuvers without therapeutic effects. Five interventions were performed in both groups, once a week, with performance of pre-intervention assessments, post-immediate assessments (after 1st intervention) and post-delayed assessments (48 hours after the 5th intervention). The sEMG activity was processed using the root mean square and normalized by the peak value (RMS EMGn). We used for comparison the Student's t-test and ANOVA two-way repeated measures, adopting as significance the amount of 5%, and the Cohen d for treatment effect size. We found a significant interaction of group vs time (p<0.05) in the RMS EMGn of the left and right temporal muscles at rest, as well as for all masticatory muscles during maximal isometric contraction during jaw-elevation and jaw-depression. Treatment effect size, high to moderate, was observed in the EG, especially in the post-delayed assessment. We also observed a significant increase (p<0.05) and a high treatment effect during mouth opening in the EG. The upper cervical manipulation demonstrated a balance of the RMS EMGn of the masticatory muscles and increase the opening range of motion of the mouth in women with myogenic TMD.Downloads
References
Bender SD. Temporomandibular disorders, facial pain, and
headaches. Headache. 2012;52(1):22-5.
Eriksson PO, Haggman-Henrikson B, Zafar H. Jaw-neck
dysfunction in whiplash-associated disorders. Arch Oral
Biol. 2007;52:404-8.
Gomes CA, Politti F, Andrade DV, Sousa DF, Herpich CM,
Dibai-Filho AV, et al. Effects of massage therapy and occlusal
splint therapy on mandibular range of motion in individuals
with temporomandibular disorder: a randomized clinical
trial. J Manipulative Physiol Ther. 2014;37(3):164-9.
Gomes NCMC, Berni-Schwarzenbeck KCS, Packer AC,
Rodrigues-Bigaton D. Effect of cathodal high-voltage
electrical stimulation on pain in women with TMD. Rev Bras
Fisioter. 2012;16:10-5.
Packer AC, Pires PF, Dibai-Filho AV, Rodrigues-Bigaton
D. Effect of upper thoracic manipulation on mouth
opening and electromyographic activity of masticatory
muscles in women with temporomandibular disorder:
a randomized clinical trial. J Manip Physiol Ther.
;38(4):253-61.
Martínez-Segura R, De-la-Llave-Rincón AI, Ortega-Santiago
R, Cleland JA, Fernández-de-Las-Peñas C. Immediate
changes in widespread pressure pain sensitivity, neck pain,
and cervical range of motion after cervical or thoracic thrust
manipulation in patients with bilateral chronic mechanical
neck pain: a randomized clinical trial. J Orthop Sports Phys
Ther. 2012;42(9):806-14.
Mansilla-Ferragut P, Fernández-de-Las Peñas C,
Alburquerque-Sendín F, Cleland JA, Boscá-Gandía JJ.
Immediate effects of atlanto-occipital joint manipulation
on active mouth opening and pressure pain sensitivity in
women with mechanical neck pain. J Manip Physiol Ther.
;32(2):101-6.
Vernon H, Humphreys BK. Chronic mechanical neck pain in
adults treated by manual therapy: a systematic review of
change scores in randomized controlled trials of a single
session. J Man Manip Ther. 2008;16(2):42-52.
Vicenzino B, Wright A. Effects of a novel manipulative
physiotherapy technique on tennis elbow: a single case
study. Man Ther. 1995;1(1):30-5.
Yu X, Wang X, Zhang J, Wang Y. Changes in pressure
pain thresholds and Basal electromyographic activity after instrument-assisted spinal manipulative therapy in
asymptomatic participants: a randomized, controlled trial.
J Manip Physiol Ther. 2012;35(6):437-45.
Herzog W, Scheele D, Conway PJ. Electromyography
responses of back and limb muscles associated with spinal
manipulative therapy. Spine. 1999;24:146-52.
Calixtre LB, Moreira RF, Franchini GH, Alburquerque-Sendín
F, Oliveira AB. Manual therapy for the management of pain
and limited range of motion in subjects with signs and
symptoms of temporomandibular disorder: a systematic
review of randomised controlled trials. J Oral Rehabil.
;42(11):847-61.
Yu H, Hou S, Wu W, He X. Upper cervical manipulation
combined with mobilization for the treatment of atlantoaxial
osteoarthritis: a report of 10 cases. J Manip Physiol Ther.
;34(2):131-7.
Dunning JR, Cleland JA, Waldrop MA, Arnot CF, Young IA,
Turner M, et al. Upper cervical and upper thoracic thrust
manipulation versus nonthrust mobilization in patients with
mechanical neck pain: a multicenter randomized clinical
trial. J Orthop Sports Phys Ther. 2012;42:5-18.
Mansilla Ferragud P, Boscá Gandia JJ. Efecto de la
manipulacion de la charnela occipito-atlo-axoidea en la
apertura de la boca. Osteopat Cientıfica. 2008;3:45-51.
Hurwitz EL, Aker PD, Adams AH, Meeker WC, Shekelle
PG. Manipulation and mobilization of the cervical spine: a
systematic review of the literature. Spine. 1996;21:1746-59.
Erhardt JW, Windsor BA, Kerry R, Hoekstra C, Powell DW,
Porter-Hoke A, Taylor A. The immediate effect of atlantoaxial high velocity thrust techniques on blood flow in the
vertebral artery: A randomized controlled trial. Man Ther.
;20(4):614-22.
Cattrysse E, Swinkels RA, Oostendorp RA, Duquet W. Upper
cervical instability: are clinical tests reliable? Man Ther.
;2(2):91-7.
Licht PB, Christensen HW, Høilund-Carlsen PF. Vertebral
artery volume flow in human beings. J Manip Physiol Ther.
;22(6):363-7.
Berni KC, Dibai-Filho AV, Pires PF, Rodrigues-Bigaton D.
Accuracy of the surface electromyography RMS processing
for the diagnosis of myogenous temporomandibular
disorder. J Electromyogr Kinesiol. 2015;25(4):596-602.
Fernández-de-Las-Peñas C, Alonso-Blanco C, Cleland
JA, Rodríguez-Blanco C, Alburquerque-Sendín F.
Changes in pressure pain thresholds over C5-C6
zygapophyseal joint after a cervicothoracic junction
manipulation in healthy subjects. J Manip Physiol Ther.
; 31(5):332-7.
Cohen J. Statistical power analysis for the behavioral
sciences. 2ª ed. New Jersey: Lawrence Erlbaum; 1988.
Hugger S, Schindler HJ, Kordass B, Hugger A. Clinical
relevance of surface EMG of the masticatory muscles. (Part
: Resting activity, maximal and submaximal voluntary
contraction, symmetry of EMG activity. Int J Comput Dent.
;15(4):297-314.
Pickar JG. Neurophysiological effects of spinal manipulation.
Spine J. 2002; 2(5):357-71.
Bicalho E, Setti JA, Macagnan J, Cano JL, Manffra
EF. Immediate effects of a high-velocity spine
manipulation in paraspinal muscles activity of
nonspecific chronic low-back pain subjects. Man Ther.
;15(5):469-75.
Camargo VM, Alburquerque-Sendín F, Bérzin F, Stefanelli
VC, Souza DP, Fernández-de-las-Peñas C. Immediate
effects on electromyographic activity and pressure pain
thresholds after a cervical manipulation in mechanical neck
pain: a randomized controlled trial. J Manip Physiol Ther.
;34(4):211-20.
Pires PF, Packer AC, Dibai-Filho AV, Rodrigues-Bigaton
D. Immediate and short-term effects of upper thoracic
manipulation on myoelectric activity of sternocleidomastoid
muscles in young women with chronic neck pain: A
Randomized Blind Clinical Trial. J Manip Physiol Ther.
;38(8):555-63.
La Touche R, Fernández-de-las-Peñas C, FernándezCarnero J, Escalante K, Angulo-Díaz-Parreño S,
Paris-Alemany A, Cleland JA. The effects of manual
therapy and exercise directed at the cervical spine
on pain and pressure pain sensitivity in patients with
myofascial temporomandibular disorders. J Oral Rehabil.
;36(9):644-52.
Downloads
Published
Issue
Section
License
Copyright (c) 2015 Fisioterapia e Pesquisa
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
