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Sixty-one women with TMD were divided into intervention and control groups. Visual Analogue Scale (VAS), Headache Impact Test (HIT-6), pressure pain thresholds (PPTs) of masticatory muscles, Mandibular Function Impairment Questionnaire (MFIQ), and Craniocervical Flexion Test (CCFT) were collected at baseline and 5-weeks follow-up.
O objetivo esse estudo foi avaliar a eficácia da prescrição de atividade física comparadas com outros tratamentos para diminuir a intensidade da dor em indivíduos com Disfunção Temporomandibular (DTM). A revisão sistemática foi previamente registrada (PROSPERO CRD42024594589). As buscas preliminares foram realizadas em Maio de 2023 em cinco bases eletrônicas. O risco de viés foi avaliado pelo instrumento Risk of bias tool 2 do grupo Cochrane. De 2.753 estudos triadas pelos títulos e resumos, 22 foram incluídos na revisão primária (DTM, dor cervical e cefaleia). Entretanto, apenas 5 estudos (publicados entre 1999 e 2024) focaram em indivíduos com DTM, e todos envolveram a prescrição de exercícios mandibulares. Dois estudos compararam exercícios mandibulares domiciliares com recomendações de autocuidado, e a metanálise não encontrou diferenças (diferença média 0.06 IC -0.25; 0.36). Um estudo ressaltou que a combinação de exercícios domiciliares com terapia manual não foi superior a terapia manual isolada, mas superior ao grupo controle sem tratamento. Outro estudo mostrou que exercícios mandibulares supervisionados foram superiores à prescrição domiciliar. Dois estudos comparam exercícios mandibulares com uso de placa interoclusal, ressaltando efeitos similares das terapias. 80% dos estudos incluídos tiverem um alto risco de viés. Conclui-se preliminarmente que a prescrição de exercícios mandibulares tem efeito coadjuvante quando comparado a terapia manual, exercícios supervisionados ou uso de placa interoclusal.
Purpose
Sedentary behaviour (SED) and low level of physical activity (PA) might be associated with the development or worsening of pain. Still, studies assessing physical behaviours by accelerometry in individuals with orofacial pain are limited. This study aims to assess whether women with temporomandibular disorders (TMD) present different patterns of physical behaviours in days with (DWP) or without pain (DWoP).
Methods
Twenty-nine out of forty-four women (mean age 29.21 sd 7.96) were diagnosed with TMD and monitored over seven days using a thigh-worn accelerometer. DWP was determined when subjects presented pain in one of the craniocervical regions (head, jaw and neck) with intensity of at least 3 in the numerical rating scale. To be considered a DWoP, the individual presented less than 3 points in the three regions. Daily time-use compositions were described in terms of SED in short (<30 min) and long (≥30 min) bouts, light PA (LPA), moderate-to-vigorous PA (MVPA), and time-in-bed. Isometric log-ratios (ilr) were calculated to express the ratio of time-in-bed to time spent awake, SED relative to LPA and MVPA, SED in short relative to long bouts, and LPA relative to MVPA. Differences between DWP and DWoP were examined using MANOVA, followed by univariate post-hoc tests of pairwise differences.
Results
During DWP, women with TMD spent more time in SED in short (239 min) and long bouts (419 min), less time in LPA (245 min), MVPA (68 min), and in bed (468 min) compared with DWoP (235, 378, 263, 70 and 493 min, respectively). The MANOVA showed that all sets of ilrs did not differ statistically (ηp2 = 0.19, p = 0.25). Still, the post-hoc tests showed a trend that time spent SED relative to LPA and MVPA was larger in DWP than in DWoP (Cohen’s d = 0.36, p = 0.05).
Conclusions
Women with TMD did not show different patterns of physical behaviours in DWP or DWoP. However, there is a trend of more sedentary behaviour and less physical activity in DWP compared to DWoP. Future studies should consider other pain intensity cut-offs, isolated pain locations, and larger sample sizes to confirm these results.