Percorrer por autor "Moreira, Marion"
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- Evolving dynamics of neck muscle activation patterns in dental students : a longitudinal studyPublication . Almeida, Manuel Barbosa de; Moreira, Marion; Miranda-Oliveira, Paulo; Moreira, José; Família, Carlos; Vaz, João R.; Moleirinho-Alves, Paula; Oliveira, RaúlCervical pain has been linked to increased motor unit activity, potentially associated with the initiation and progression of chronic neck pain. Therefore, this study aimed to compare the time-course changes in cervical superficial muscle activation patterns among dental students with and without neck pain throughout their initial semester of clinical training. We used an online Nordic Musculoskeletal Questionnaire for group allocation between neck pain (NP) (n = 21) and control group (CG) (n = 23). Surface electromyography (sEMG) of the sternocleidomastoid and upper bilateral trapezius was recorded before starting their clinical practice and after their first semester while performing a cranio-cervical flexion test (CCFT) in five increasing levels between 22 mmHg and 30 mmHg. After the first semester, both the CG (p < 0.001) and NP (p = 0.038) groups showed decreased sternocleidomastoid activation. The NP group exhibited a concomitant increase in upper trapezius coactivation (p < 0.001), whereas the muscle activation pattern in asymptomatic students remained unchanged (p = 0.980). During the first semester of clinical training, dental students exhibited decreased superficial flexor activity, but those with neck pain had increased co-contraction of the upper trapezius, likely to stabilize the painful segment. This altered activation pattern could be associated with further dysfunction and symptoms, potentially contributing to chronicity.
- Neck pain in dental education : a cross-sectional analysis of neck strength differencesPublication . Almeida, Manuel B.; Moreira, Marion; Moleirinho-Alves, Paula; Oliveira, RaúlThis study aimed to investigate if there are differences in neck strength between dental students in their fourth and fifth years, with and without neck pain. Neck muscle strength was assessed in flexion, extension, and lateral flexion to both sides using a handheld dynamometer while participants performed maximum voluntary isometric contractions with a make test procedure. Differences between groups were evaluated through a one-way analysis of variance followed by Tukey’s post hoc comparison. Forty-three students (twenty-one fourth-year and twenty-two fifth-year students) participated in the study. Fifth-year students with neck pain (P5) (n = 14) showed less strength (p = 0.018) compared to the no-pain group (NP) (n = 15) in neck flexion and lateral flexion for both sides (p < 0.001). The fourth-year symptomatic students (P4) (n = 14) showed reduced right lateral flexion strength compared to the NP group (p = 0.035). No significant differences were observed in neck extension across all groups (p = 0.085). Our research indicates a progressive decline in neck muscle strength in flexion and lateral flexion among students with neck pain over their training years. Our findings suggest that this may be linked to the increasing mechanical demands of clinical practice during training, potentially affecting muscle balance and cervical function. This pain could be associated with changes in motor behavior and reduced cervical muscle strength.
- Neck strength variations in dental students with and without neck pain : a longitudinal studyPublication . Almeida, Manuel Barbosa; Moreira, Marion; Moleirinho-Alves, Paula; Oliveira, RaúlNeck pain can induce specific motor responses and alterations in muscle strength. Therefore, this study aimed to investigate and compare the progression of cervical muscle strength within and between students with and without neck pain over the course of their first semester of clinical training. We used an online Nordic Musculoskeletal Questionnaire for group allocation, and neck strength in flexion, extension, and lateral flexion on both sides was measured using the KForce Bubble Pro hand-held dynamometer. Forty-four students were divided into neck pain (n = 21) and asymptomatic (n = 23) groups. Both groups increased neck strength by the end of the semester in flexion, extension, and left and right lateral flexion (p < 0.001). Students experiencing neck pain showed a significantly lesser degree of improvement (p = 0.036) in right lateral flexion. The agonist/antagonist ratios revealed an enhanced role of neck extensors across both groups. Dental students showed overall increased cervical strength in their first semester of clinical training. Those with neck pain exhibited a diminished rate of strength gain in right lateral flexion when compared with students without pain by the semester’s end, suggesting different neuromuscular adjustments to clinical practice in students experiencing pain, which may lead to functional impairments in later training stages.
- The time-course changes in postural control variability between neck pain and asymptomatic dental studentsPublication . Almeida, Manuel Barbosa; Moreira, Marion; Moreira, José; Vaz, João R.; Moleirinho-Alves, Paula; Oliveira, RaúlChanges in postural control associated with clinical practice or specific conditions such as the presence of neck pain remain unexplored in dental students. Therefore, this study aimed to explore the time-course changes in postural control complexity among dental students enrolled in clinical practice, comparing those with and without neck pain. We used an online Nordic Musculoskeletal Questionnaire for group allocation and center of pressure (CoP) oscillations with a tri-axial Bertec force plate. Baseline data were acquired from dental students with neck pain (NP) (n = 21) and asymptomatic in a control group (n = 23), before starting their clinical practice, and assessments were repeated after their first semester. CoP fluctuations were determined through the calculation of sample entropy. Both groups had similar postural control at baseline, but asymptomatic students exhibited more irregular CoP AP (p = 0.013) and ML (p = 0.015) oscillations, while students with neck pain showed a more rigid pattern (p = 0.004) in the AP direction at the endpoint. Our results showed that dental students’ postural control complexity decreased during the first semester of clinical practice. Over time, asymptomatic students exhibited more random postural control patterns, while students with neck pain demonstrated more rigid postural control during upright stance, indicating that postural control complexity differs between students with and without neck pain when exposed to clinical training.