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Meta-Analysis
. 2020 Oct;24(4):84-101.
doi: 10.1016/j.jbmt.2020.05.001. Epub 2020 May 11.

Cervical musculoskeletal disorders in patients with temporomandibular dysfunction: A systematic review and meta-analysis

Ana Izabela S de Oliveira-Souza  1 , Josepha Karinne de O Ferro  2 , Manuella M M B Barros  3 , Daniella A de Oliveira  4
Affiliations
Meta-Analysis

Cervical musculoskeletal disorders in patients with temporomandibular dysfunction: A systematic review and meta-analysis

Ana Izabela S de Oliveira-Souza et al. J Bodyw Mov Ther. 2020 Oct.

Abstract

Objective: To verify which are the neck musculoskeletal disorders presented by individuals with temporomandibular disorders (TMD).

Methods: It is a systematic review and meta-analysis that were included cohort, case-control and cross-section studies that analyzed the presence of cervical musculoskeletal disorders in individuals with TMD, with age between 18 and 55 years. The searches were carried out in the databases: Medline/PubMed, Cinahl, Web of Science, Cochrane, Lilacs and Scopus; and there was no linguistic or temporal restriction. The evidence quality was evaluated by GRADE system and methodological quality by Newcastle-Ottawa Quality Assessment Scale (NOS) and the risk of publication bias assessed by the funnel plot graph. The data was quantitatively analyzed by the meta-analysis using the mean differences (MD) as an effect measure.

Results: There were included 21 manuscripts in the synthesis, of theses 16 were evaluated by meta-analysis with methodological quality ranging from poor to excellent by NOS scale. Individuals with TMD present lower endurance of extensor neck muscle compared to TMD-free (MD = -194.66s [95%CI: 212.44;-176.88]), with moderate to excellent quality. As, upper neck hymobility on the right (MD = -8.59° (95%CI: -10.43°;-6.75°) and left (MD = -7.99° (95%CI: -9.63°;-6.35°), and in all global neck movements. Also, individuals with TMD presented worse self-reported neck disability (MD = 7.91 (95%CI: 7.39; 8.43)) compared to free-TMD.

Conclusion: There is moderate and strong evidence that patients with TMD present lower endurance of extensor neck muscle, global and upper neck hypomobility, worse self-reported neck disability, however, their cranio-cervical posture is similar to individuals without TMD, based on a moderate to excellent methodological quality.

Systematic review registration number: PROSPERO CRD42018103918.

Keywords: Musculoskeletal diseases; Neck injuries; Neck muscles; Temporomandibular joint disorders.

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Conflict of interest statement

Declaration of competing interest None. N = number of participants; TMD = temporomandibular disfunction; Mix TMD = mixed temporomandibular disfunction; Myo TMD = myogenic temporomandibular disfunction; MD = minimal difference; ES = effect size; MID = minimal important difference; NCR = no clinical relevance; CR = clinical relevance; PCR = partial clinical relevance; NDI = neck disability index; MVC = maximal voluntary contraction;

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