title: Do subjects with acute/subacute temporomandibular disorder have associated cervical impairments: A cross-sectional study.
abstract: BACKGROUND
  There is preliminary evidence of cervical musculoskeletal impairment in some temporomandibular disorder (TMD) pain states.
  
  
  OBJECTIVE
  To determine whether people with TMD, classified as either mild or moderate/severe TMD, have more cervical signs of dysfunction than healthy subjects.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Based on the Conti Amnestic Questionnaire and examination of the temporomandibular joint (Axis I classification of the Research Diagnostic Criteria for TMD), of 144 people examined 59 were classified to a mild TMD group, 40 to a moderate/severe TMD group and 45 to an asymptomatic control group without TMD. Subjects were evaluated for signs of cervical musculoskeletal impairment and disability including the Neck Disability Index, active cervical range of motion, the Flexion-Rotation Test, mechanical pain threshold of the upper trapezius and obliquus capitis inferior muscles, Cranio-Cervical Flexion test and passive accessory movements of the upper 3 cervical vertebrae.
  
  
  RESULTS
  According to cervical musculoskeletal dysfunction, the control group without TMD were consistently the least impaired and the group with moderate/severe TMD were the most impaired. These results suggest, that the more dysfunction and pain is identified in the temporomandibular region, the greater levels of dysfunction is observable on a number of cervical musculoskeletal function tests. The pattern of cervical musculoskeletal dysfunction is distinct to other cervical referred pain phenomenon such as cervicogenic headache.
  
  
  CONCLUSIONS
  These findings provide evidence that TMD in an acute/subacute pain state is strongly related with certain cervical spine musculoskeletal impairments which suggests the cervical spine should be examined in patients with TMD as a potential contributing factor.
authors.affiliation: Faculty of Business, Management and Social Science, Department Movement and Rehabilitationscience Caprivistrasse 30a, 49076 Osnabrueck, Germany. Electronic address: H.von-Piekartz@hs-osnabrueck.de.
authors.forename: Harry
authors.initials: H
authors.lastname: von Piekartz
authors.affiliation: Faculty of Business, Management and Social Science, Department Movement and Rehabilitationscience Caprivistrasse 30a, 49076 Osnabrueck, Germany.
authors.forename: Ani
authors.initials: A
authors.lastname: Pudelko
authors.affiliation: Faculty of Business, Management and Social Science, Department Movement and Rehabilitationscience Caprivistrasse 30a, 49076 Osnabrueck, Germany.
authors.forename: Mira
authors.initials: M
authors.lastname: Danzeisen
authors.affiliation: School of Physiotherapy and Curtin Health Innovation Research, Curtin University, P.O. Box U1987, Perth, WA 6845, Australia.
authors.forename: Toby
authors.initials: T
authors.lastname: Hall
authors.affiliation: Faculty of Business, Management and Social Science, Department Movement and Rehabilitationscience Caprivistrasse 30a, 49076 Osnabrueck, Germany.
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Ballenberger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology* / Q000503:physiopathology*; D013705:Temporomandibular Joint Disorders / Q000150:complications* / Q000503:physiopathology*
keywords: Cervical spine; Cervico-trigeminal complex; Neck disability; Temporomandibular disorder