Percorrer por autor "Moleirinho-Alves, Paula Manuela Mendes"
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- Effects of therapeutic and aerobic exercise programs in temporomandibular disorder-associated headachesPublication . Moleirinho-Alves, Paula Manuela Mendes; Almeida, André Mariz Coelho Santos de; Cebola, Pedro Miguel Teixeira Carvas; Oliveira, Raul Alexandre Nunes da Silva; Pezarat-Correia, Pedro Luís Camecelha deObjective: To assess the effects of three 8-week exercise programs on the frequency, intensity, and impact of headaches in patients with headache attributed to temporomandibular disorder (TMD). Methodology: Thirty-six patients diagnosed with headache attributed to TMD participated in the study and were divided into three groups of 12 patients: a therapeutic exercise program (G1, mean age: 26.3±5.6 years), a therapeutic and aerobic exercise program (G2, mean age: 26.0±4.6 years), and an aerobic exercise program (G3, 25.8±2.94 years). Headache frequency and intensity were evaluated using a headache diary, and the adverse headache impact was evaluated using the Headache Impact Test (HIT-6). The intensity was reported using the numerical pain rating scale. These parameters were evaluated twice at baseline (A01/A02), at the end of the 8-week intervention period (A1), and 8–12 weeks after the end of the intervention (A2). Results: At A1, none of the G2 patients reported having headaches, in G1, only two patients reported headaches, and in G3, ten patients reported headache. The headache intensity scores (0.3 [95% CI: -0.401, 1.068]), (0.0 [95% CI: -0.734, 0.734]) and HIT-6 (50.7 [95% CI: 38.008, 63.459]), (49.5 [95% CI: 36.808, 62.259]), significantly decreased in G1 and G2 at A1. At A2 headache intensity scores (0.5 [95% CI: -0.256, 1.256]), (0.0 [95% CI: -0.756, 0.756]) and HIT-6 (55.1 [95% CI: 42.998, 67.268]), (51.7 [95% CI: 39.532, 63.802]) in G1 and G2 haven’t change significantly. The effects obtained immediately after the completion of the intervention programs were maintained until the final follow-up in all groups. Conclusion: The programs conducted by G1 (therapeutic exercises) and G2 (therapeutic and aerobic exercise) had significant results at A1 and A2.
- Effects of therapeutic and aerobic exercise programs on pain, neuromuscular activation, and bite force in patients with temporomandibular disordersPublication . Moleirinho-Alves, Paula Manuela Mendes; Cebola, Pedro Miguel Teixeira Cravas; Santos, Paulo Duarte Guia dos; Correia, João Pedro; Godinho, Catarina; Oliveira, Raul Alexandre Nunes da Silva; Pezarat-Correia, Pedro Luís CemacelhaPain in masticatory muscles is one of the most frequent symptoms in patients with temporomandibular disorders (TMD) and can lead to changes in the patterns of neuromuscular activity of masticatory muscles and decrease in bite force. This study assesses the effects of three eight-week exercise programs on pain intensity, neuromuscular activation, and bite force of masticatory muscles in patients with TMD. Forty-five patients were divided into three groups: a therapeutic exercise program (G1), a therapeutic and aerobic exercise program (G2), and an aerobic exercise program (G3). The masticatory muscles’ pain was evaluated using the numeric pain rating scale (NPRS), surface electromyographic (sEMG) activity of the masseter was recorded during maximum voluntary contraction and at rest, and bite force was evaluated using a dynamometer. These parameters were evaluated twice at baseline (A01/A02), at the end of the eight-week intervention period (A1), and 8–12 weeks after the end of the intervention (A2). After intervention, G2 showed the best results, with a significantly decrease in masticatory muscles’ pain and increase in bite force. These results suggest that interventions to reduce pain in patients with TMD should be multimodal.
- Prevalence and interplay of hypervigilance and kinesiophobia in TMD patients : implications in clinical outcomesPublication . Cebola, Pedro Miguel Teixeira Carvas; Lourenço, André Schneider; Hoppe, Alexandre Mangabeira; Colombo, Livia Mourão Pereira Costa; Proença, Leilane Samary de; Moleirinho-Alves, Paula Manuela Mendes; Christidis, Nikolaos; Poluha, Rodrigo Lorenzi; Canales, Giancarlo De la TorreBackground: Behavioural cognitive factors, like kinesiophobia and coping skills like hypervigilance, may contribute to a worse prognosis of TMD symptoms. However, there is a lack of evidence about the prevalence and relationship of hypervigilance and kinesiophobia with TMD. Objective: This study aimed to assess the prevalence and associations of hypervigilance and kinesiophobia in TMD. Methods: The sample consisted of 233 participants, divided into the TMD group (133) and a control group (100). The following instruments were used: diagnostic criteria for temporomandibular disorders (DC/TMD), Pain Vigilance and Awareness Questionnaire (PVAQ), and Tampa Scale for kinesiophobia/temporomandibular joint dysfunction (TSK/TMD). Pain pressure threshold (PPT) was measured on the masticatory muscles and the temporomandibular joint. Mandibular movements were assessed with a millimetre ruler. Mann–Whitney U test was used for group comparisons and Spearman's correlation test for association analyses. Results: The TMD-group showed higher hypervigilance and kinesiophobia values,and lower PPT and mandibular movement (opening and protrusion) values compared with controls (p < 0.05). Also, a positive moderate correlation between hypervigilance and kinesiophobia (p = 0.000001), a significant negative correlation between hypervigilance and PPT (p = 0.00001) and a significant negative correlation between hypervigilance, kinesiophobia and mandibular movements (p < 0.05) in the TMD-group were found. A positive weak correlation was found just between hypervigilance and kinesiophobia in the control group (p = 0.01). Conclusion: TMD patients present high levels of kinesiophobia and hypervigilance, which in turn are correlated and affect TMD symptoms.