Brief Summary

Temporomandibular disorder (TMD) is a collective term for pain and dysfunction of the masticatory muscles and temporomandibular joint (TMJ). Typical signs and symptoms of TMD includes regional pain, noises from the TMJs and limitations in jaw movements. Altered jaw kinematics and muscle activity have also been reported. TMD may be related to neck problems. Over 50% of patients with TMD suffer from nonspecific neck pain. Patients with TMD often have symptoms over neck, including upper cervical spine movement impairment and reduced cervical muscles endurance. Conversely, TMD may also develop in patients with neck pain. Twenty to thirty-three percent of patients with neck pain also have TMD. Subjects with neck pain present with a twofold higher prevalence of TMD than those without neck pain. In patients with neck pain, the development or perpetuation of TMD may be due to the anatomical connection between TMJ and neck: neck posture affects the mandible position and sensory inputs from the cervical-mandibular region converge at the trigemino-cervical nucleus. Early identification of TMD is essential but to our knowledge, no study has investigated whether patients with neck pain demonstrate altered jaw movement and muscle activity, which is associated with TMD. The purposes of this proposal are to compare the jaw kinematics, muscle activity and muscle sensitivity in healthy individuals and patients with non-specific chronic neck pain (NCNP). This study also aimed to investigate the relationship between forward-head posture and the jaw kinematics, muscle activity as well as muscle sensitivity. With a cross-sectional exploratory study design, 30 healthy control subjects and 30 subjects with NCNP will be recruited. Clinical assessments will include cervical range of motion (CROM), pressure pain threshold (PPT) over the cervical-mandibular region and the cranial-cervical angle (CCA). Jaw kinematics will be measured by Ultrasonic Jaw Motion Analyzer (Zebris GmbH) during functional jaw movements. Muscle activities are record from bilateral anterior temporalis, masseter, sternocleidomastoid muscle and upper trapezius by surface electromyography during resting and clenching.

Trial Health

On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment

participants targeted

Target at P25-P50 for all trials

Timeline

Completed

Started Oct 2019

Shorter than P25 for all trials

Geographic Reach

1 country

1 active site

Status

completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

11 months study duration

First Submitted

Initial submission to the registry

July 28, 2019

Completed

4 days until next milestone

First Posted

Study publicly available on registry

August 1, 2019

Completed

2 months until next milestone

Study Start

First participant enrolled

October 11, 2019

Completed

11 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 30, 2020

Completed

Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

August 30, 2020

Completed

Last Updated

November 10, 2020

Status Verified

September 1, 2020

Enrollment Period

11 months

First QC Date

July 28, 2019

Last Update Submit

November 9, 2020

Conditions

Temporomandibular Disorder Nonspecific Chronic Neck Pain Biomechanical Phenomena

Keywords

Temporomandibular disorderNonspecific chronic neck painJaw kinematicsMuscle activityMuscle sensitivityForward head

Outcome Measures

Primary Outcomes (5)

Jaw maximum range of motion
Including maximum mouth opening, lateral right, lateral left, and protrusion, which will be described with millimeter (mm)
Immediately during the experiment
Jaw velocity
Jaw opening and closing velocity, which will be described with millimeter per second (mm/s)
Immediately during the experiment
Condylar rotation
The rotation will be described with degree (°).
Immediately during the experiment
Condylar translation
Including condylar translation and condylar path length, which will be described with millimeter (mm)
Immediately during the experiment
Muscle activation
The root mean square of electromyography (EMG) data of the masseter, anterior temporalis, sternocleidomastoid muscle and upper trapezius will be normalized by the maximum voluntary contraction amplitude (percentage of maximal voluntary contraction, %).
Immediately during the experiment

Secondary Outcomes (3)

Cervical and jaw range of motion
Immediately during the experiment
Pressure pain threshold
Immediately during the experiment
Cranial-cervical angle
Immediately during the experiment

Study Arms (2)

Nonspecific chronic neck pain (NCNP) group

Subjects with nonspecific chronic neck pain will be included to perform clinical test and assess their jaw kinematics and muscle activation.

Other: Cervical range of motion (CROM)Other: Pressure pain threshold (PPT)Other: Cranial-cervical angle (CCA)Other: Jaw kinematicsOther: Muscle activation

Control group

Healthy control subjects will be included to compare the differences in jaw kinematics, muscle activation and clinical tests between healthy subjects and subjects with nonspecific chronic neck pain. Subjects in this group will received the same assessment as the NCNP group.

Other: Cervical range of motion (CROM)Other: Pressure pain threshold (PPT)Other: Cranial-cervical angle (CCA)Other: Jaw kinematicsOther: Muscle activation

Interventions

Cervical range of motion (CROM)OTHER

Subjects will perform full-range cervical flexion, extension, side-bending and rotation actively in sitting position. In supine position, cervical flexion-rotation will be performed passively by the assessor.