Neurophysiological aspects of isotonic exercises in temporomandibular joint dysfunction syndrome
Efeito de exercícios isotônicos para redução da dor da musculatura orofacial em indivíduos com disfunção temporomandibular: aspectos neurofisiológicos
Renata de Assis Fonseca Santos Brandão, Carlos Maurício Cardeal Mendes, Tiago da Silva Lopes, Rivail Almeida Brandão Filho, Eduardo Pondé de Sena
Abstract
Purpose: The aim of the study was to investigate the electroneurophysiological aspects of volunteers with temporomandibular disorders before and after performing isotonic exercises for pain relief and self-care guidelines. Methods: The study was a parallel controlled randomized controlled trial under protocol 1,680,920. The inclusion criteria were age between 18 and 60 years, muscle temporomandibular dysfunction with or without limitation of mouth opening and self-reported pain with scores between 4 and 10. The individuals were randomized into experimental group and control. Twenty-three volunteers participated in the study, most of then were female. Control group had 11 and experimental group 12 individuals. Dropouts occurred in both groups, two in the experimental group and three in the control group. Since there were an intergroup imbalance the power density was analysed just in experimental group. Electroencephalographic recording was performed before and after the interventions, using the 32-channel apparatus, with sample frequency of 600 Hz and impedance of 5 kΩ. The data were processed through the MATLAB computer program. The individual records filtered off-line, using bandpass between 0.5 and 50 Hz. Epochs of 1,710 ms were created and the calculation of the absolute power density calculated by means of the fast Fourier transform. The statistical approach was inferential and quantitative. Results: The alpha power density analyzed presented a difference, but not significant, when compared in the two moments. Conclusion: According to this study, isotonic exercises performed to reduce pain provided a small increase in alpha power density in the left temporal, parietal and occipital regions.
Keywords
Resumo
Objetivo: O objetivo do estudo foi investigar os aspectos eletroneurofisiológicos de voluntários com disfunção temporomandibular antes e após realização de exercícios para redução de dor e orientações de autocuidado. Método: Foi realizado ensaio clínico randomizado controlado paralelo, aprovado por um Comitê de Ética. Os critérios de inclusão foram idade de 18 a 60 anos, disfunção temporomandibular muscular, com ou sem limitação de abertura de boca, e dor autorreferida com escores entre 4 e 10. Os indivíduos foram distribuídos, por sorteio, em grupo experimental ou controle. Participaram do estudo 23 voluntários,11 controles e 12 do grupo experimental sendo a maioria do sexo feminino. Desistências ocorreram, sendo duas no grupo experimental e três no controle. Houve desbalanceamento entre grupos e apenas o experimental foi analisado. Foi realizado registro eletroencefalográfico antes e depois das intervenções, por meio de aparelho com 32 canais, frequência amostral de 600 Hz e impedância de 5 kΩ. Os dados foram processados por meio do programa computacional MATLAB. Os registros individuais filtrados off-line, utilizando passa banda entre 0,5 e 50 Hz. Épocas de 1,710 ms foram criadas e o cálculo da densidade de potência absoluta calculada por meio da transformada rápida de Fourier. A abordagem estatística foi inferencial e quantitativa. Resultados: A densidade de potência alfa analisada apresentou diferença, porém não significativa, quando comparada nos dois momentos. Conclusão: Pode-se concluir que, com base nesse estudo, os exercícios isotônicos realizados para redução de dor proporcionaram pequeno aumento na densidade de potência alfa nas regiões temporal, parietal e occipital esquerdas.
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Referências
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Submetido em:
02/09/2019
Aceito em:
03/06/2020
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