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

Completed

• Conditions: Temporomandibular Disorder; Nonspecific Chronic Neck Pain; Biomechanical Phenomena
• Interventions: Other: Cervical range of motion (CROM); Other: Pressure pain threshold (PPT); Other: Cranial-cervical angle (CCA); Other: Jaw kinematics; Other: Muscle activation

• Registration Number: NCT04041271
• Lead Sponsor: National Yang Ming Chiao Tung University

Brief Summary

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.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2019-07-28
• Study First Submitted QC: 2019-07-31
• Study First Posted: 2019-08-01
• Study Start: 2019-10-11
• Primary Completion: 2020-08-30
• Study Completion: 2020-08-30
• Status Verified: 2020-09
• Last Update Submitted: 2020-11-09
• Last Update Posted: 2020-11-10

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 44

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Nonspecific chronic neck pain (NCNP) group	Cervical range of motion (CROM)	Subjects with nonspecific chronic neck pain will be included to perform clinical test and assess their jaw kinematics and muscle activation.
Nonspecific chronic neck pain (NCNP) group	Cranial-cervical angle (CCA)	Subjects with nonspecific chronic neck pain will be included to perform clinical test and assess their jaw kinematics and muscle activation.
Control group	Cervical range of motion (CROM)	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.
Nonspecific chronic neck pain (NCNP) group	Pressure pain threshold (PPT)	Subjects with nonspecific chronic neck pain will be included to perform clinical test and assess their jaw kinematics and muscle activation.
Nonspecific chronic neck pain (NCNP) group	Jaw kinematics	Subjects with nonspecific chronic neck pain will be included to perform clinical test and assess their jaw kinematics and muscle activation.
Nonspecific chronic neck pain (NCNP) group	Muscle activation	Subjects with nonspecific chronic neck pain will be included to perform clinical test and assess their jaw kinematics and muscle activation.
Control group	Pressure pain threshold (PPT)	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.
Control group	Cranial-cervical angle (CCA)	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.
Control group	Jaw kinematics	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.
Control group	Muscle activation	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.

Primary Outcome Measures

Name	Time	Method
Jaw maximum range of motion	Immediately during the experiment	Including maximum mouth opening, lateral right, lateral left, and protrusion, which will be described with millimeter (mm)
Jaw velocity	Immediately during the experiment	Jaw opening and closing velocity, which will be described with millimeter per second (mm/s)
Condylar rotation	Immediately during the experiment	The rotation will be described with degree (°).
Condylar translation	Immediately during the experiment	Including condylar translation and condylar path length, which will be described with millimeter (mm)
Muscle activation	Immediately during the experiment	The root mean square of electromyography (EMG) data of the masseter, anterior temporalis, sternocleidomastoid muscle and upper trapezius will be normalized by the maximum voluntary contraction amplitude (percentage of maximal voluntary contraction, %).

Secondary Outcome Measures

Name	Time	Method
Cervical and jaw range of motion	Immediately during the experiment	Including range of motion of cervical flexion, cervical extension, cervical side-bending,cervical rotation and cervical flexion-rotation as well as maximum mouth opening, jaw lateral right, jaw lateral left, protrusion. The motion will be described with degree (°).
Pressure pain threshold	Immediately during the experiment	Pressure pain threshold of masseter, anterior temporalis, sternocleidomastoid muscle, upper trapezius and suboccipitals will each be averaged and will be described with kg/cm2.
Cranial-cervical angle	Immediately during the experiment	Cranial-cervical angle will be measured as the included angle between the ear lobe, C7 spinous process and the horizontal line and will be described with degree (°).

Trial Locations

Locations (1)

National Yang-Ming University; 🇨🇳 Taipei, Taiwan