Influência da dor muscular experimental sobre a função mastigatória: análise cinemática e eletromiográfica

Abstract

This thesis aimed to investigate the effects of experimentally induced jaw-muscle pain on the movements and electromyographic activity of jaw and head-neck during chewing in healthy subjects. Kinematic variables related were analyzed: (1) the masticatory sequence (duration, number of cycles masticatory and frequency); (2) the chewing cycle: time of opening, closing and occlusal phase; maximum range of motion and vertical, medial-lateral, anteroposterior and three-dimensional speed of jaw during the phases of opening and closing; maximum amplitude of displacement and head-neck three-dimensional speed during the phases of opening and closing jaw; maximum variation of the cervical flexion-extension angle while chewing; relationship between jaw and head-neck three-dimensional movement. The electromyography variables of the masticatory cycle analyzed were: inactive and active time of the masseter muscles in the side of work and balancing; muscle activation amplitude (MAA) of the masseter and ECM muscles, during active and inactive periods; activation symmetry of the masseter muscles and ECM; coactivation and correlation between masseter MAA and the ECM side of balancing work, during the active period. The study included 28 male volunteers, mean age of 20.6 years. Kinematic data were obtained from Qualisys System and electromyographic data via wireless sensors Delsys. Records were conducted during unilateral chewing wine gum before and after monosodium glutamate solution injections (pain-inducing substance) and normal saline (control). The order and the side of the applications were randomized and separated by a minimum of 45 min. The records before and after experimental procedures were analyzed by t test and Wilcoxon test for dependent variables and the Spearman correlation coefficient was used to analyze the relationship between mandibular and head-neck variables. As a result, it was observed that pain incited reduction on range of mid-lateral movement during the closing jaw, on vertical and three-dimensional speed during the opening and mid-lateral speed during the opening and closing of the masticatory cycle, reduction on MAA masseter muscle side job during the active period prescribed and increased activation symmetry between the masseter muscles on the side of balancing work and during the chewing cycle. However, no effect of pain was observed on the kinematic and electromyographic head-neck variables or on the movement relations and MAA or coactivation between the mandibular and head-neck systems. Moderate effect sizes were observed for results of the kinematic variables of mid-lateral amplitude and mid-lateral/vertical mandibular speed, suggesting that these may have clinical relevance in the evaluation of mastication in the presence of acute pain. Small effect sizes were observed in all results of electromyographic variables, limiting generalizability of the results to the population of patients with TMD. In conclusion, in the presence of acute pain of the stomatognathic system adaptations involve mainly local mechanisms, influencing only kinematic parameters and mandibular electromyographic without compensation on the movement and head-neck electromyographic activity.