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

NCT ID: NCT04041271

Last Updated: 2020-11-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

44 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-10-11

Study Completion Date

2020-08-30

Brief Summary

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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

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Conditions

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Temporomandibular Disorder Nonspecific Chronic Neck Pain Biomechanical Phenomena

Keywords

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Temporomandibular disorder Nonspecific chronic neck pain Jaw kinematics Muscle activity Muscle sensitivity Forward head

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Nonspecific chronic neck pain (NCNP) group

Subjects with nonspecific chronic neck pain will be included to perform clinical test and assess their jaw kinematics and muscle activation.

Cervical range of motion (CROM)

Intervention Type OTHER

Subjects will perform full-range cervical flexion, extension, side-bending and rotation actively in sitting position. In supine position, cervical flexion-rotation will be performed passively by the assessor.

Pressure pain threshold (PPT)

Intervention Type OTHER

A digital algometer with rubber head will be used to apply pressure on the muscles of subjects. When the subjects start to feel pain, the algometer will be removed immediately.

Cranial-cervical angle (CCA)

Intervention Type OTHER

Subjects will stand in a relaxed position with colour markers on the earlobe and C7 spinous process. A photo of the head posture will be taken to calculate the included angle between the markers and the horizontal line.

Jaw kinematics

Intervention Type OTHER

Jaw kinematics is measured by Ultrasonic Jaw Motion Analyzer (Zebris). The subjects will perform jaw opening, closing, lateral left, lateral right and protrusion for three times.

Muscle activation

Intervention Type OTHER

Surface electromyography is used to assess the activities of bilateral masseter, anterior temporalis, sternocleidomastoid muscle and upper trapezius. Subjects will perform jaw resting and clenching.

Control group

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.

Cervical range of motion (CROM)

Intervention Type OTHER

Subjects will perform full-range cervical flexion, extension, side-bending and rotation actively in sitting position. In supine position, cervical flexion-rotation will be performed passively by the assessor.

Pressure pain threshold (PPT)

Intervention Type OTHER

A digital algometer with rubber head will be used to apply pressure on the muscles of subjects. When the subjects start to feel pain, the algometer will be removed immediately.

Cranial-cervical angle (CCA)

Intervention Type OTHER

Subjects will stand in a relaxed position with colour markers on the earlobe and C7 spinous process. A photo of the head posture will be taken to calculate the included angle between the markers and the horizontal line.

Jaw kinematics

Intervention Type OTHER

Jaw kinematics is measured by Ultrasonic Jaw Motion Analyzer (Zebris). The subjects will perform jaw opening, closing, lateral left, lateral right and protrusion for three times.

Muscle activation

Intervention Type OTHER

Surface electromyography is used to assess the activities of bilateral masseter, anterior temporalis, sternocleidomastoid muscle and upper trapezius. Subjects will perform jaw resting and clenching.

Interventions

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Cervical range of motion (CROM)

Subjects will perform full-range cervical flexion, extension, side-bending and rotation actively in sitting position. In supine position, cervical flexion-rotation will be performed passively by the assessor.

Intervention Type OTHER

Pressure pain threshold (PPT)

A digital algometer with rubber head will be used to apply pressure on the muscles of subjects. When the subjects start to feel pain, the algometer will be removed immediately.

Intervention Type OTHER

Cranial-cervical angle (CCA)

Subjects will stand in a relaxed position with colour markers on the earlobe and C7 spinous process. A photo of the head posture will be taken to calculate the included angle between the markers and the horizontal line.

Intervention Type OTHER

Jaw kinematics

Jaw kinematics is measured by Ultrasonic Jaw Motion Analyzer (Zebris). The subjects will perform jaw opening, closing, lateral left, lateral right and protrusion for three times.

Intervention Type OTHER

Muscle activation

Surface electromyography is used to assess the activities of bilateral masseter, anterior temporalis, sternocleidomastoid muscle and upper trapezius. Subjects will perform jaw resting and clenching.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Aged between 20 to 65 years old
* Mechanical pain that provoked by sustained neck postures or specific neck movements without any identifiable diseases or structure anomalies
* Chronic or recurrent neck pain of at least 3 months duration
* Minimum of 3 points on the numerical pain rating scale (NPRS) over cervical region
* Without any pain, clicking or range of motion limitation over TMJ


* Age (± 5 years) and gender match to NCNP group
* No pain or clinical pathology involving the masticatory system or cervical spine for at least one year prior to the start of the study

Exclusion Criteria

* Serious injury, tumor, infection
* Recent cervical-cranial surgery
* Neurologic involvement
* Inflammatory rheumatic diseases
* Pregnancy
* Nonmechanical cause of neck pain (e.g. herniated disk, spinal fractures)
* Had been diagnosed with spinal conditions (e.g. spondylolisthesis)
* Shoulder pain within 1 years
* Loss of posterior tooth
* Dental pain or periodontal problems
* Orthodontic, orofacial myofunctional or TMD treatment within 3 months
* Use of analgesic or anti-inflammatory drugs within 3 days
Minimum Eligible Age

20 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Cheng-Hsin General Hospital

OTHER

Sponsor Role collaborator

National Yang Ming Chiao Tung University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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National Yang-Ming University

Taipei, , Taiwan

Site Status

Countries

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Taiwan

Other Identifiers

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(717)108A-33

Identifier Type: -

Identifier Source: org_study_id