Evaluation of Postural Awareness, Pressure Pain Threshold, Proprioception and Jaw Functionality According to Head Posture in Temporomandibular Disorder

Öz

Aims: Although the relationship between temporomandibular disorders (TMD) and forward head posture (FHP) has been investigated previously, specifically posture habits and awareness have not been evaluated together with musculoskeletal system parameters in TMD. Therefore, this study aimed to investigate postural habits and awareness, pressure pain threshold, proprioception, and functionality in individuals with TMD according to the presence of FHP. Methods: Fifty individuals with myogenic TMD participated in the study. FHP was assessed via measurement of Craniovertebral Angle. Postural habits and awareness levels were assessed using the Postural Habits and Awareness Scale (PHAS). Pressure-pain levels were assessed using an algometer, and proprioception was assessed using the Laser Cursor-Assisted Angle Repetition Test (LART). The Helkimo Clinical Dysfunction Index (HCDI) and Mandibular Function Impairment Questionnaire (MFIQ) were used to measure jaw functionality. To strengthen the clinical significance level, data from the first quartile (n=12) and fourth quartile (n=12) cases were analysed. Results: No significant difference was observed between the groups of FHP and control in terms of PHAS scores (p>.05). The pressure pain threshold was significantly higher in the m. temporalis and m. trapezius, as well as in the lateral and dorsal capsules in the FHP group (p<.05) and LART value during both flexion and extension was lower, and scores of HCDI and MFIQ were lower in the FHP group (p<.05). Conclusion: While no difference was found between the groups in terms of postural habits and awareness, higher pressure pain thresholds were observed in the m. temporalis, m. trapezius, and joint capsules, along with better level of proprioception and jaw function in the FHP group. We think that in TMD individuals with FHP, postural awareness may have increased due to musculoskeletal system problems, a compensatory strategy may have been developed, or a more adaptive level may have been developed in the relevant parameters.

Anahtar Kelimeler

• temporomandibular joint disorders
• postural awareness
• proprioception
• pain
• function

Temporomandibular Bozukluğunda Baş Postürüne Göre Postüral Farkındalık, Basınç Ağrı Eşiği, Propriyosepsiyon ve Çene Fonksiyonelliğinin Değerlendirilmesi

Öz

Amaç: Temporomandibular bozukluklar (TMB) ve baş önde postürü (BÖP) arasındaki ilişki incelenmiş olsa da özellikle postür alışkanlığı ve farkındalığı kas-iskelet sistemi parametreleriyle birlikte değerlendirilmemiştir. Bu sebeple bu çalışmada, TMBli bireylerde BÖPe göre postüral alışkanlık ve farkındalık düzeyi, basınç ağrı eşiği, propriyosepsiyon ve fonksiyonelliğin araştırılması amaçlamıştır. Yöntemler: Çalışmaya 50 miyojenik TMBli birey katıldı. BÖP değerlendirmesi amacıyla Kraniyovertebral açı (KVA) ölçümü gerçekleştirildi. Postüral alışkanlık ve farkındalık düzeyi, Postüral Alışkanlık ve Farkındalık Ölçeği (PAFÖ) ile değerlendirildi. Basınç-ağrı düzeyi algometreyle, propriyosepsiyon Lazer İmleç Yardımlı Açı Tekrarlama Testi (LİYATT) ile değerlendirildi. Çene fonksiyonelliği ölçümünde Helkimo Klinik Disfonksiyon İndeksi (HKDİ) ve Mandibular Fonksiyon Bozukluğu Anketi (MFBA) kullanıldı. Klinik anlamlılık düzeyini güçlendirmek adına birinci çeyrekte (n=12) ve dördüncü çeyrekteki (n=12) olguların verileri analiz edildi. Bulgular: BÖP ve kontrol grubu arasında PAFÖ skorları açısından anlamlı bir fark gözlenmedi (p>,05). BÖP grubunda basınç ağrı eşiği; m. temporalis ve m. trapezius, lateral ve dorsal kapsülde daha yüksekti (p<,05), fleksiyon ve ekstansiyon yönlerinde LİYATT testi değerleri daha düşüktü (p<,05) ve HKDİ ve MFBA skorları daha düşüktü (p<,05). Sonuç: Gruplar arasında postür alışkanlığı ve farkındalığı açısından fark saptanmazken, BÖP grubunda m. temporalis ve m. trapezius ile lateral ve dorsal kapsülde basınç ağrı eşiğinin daha yüksek, fleksiyon ve ekstansiyon yönlerindeki propriyosepsiyon duyusunun ve çene eklemi fonksiyonelliğinin daha iyi düzeyde olduğu görüldü. BÖP olan TMBli bireylerde; kas iskelet sistemi problemleri sebebiyle postüral farkındalıklar artmış, kompanse edici bir strateji geliştirilmiş veya ilgili parametrelerde daha adaptif bir seviye geliştirilmiş olabileceğini düşünmekteyiz.

Anahtar Kelimeler

• temporomandibular eklem bozuklukları
• postüral farkındalık
• propriyosepsiyon
• ağrı
• fonksiyonellik

Kaynakça

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