Journal of back and musculoskeletal rehabilitation, 1996
The interexaminer reliability of six orthopedic tests, applied to the masticatory system, was det... more The interexaminer reliability of six orthopedic tests, applied to the masticatory system, was determined in a group of 79 patients with signs and/or symptoms of TMD. Multitest Scores were composed for each test and combinations of tests for the three main symptoms of TMD, namely, pain, joint sounds, and restriction of movement. Although the tests showed different reliability scores, the reliability of detecting these three main symptoms of TMD was satisfactory. All the tests contributed to the diagnostic process, with active movements being the most powerful test. The combination of active movements, passive movements, and palpation provided valuable diagnostic information. Other tests could be used for specific diagnostic problems. The scores of the orthopedic tests applied to the neck show that extension and flexion can be evaluated most reliably with active movements and by assessing end feel. The interexaminer agreement for recording pain was also satisfactory for flexion and ex...
Background: Sleep bruxism is a phenomenon associated with masticatory muscle hyperactivity. While... more Background: Sleep bruxism is a phenomenon associated with masticatory muscle hyperactivity. While stretching of limb and trunk muscles has been extensively studied for musculoskeletal disorders, little is known about the effectiveness of stretching of masticatory muscles in the management of bruxism. Objective: The aim of this study is to determine the effectiveness of stretching of the masticatory muscles for sleep bruxism. A cc ep te d A rt ic le This article is protected by copyright. All rights reserved. Methods: 24 pain-free individuals with sleep bruxism were randomly assigned to either an intervention group or a control group. Both groups were given sleep hygiene advice and the intervention group additionally received muscle-stretching exercises for 10 days. Primary outcome measures, bruxism bursts and episodes per hour of sleep, were measured by ambulant polysomnography. Secondary outcome measures were among others pain-free active maximum mouth opening (MMO) and masseter pr...
Journal of oral and facial pain and headache, 2009
The authors would like to thank Drs Goulet, Greene, and Svensson for their valuable comments on o... more The authors would like to thank Drs Goulet, Greene, and Svensson for their valuable comments on our Focus Article4 "Validity of the research diagnostic criteria for temporomandibular disorders Axis I in clinical and research settings." Because the Critical Commentaries in general are very supportive of the thoughts and suggestions brought forward in the Focus Article, we would like to add some comments on their use in children and adolescents in addition to our response to the Commentaries.
BACKGROUND Sleep bruxism is a phenomenon associated with masticatory muscle hyperactivity. While ... more BACKGROUND Sleep bruxism is a phenomenon associated with masticatory muscle hyperactivity. While stretching of limb and trunk muscles has been extensively studied for musculoskeletal disorders, little is known about the effectiveness of stretching of masticatory muscles in the management of bruxism. OBJECTIVE The aim of this study is to determine the effectiveness of stretching of the masticatory muscles for sleep bruxism. METHODS Twenty four pain-free individuals with sleep bruxism were randomly assigned to either an intervention group or a control group. Both groups were given sleep hygiene advice and the intervention group additionally received muscle-stretching exercises for 10Â days. Primary outcome measures, bruxism bursts and episodes per hour of sleep, were measured by ambulant polysomnography. Secondary outcome measures were among others pain-free active maximum mouth opening (MMO) and masseter pressure pain threshold (PPT). RESULTS The number of bruxism episodes per hour of sleep increased more in the intervention group than in the control group (by 1.1 episodes, PÂ =Â 0.066), as did the number of bruxism bursts per hour of sleep (by 8.6 bursts, PÂ =Â 0.049). MMO and PPT increased significantly more in the intervention group (by 3.2Â mm, PÂ =Â 0.020; and by 1.0Â kg/cm2 , PÂ =Â 0.036, respectively). CONCLUSION Static stretching of the masticatory muscles resulted in a minor increase in sleep bruxism episodes (not significant) and bursts (significant). It also led to a significant increase in MMO and PPT. Therefore, masticatory muscle stretching was not effective in reducing sleep bruxism in the absence of pain and/or dysfunction.
The recently published Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I, which... more The recently published Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I, which is recommended for use in clinical and research settings, has provided an update of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The authors of the DC/TMD based their publication on the results of a Validation Project (2001-2008) and consecutive workgroup sessions held between 2008 and 2013. The DC/TMD represents a major change in both content and procedures; nonetheless, earlier concerns and new insights have only partly been followed up when drafting the new recommendations. Moreover, the emphasis on immediate implementation in clinical and research settings is not in line with the provided external evidence on which the DC/TMD is based. This Focus Article describes these concerns with regard to several aspects of the DC/TMD: the additional classification categories; the high dependency on pressure-pain results from use of the recommended palpation techn...
This study was performed to assess the prevalence of signs and symptoms of temporomandibular diso... more This study was performed to assess the prevalence of signs and symptoms of temporomandibular disorders (TMD) in patients with cervical spine disorders (CSD) and to compare patients with CSD and subgroups of patients with TMD with regard to the results of orthopaedic tests of the stomatognathic system. A group of 103 consecutive patients with signs and symptoms of CSD and a group of 111 consecutive patients with TMD were examined. All subgroups of TMD patients showed a significantly smaller range of motion than the CSD patients. Patients with TMD had limited mouth opening (< 40 mm) on active and passive mouth opening more often than CSD patients. TMD patients with myogenous problems reported oral habits more often than CSD patients, although no objective differences between CSD and TMD patients were found. Subgroups of TMD patients reported joint sounds, and pain on palpation and joint play tests of the temporomandibular joint (TMJ) more frequently than CSD patients. Joint sounds on active movements, pain on palpation of the TMJ, and pain on joint play tests correctly classified 82% of the patients with TMD and 72% of the patients with CSD. In spite of the biomechanical and anatomical relationship between the neck and the stomatognathic system, the results of the study show that CSD patients have signs and symptoms of TMD comparable with those of the adult Dutch population. It was concluded that the function of the masticatory system should be evaluated in patients with neck complaints in order to rule out a possible involvement of the masticatory system.
Journal of Orthopaedic & Sports Physical Therapy, 2016
Study Design Prospective cohort. Background The popularity of running events is still growing, pa... more Study Design Prospective cohort. Background The popularity of running events is still growing, particularly among women; however, little is known about the risk factors for running-related injuries in female runners. Objectives The aims of this study were to determine the incidence and characteristics (site and recurrence) of running-related injuries and to identify specific risk factors for running-related injuries among female runners training for a 5- or 10-km race. Methods Four hundred thirty-five women registered for the Marikenloop run of 5 or 10 km were recruited. Follow-up data were collected over 12 weeks using questionnaires, starting 8 weeks before the event and ending 4 weeks after the event. Two orthopaedic tests (navicular drop test and extension of the first metatarsophalangeal joint) were performed in the 8 weeks before the event. Running-related injuries, defined as running-related pain of the lower back and/or the lower extremity that restricted running for at least 1 day, were assessed at 1-, 2-, and 3-month follow-ups. Results Of 417 female runners with follow-up data (96%), 93 runners (22.3%) reported 109 running-related injuries, mainly of the hip/groin, knee, and lower leg. Multivariable Cox regression analysis showed that a weekly training distance of more than 30 km (hazard ratio = 3.28; 95% confidence interval [CI]: 1.23, 8.75) and a previous running injury longer than 12 months prior (hazard ratio = 1.88; 95% CI: 1.03, 3.45) were associated with the occurrence of running-related injuries. Conclusion Hip/groin, knee, and lower-leg injuries were common among female runners. Only weekly training distance (greater than 30 km) and previous running injury (greater than 12 months prior) were associated with running-related injuries in female runners training for a 5- or 10-km event. Level of Evidence Etiology, 2b. J Orthop Sports Phys Ther 2016;46(6):462-470. Epub 26 Apr 2016. doi:10.2519/jospt.2016.6402.
The authors assessed the results of an anamnestic self-administered questionnaire given to 111 pa... more The authors assessed the results of an anamnestic self-administered questionnaire given to 111 patients with temporomandibular disorders and 103 patients with cervical spine disorders. The present study was performed to investigate whether patients with cervical spine disorders and subgroups of patients with temporomandibular disorders differ regarding specific and accompanying signs and symptoms of temporomandibular disorders and cervical spine disorders. Patients with temporomandibular disorders frequently show signs and symptoms related to cervical spine disorders, and, vice versa, patients with cervical spine disorders may show signs and symptoms related to temporomandibular disorders. Many authors have pointed out the existence of neuroanatomical and biomechanical relationships. The questionnaire included questions about pain, symptoms of temporomandibular disorders, accompanying signs and symptoms, psychosocial factors, and general health. Before their clinical examination, all patients were requested by mail to complete the questionnaire. Patients with cervical spine disorders reported fewer symptoms of temporomandibular disorders than the subgroups of patients with temporomandibular disorders, more general health symptoms than patients with temporomandibular disorders with an arthrogenous or myogenous component, and fewer ear symptoms than patients with temporomandibular disorders. There was no difference between the patient groups regarding other associated signs and symptoms and psychosocial factors as measured with the questionnaire. Logistic regression analyses showed that six variables (jaws, ears, eyes, temporomandibular joint sounds, complaints of the shoulders, and pain in joints other than the temporomandibular joint) correctly classified 91% of the patients as having temporomandibular disorders or cervical spine disorders. The results of this study do not support the theoretical concept that cervical spine disorders may give rise to temporomandibular disorders. The authors' results indicate that the anamnestic questionnaire can be used as an aid to distinguish patients with cervical spine disorders from subgroups of patients with temporomandibular disorders.
Journal of back and musculoskeletal rehabilitation, 1996
The interexaminer reliability of six orthopedic tests, applied to the masticatory system, was det... more The interexaminer reliability of six orthopedic tests, applied to the masticatory system, was determined in a group of 79 patients with signs and/or symptoms of TMD. Multitest Scores were composed for each test and combinations of tests for the three main symptoms of TMD, namely, pain, joint sounds, and restriction of movement. Although the tests showed different reliability scores, the reliability of detecting these three main symptoms of TMD was satisfactory. All the tests contributed to the diagnostic process, with active movements being the most powerful test. The combination of active movements, passive movements, and palpation provided valuable diagnostic information. Other tests could be used for specific diagnostic problems. The scores of the orthopedic tests applied to the neck show that extension and flexion can be evaluated most reliably with active movements and by assessing end feel. The interexaminer agreement for recording pain was also satisfactory for flexion and ex...
Background: Sleep bruxism is a phenomenon associated with masticatory muscle hyperactivity. While... more Background: Sleep bruxism is a phenomenon associated with masticatory muscle hyperactivity. While stretching of limb and trunk muscles has been extensively studied for musculoskeletal disorders, little is known about the effectiveness of stretching of masticatory muscles in the management of bruxism. Objective: The aim of this study is to determine the effectiveness of stretching of the masticatory muscles for sleep bruxism. A cc ep te d A rt ic le This article is protected by copyright. All rights reserved. Methods: 24 pain-free individuals with sleep bruxism were randomly assigned to either an intervention group or a control group. Both groups were given sleep hygiene advice and the intervention group additionally received muscle-stretching exercises for 10 days. Primary outcome measures, bruxism bursts and episodes per hour of sleep, were measured by ambulant polysomnography. Secondary outcome measures were among others pain-free active maximum mouth opening (MMO) and masseter pr...
Journal of oral and facial pain and headache, 2009
The authors would like to thank Drs Goulet, Greene, and Svensson for their valuable comments on o... more The authors would like to thank Drs Goulet, Greene, and Svensson for their valuable comments on our Focus Article4 "Validity of the research diagnostic criteria for temporomandibular disorders Axis I in clinical and research settings." Because the Critical Commentaries in general are very supportive of the thoughts and suggestions brought forward in the Focus Article, we would like to add some comments on their use in children and adolescents in addition to our response to the Commentaries.
BACKGROUND Sleep bruxism is a phenomenon associated with masticatory muscle hyperactivity. While ... more BACKGROUND Sleep bruxism is a phenomenon associated with masticatory muscle hyperactivity. While stretching of limb and trunk muscles has been extensively studied for musculoskeletal disorders, little is known about the effectiveness of stretching of masticatory muscles in the management of bruxism. OBJECTIVE The aim of this study is to determine the effectiveness of stretching of the masticatory muscles for sleep bruxism. METHODS Twenty four pain-free individuals with sleep bruxism were randomly assigned to either an intervention group or a control group. Both groups were given sleep hygiene advice and the intervention group additionally received muscle-stretching exercises for 10Â days. Primary outcome measures, bruxism bursts and episodes per hour of sleep, were measured by ambulant polysomnography. Secondary outcome measures were among others pain-free active maximum mouth opening (MMO) and masseter pressure pain threshold (PPT). RESULTS The number of bruxism episodes per hour of sleep increased more in the intervention group than in the control group (by 1.1 episodes, PÂ =Â 0.066), as did the number of bruxism bursts per hour of sleep (by 8.6 bursts, PÂ =Â 0.049). MMO and PPT increased significantly more in the intervention group (by 3.2Â mm, PÂ =Â 0.020; and by 1.0Â kg/cm2 , PÂ =Â 0.036, respectively). CONCLUSION Static stretching of the masticatory muscles resulted in a minor increase in sleep bruxism episodes (not significant) and bursts (significant). It also led to a significant increase in MMO and PPT. Therefore, masticatory muscle stretching was not effective in reducing sleep bruxism in the absence of pain and/or dysfunction.
The recently published Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I, which... more The recently published Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I, which is recommended for use in clinical and research settings, has provided an update of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The authors of the DC/TMD based their publication on the results of a Validation Project (2001-2008) and consecutive workgroup sessions held between 2008 and 2013. The DC/TMD represents a major change in both content and procedures; nonetheless, earlier concerns and new insights have only partly been followed up when drafting the new recommendations. Moreover, the emphasis on immediate implementation in clinical and research settings is not in line with the provided external evidence on which the DC/TMD is based. This Focus Article describes these concerns with regard to several aspects of the DC/TMD: the additional classification categories; the high dependency on pressure-pain results from use of the recommended palpation techn...
This study was performed to assess the prevalence of signs and symptoms of temporomandibular diso... more This study was performed to assess the prevalence of signs and symptoms of temporomandibular disorders (TMD) in patients with cervical spine disorders (CSD) and to compare patients with CSD and subgroups of patients with TMD with regard to the results of orthopaedic tests of the stomatognathic system. A group of 103 consecutive patients with signs and symptoms of CSD and a group of 111 consecutive patients with TMD were examined. All subgroups of TMD patients showed a significantly smaller range of motion than the CSD patients. Patients with TMD had limited mouth opening (< 40 mm) on active and passive mouth opening more often than CSD patients. TMD patients with myogenous problems reported oral habits more often than CSD patients, although no objective differences between CSD and TMD patients were found. Subgroups of TMD patients reported joint sounds, and pain on palpation and joint play tests of the temporomandibular joint (TMJ) more frequently than CSD patients. Joint sounds on active movements, pain on palpation of the TMJ, and pain on joint play tests correctly classified 82% of the patients with TMD and 72% of the patients with CSD. In spite of the biomechanical and anatomical relationship between the neck and the stomatognathic system, the results of the study show that CSD patients have signs and symptoms of TMD comparable with those of the adult Dutch population. It was concluded that the function of the masticatory system should be evaluated in patients with neck complaints in order to rule out a possible involvement of the masticatory system.
Journal of Orthopaedic & Sports Physical Therapy, 2016
Study Design Prospective cohort. Background The popularity of running events is still growing, pa... more Study Design Prospective cohort. Background The popularity of running events is still growing, particularly among women; however, little is known about the risk factors for running-related injuries in female runners. Objectives The aims of this study were to determine the incidence and characteristics (site and recurrence) of running-related injuries and to identify specific risk factors for running-related injuries among female runners training for a 5- or 10-km race. Methods Four hundred thirty-five women registered for the Marikenloop run of 5 or 10 km were recruited. Follow-up data were collected over 12 weeks using questionnaires, starting 8 weeks before the event and ending 4 weeks after the event. Two orthopaedic tests (navicular drop test and extension of the first metatarsophalangeal joint) were performed in the 8 weeks before the event. Running-related injuries, defined as running-related pain of the lower back and/or the lower extremity that restricted running for at least 1 day, were assessed at 1-, 2-, and 3-month follow-ups. Results Of 417 female runners with follow-up data (96%), 93 runners (22.3%) reported 109 running-related injuries, mainly of the hip/groin, knee, and lower leg. Multivariable Cox regression analysis showed that a weekly training distance of more than 30 km (hazard ratio = 3.28; 95% confidence interval [CI]: 1.23, 8.75) and a previous running injury longer than 12 months prior (hazard ratio = 1.88; 95% CI: 1.03, 3.45) were associated with the occurrence of running-related injuries. Conclusion Hip/groin, knee, and lower-leg injuries were common among female runners. Only weekly training distance (greater than 30 km) and previous running injury (greater than 12 months prior) were associated with running-related injuries in female runners training for a 5- or 10-km event. Level of Evidence Etiology, 2b. J Orthop Sports Phys Ther 2016;46(6):462-470. Epub 26 Apr 2016. doi:10.2519/jospt.2016.6402.
The authors assessed the results of an anamnestic self-administered questionnaire given to 111 pa... more The authors assessed the results of an anamnestic self-administered questionnaire given to 111 patients with temporomandibular disorders and 103 patients with cervical spine disorders. The present study was performed to investigate whether patients with cervical spine disorders and subgroups of patients with temporomandibular disorders differ regarding specific and accompanying signs and symptoms of temporomandibular disorders and cervical spine disorders. Patients with temporomandibular disorders frequently show signs and symptoms related to cervical spine disorders, and, vice versa, patients with cervical spine disorders may show signs and symptoms related to temporomandibular disorders. Many authors have pointed out the existence of neuroanatomical and biomechanical relationships. The questionnaire included questions about pain, symptoms of temporomandibular disorders, accompanying signs and symptoms, psychosocial factors, and general health. Before their clinical examination, all patients were requested by mail to complete the questionnaire. Patients with cervical spine disorders reported fewer symptoms of temporomandibular disorders than the subgroups of patients with temporomandibular disorders, more general health symptoms than patients with temporomandibular disorders with an arthrogenous or myogenous component, and fewer ear symptoms than patients with temporomandibular disorders. There was no difference between the patient groups regarding other associated signs and symptoms and psychosocial factors as measured with the questionnaire. Logistic regression analyses showed that six variables (jaws, ears, eyes, temporomandibular joint sounds, complaints of the shoulders, and pain in joints other than the temporomandibular joint) correctly classified 91% of the patients as having temporomandibular disorders or cervical spine disorders. The results of this study do not support the theoretical concept that cervical spine disorders may give rise to temporomandibular disorders. The authors' results indicate that the anamnestic questionnaire can be used as an aid to distinguish patients with cervical spine disorders from subgroups of patients with temporomandibular disorders.
Uploads