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Influência da hipervigilância e cinesiofobia no limiar de dor à pressão em pacientes com disfunção temporomandibular
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Advisor(s)
Abstract(s)
Objetivos: Avaliar a influência da hipervigilância e cinesiofobia no limiar de dor à pressão (LDP) e movimentos mandibulares em pacientes com Disfunção Temporomandibular (DTM). Materiais e Métodos: Incluíram-se 225 indivíduos em dois grupos: grupo DTM (133) e grupo controlo (92). Foram aplicados os seguintes instrumentos validados: Critério Diagnóstico para Desordens Temporomandibulares (DC/TMD), Questionário de Vigilância e Conscientização da Dor (PVQA), e Escala de Cinesiofobia para Disfunção Temporomandibular (TSK/TMD). O LDP foi medido com um dinamómetro analógico nos músculos temporal e masseter e na articulação temporomandibular (ATM). Os movimentos mandibulares foram avaliados com uma régua milimétrica, específica para estas medições. Os dados foram analisados utilizando análise descritiva e o teste de U-Mann Whitney com nível de significância de 5%. Resultados: Foi encontrada uma maior prevalência de mulheres no grupo de DTM (p<0,05). O grupo DTM apresentou maiores valores de cinesiofobia e hipervigilância, e menores valores de LDP na ATM e nos músculos temporal e masseter (p<0,05). Não foram encontradas diferenças significativas só na avaliação da lateralidade (p>0,05). No subgrupo DTM dolorosa, o LDP foi significativamente menor no masseter e ATM, assim como os movimentos de abertura bucal e protrusão (p<0,05). Houve uma correlação positiva e significante entre hipervigilância e cinesiofobia (p<0,05). Houve também uma associação significativa entre os níveis de hipervigilância e cinesiofobia com a amplitude dos movimentos mandibulares (p<0,05) Conclusão: A hipervigilância e a cinesiofobia influenciaram de forma inversamente proporcional o LDP em pacientes com DTM, assim como na diminuição da amplitude dos movimentos mandibulares.
Objectives: To evaluate the influence of hypervigilance and kinesiophobia on pressure pain threshold (PPT) and mandibular movements in patients with Temporomandibular Disorder (TMD). Materials and Methods: A total of 225 participants were divided into two groups: TMD group (133) and control group (92). The following validated instruments were applied: Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), Pain Vigilance and Awareness Questionnaire (PVAQ), and Tampa Scale for Kinesiophobia/Temporomandibular Joint Dysfunction (TSK/TMD). PPT was measured using an analog dynamometer on the temporal and masseter muscles and the temporomandibular joint (TMJ). Mandibular movements were assessed with a millimeter ruler specific for these measurements. Data were analyzed using descriptive analysis and the Mann-Whitney U test with a significance level of 5%. Results: There was a higher prevalence of women in the TMD group (p<0.05). The TMD group exhibited higher values of kinesiophobia and hypervigilance, and lower PPT values in the TMJ and the temporal and masseter muscles (p<0.05). No significant differences were found in the evaluation of lateral movements (p>0.05). In the painful TMD subgroup, PPT was significantly lower in the masseter and TMJ, as well as in mouth opening and protrusion movements (p<0.05). A significant positive correlation was found between hypervigilance and kinesiophobia (p<0.05). There was also a significant association between levels of hypervigilance and kinesiophobia with the range of mandibular movements (p<0.05). Conclusion: Hypervigilance and kinesiophobia inversely influenced PPT in patients with TMD, as well as decreased the range of mandibular movements.
Objectives: To evaluate the influence of hypervigilance and kinesiophobia on pressure pain threshold (PPT) and mandibular movements in patients with Temporomandibular Disorder (TMD). Materials and Methods: A total of 225 participants were divided into two groups: TMD group (133) and control group (92). The following validated instruments were applied: Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), Pain Vigilance and Awareness Questionnaire (PVAQ), and Tampa Scale for Kinesiophobia/Temporomandibular Joint Dysfunction (TSK/TMD). PPT was measured using an analog dynamometer on the temporal and masseter muscles and the temporomandibular joint (TMJ). Mandibular movements were assessed with a millimeter ruler specific for these measurements. Data were analyzed using descriptive analysis and the Mann-Whitney U test with a significance level of 5%. Results: There was a higher prevalence of women in the TMD group (p<0.05). The TMD group exhibited higher values of kinesiophobia and hypervigilance, and lower PPT values in the TMJ and the temporal and masseter muscles (p<0.05). No significant differences were found in the evaluation of lateral movements (p>0.05). In the painful TMD subgroup, PPT was significantly lower in the masseter and TMJ, as well as in mouth opening and protrusion movements (p<0.05). A significant positive correlation was found between hypervigilance and kinesiophobia (p<0.05). There was also a significant association between levels of hypervigilance and kinesiophobia with the range of mandibular movements (p<0.05). Conclusion: Hypervigilance and kinesiophobia inversely influenced PPT in patients with TMD, as well as decreased the range of mandibular movements.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Limiar de dor à pressão Disfunção temporomandibular Fatores psicossociais