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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.
Methods: Systematic review of randomized controlled trials (RCT). Searches were conducted in five electronic databases. Studies were selected if they included patients with NP over 18 years old treated with aerobic exercise (AE) (e.g., cycling, running, hiking, and walking). The main outcome of interest was pain intensity. Qualitative and quantitative data were extracted. The risk of bias (RoB) was determined using the Cochrane RoB Tool-2 and the overall certainty of the evidence with the GRADE recommendations.
Results: Out of 21,585 initial records screened, a total of six individual studies published in ten manuscripts were included. There was a great heterogeneity between protocols, comparisons, and studies’ results (different magnitudes and directions). When looking at the effect of aerobic exercise versus control groups or other interventions on pain intensity measured with the VAS, not statistically (nor clinical) significant differences between aerobic exercise and control groups (MD [95%CI] 5.16 mm [-6.38, 16.70]) were identified. The combined effect of AE plus other interventions seems to be effective. Strength exercise obtained better effects than aerobic exercises (MD [95%CI]: -11.34 mm [-21.6, -1.09]).
Conclusions: Aerobic exercise presented positive results to reduce pain intensity, and improving disability, and physical and emotional functioning. However, the evidence is restricted, low quality, and heterogeneous.