Evaluation of psychosocial, somatosensory and behavioral profiles of patients with chronic temporomandibular pain
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Tipo de documento: | Tese |
Idioma: | eng |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da USP |
Texto Completo: | https://doi.org/10.11606/T.25.2020.tde-25102021-155125 |
Resumo: | Several factors have been evaluated to characterize patterns of normality in healthy individuals and relevant variations in patients with chronic temporomandibular disorders (TMD), for a more accurate diagnosis and personalized treatment. Some variables that have been associated with this type of analysis are psychosocial questionnaires, psychophysical tests, endogenous pain modulation capacity, and the practice of physical activity. The objective of this study is to investigate the inhibitory effects of endogenous pain modulation in healthy subjects and a population with chronic TMD pain and its relationship with associated factors such as psychosocial and somatosensory profiles, as well as physical activity levels. 311 healthy individuals and 68 chronic TMD pain patients aged between 18 and 50 years were included in this study. Questionnaires were applied for psychosocial assessment and provided information on state-trait anxiety (STAI), pain catastrophizing (PCS), quality of sleep (PITTSBURGH), level of physical activity (IPAQ), lifestyle quality (FLC). The somatosensory evaluation was performed on the anterior temporalis muscle of the dominant side of the healthy individuals, and on the side of the reported pain for the chronic TMD pain patients. The following somatosensory test were performed: mechanical pain threshold (MPT), temporal summation (WUR), pressure pain threshold (PPT), and the conditioned pain modulation test (CPM). The Chi-square test was used to identify possible associations between the categorical variables of the study (on a nominal or ordinal scale), comparisons among categories of Physical activity level were made by the Kruskal-Wallis test, followed by Mann-Whitney with Bonferroni correction. A logistic regression was made to evaluate the binary categories of presence of chronic pain and pain modulation capability (assuming a -10% cutoff). All statistical inferences were performed considering a significance level of 5%. Chronic TMD pain patients presented higher values for anxiety traits (p=0,008), catastrophizing (p<0,001) and Pittsburgh scores (p=0,002) as well as lower mechanical (p=0,012) and pressure pain thresholds (p<0,001), and reported a lower lifestyle quality (p<0,001) than healthy individuals. Somatosensory evaluation revealed lower pain thresholds (MPT, PPT) for individuals with chronic pain. Similar values for pain modulation were found when comparing healthy and chronic TMD pain patients and different levels of physical activity did not seem to alter pain modulation levels, but may seem to have a positive effect on anxiety levels, sleep quality, and lifestyle quality. Higher levels of anxiety, catastrophizing, and worse sleep and lifestyle quality were associated with the chronic pain group. Somatosensory evaluation revealed lower pain thresholds for individuals with chronic pain. |
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info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesis Evaluation of psychosocial, somatosensory and behavioral profiles of patients with chronic temporomandibular pain Avaliação do perfil psicossocial, somatosensorial e comportamental de pacientes com dor crônica temporomandibular 2020-11-05Paulo Cesar Rodrigues ContiLeonardo Rigoldi BonjardimCarolina Ortigosa CunhaJoel Ferreira Santiago JuniorHenrique Müller de QuevedoUniversidade de São PauloCiências Odontológicas AplicadasUSPBR Exercício Exercise Facial pain Limiar da dor Pain modulation Pain Threshold Qualidade de vida Quality of life Síndrome da articulação temporomandibular Several factors have been evaluated to characterize patterns of normality in healthy individuals and relevant variations in patients with chronic temporomandibular disorders (TMD), for a more accurate diagnosis and personalized treatment. Some variables that have been associated with this type of analysis are psychosocial questionnaires, psychophysical tests, endogenous pain modulation capacity, and the practice of physical activity. The objective of this study is to investigate the inhibitory effects of endogenous pain modulation in healthy subjects and a population with chronic TMD pain and its relationship with associated factors such as psychosocial and somatosensory profiles, as well as physical activity levels. 311 healthy individuals and 68 chronic TMD pain patients aged between 18 and 50 years were included in this study. Questionnaires were applied for psychosocial assessment and provided information on state-trait anxiety (STAI), pain catastrophizing (PCS), quality of sleep (PITTSBURGH), level of physical activity (IPAQ), lifestyle quality (FLC). The somatosensory evaluation was performed on the anterior temporalis muscle of the dominant side of the healthy individuals, and on the side of the reported pain for the chronic TMD pain patients. The following somatosensory test were performed: mechanical pain threshold (MPT), temporal summation (WUR), pressure pain threshold (PPT), and the conditioned pain modulation test (CPM). The Chi-square test was used to identify possible associations between the categorical variables of the study (on a nominal or ordinal scale), comparisons among categories of Physical activity level were made by the Kruskal-Wallis test, followed by Mann-Whitney with Bonferroni correction. A logistic regression was made to evaluate the binary categories of presence of chronic pain and pain modulation capability (assuming a -10% cutoff). All statistical inferences were performed considering a significance level of 5%. Chronic TMD pain patients presented higher values for anxiety traits (p=0,008), catastrophizing (p<0,001) and Pittsburgh scores (p=0,002) as well as lower mechanical (p=0,012) and pressure pain thresholds (p<0,001), and reported a lower lifestyle quality (p<0,001) than healthy individuals. Somatosensory evaluation revealed lower pain thresholds (MPT, PPT) for individuals with chronic pain. Similar values for pain modulation were found when comparing healthy and chronic TMD pain patients and different levels of physical activity did not seem to alter pain modulation levels, but may seem to have a positive effect on anxiety levels, sleep quality, and lifestyle quality. Higher levels of anxiety, catastrophizing, and worse sleep and lifestyle quality were associated with the chronic pain group. Somatosensory evaluation revealed lower pain thresholds for individuals with chronic pain. Vários fatores têm sido avaliados para caracterizar padrões de normalidade em indivíduos saudáveis e variações relevantes em pacientes com disfunção temporomandibular crônica (DTM), para que possa ser realizado um diagnóstico mais preciso e um tratamento personalizado. Algumas variáveis que têm sido associadas a esse tipo de análise são questionários psicossociais, testes psicofísicos, capacidade endógena de modulação da dor e prática de atividade física. O objetivo deste estudo é investigar os efeitos inibitórios da modulação endógena de dor em indivíduos saudáveis e comparar à uma população com dor crônica temporomandibular. Também serão avaliadas suas relações com fatores associados, como perfis psicossociais e somatossensoriais, bem como níveis de atividade física. 311 indivíduos saudáveis e 68 pacientes com dor crônica temporomandibular com idades entre 18 e 50 anos foram incluídos neste estudo. Questionários foram aplicados para avaliação psicossocial e forneceram informações sobre ansiedade traço-estado (IDATE), catastrofização da dor, qualidade do sono (PITTSBURGH), nível de atividade física (IPAQ), qualidade do estilo de vida. A avaliação somatossensorial foi realizada no músculo temporal anterior do lado dominante dos indivíduos saudáveis e no lado da dor relatada para os pacientes com dor crônica de DTM. Os seguintes testes somatossensoriais foram realizados: limiar de dor mecânica (MPT), somação temporal (WUR), limiar de dor à pressão (LDP) e teste de modulação condicionada da dor (CPM). O teste Qui-quadrado foi utilizado para identificar possíveis associações entre as variáveis categóricas do estudo. As comparações entre as categorias do nível de atividade física foram feitas pelo teste de Kruskal-Wallis, seguido de Mann-Whitney com correção de Bonferroni. Uma regressão logística foi feita para avaliar as categorias binárias de presença de dor crônica e capacidade de modulação da dor (assumindo um ponto de corte de -10%). Todas as inferências estatísticas foram realizadas considerando um nível de significância de 5%. Pacientes com dor crônica temporomandibular apresentaram maiores valores para traços de ansiedade (p=0,008), catastrofização (p<0,001) e escores de Pittsburgh (p=0,002), bem como menores limiares de dor mecânica (p=0,012) e a pressão (p<0,001), também relatando uma qualidade de estilo de vida inferior (p<0,001). A avaliação somatossensorial revelou limiares de dor mais baixos (MPT, PPT) para indivíduos com dor crônica. Valores semelhantes para a modulação da dor foram encontrados ao comparar pacientes saudáveis e com dor crônica temporomandibular. Ao analisar a frequência de atividade física dos indivíduos, se observou que diferentes níveis de atividade física não parecem alterar os níveis de modulação da dor, mas podem parecer ter um efeito positivo nos níveis de ansiedade, qualidade do sono e qualidade do estilo de vida. Níveis mais elevados de ansiedade, catastrofização e pior qualidade de sono e estilo de vida foram associados ao grupo de dor crônica. A avaliação somatossensorial revelou limiares de dor mais baixos para indivíduos com dor crônica. https://doi.org/10.11606/T.25.2020.tde-25102021-155125info:eu-repo/semantics/openAccessengreponame:Biblioteca Digital de Teses e Dissertações da USPinstname:Universidade de São Paulo (USP)instacron:USP2023-12-21T20:09:47Zoai:teses.usp.br:tde-25102021-155125Biblioteca Digital de Teses e Dissertaçõeshttp://www.teses.usp.br/PUBhttp://www.teses.usp.br/cgi-bin/mtd2br.plvirginia@if.usp.br|| atendimento@aguia.usp.br||virginia@if.usp.bropendoar:27212023-12-22T13:18:37.338156Biblioteca Digital de Teses e Dissertações da USP - Universidade de São Paulo (USP)false |
dc.title.en.fl_str_mv |
Evaluation of psychosocial, somatosensory and behavioral profiles of patients with chronic temporomandibular pain |
dc.title.alternative.pt.fl_str_mv |
Avaliação do perfil psicossocial, somatosensorial e comportamental de pacientes com dor crônica temporomandibular |
title |
Evaluation of psychosocial, somatosensory and behavioral profiles of patients with chronic temporomandibular pain |
spellingShingle |
Evaluation of psychosocial, somatosensory and behavioral profiles of patients with chronic temporomandibular pain Henrique Müller de Quevedo |
title_short |
Evaluation of psychosocial, somatosensory and behavioral profiles of patients with chronic temporomandibular pain |
title_full |
Evaluation of psychosocial, somatosensory and behavioral profiles of patients with chronic temporomandibular pain |
title_fullStr |
Evaluation of psychosocial, somatosensory and behavioral profiles of patients with chronic temporomandibular pain |
title_full_unstemmed |
Evaluation of psychosocial, somatosensory and behavioral profiles of patients with chronic temporomandibular pain |
title_sort |
Evaluation of psychosocial, somatosensory and behavioral profiles of patients with chronic temporomandibular pain |
author |
Henrique Müller de Quevedo |
author_facet |
Henrique Müller de Quevedo |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Paulo Cesar Rodrigues Conti |
dc.contributor.referee1.fl_str_mv |
Leonardo Rigoldi Bonjardim |
dc.contributor.referee2.fl_str_mv |
Carolina Ortigosa Cunha |
dc.contributor.referee3.fl_str_mv |
Joel Ferreira Santiago Junior |
dc.contributor.author.fl_str_mv |
Henrique Müller de Quevedo |
contributor_str_mv |
Paulo Cesar Rodrigues Conti Leonardo Rigoldi Bonjardim Carolina Ortigosa Cunha Joel Ferreira Santiago Junior |
description |
Several factors have been evaluated to characterize patterns of normality in healthy individuals and relevant variations in patients with chronic temporomandibular disorders (TMD), for a more accurate diagnosis and personalized treatment. Some variables that have been associated with this type of analysis are psychosocial questionnaires, psychophysical tests, endogenous pain modulation capacity, and the practice of physical activity. The objective of this study is to investigate the inhibitory effects of endogenous pain modulation in healthy subjects and a population with chronic TMD pain and its relationship with associated factors such as psychosocial and somatosensory profiles, as well as physical activity levels. 311 healthy individuals and 68 chronic TMD pain patients aged between 18 and 50 years were included in this study. Questionnaires were applied for psychosocial assessment and provided information on state-trait anxiety (STAI), pain catastrophizing (PCS), quality of sleep (PITTSBURGH), level of physical activity (IPAQ), lifestyle quality (FLC). The somatosensory evaluation was performed on the anterior temporalis muscle of the dominant side of the healthy individuals, and on the side of the reported pain for the chronic TMD pain patients. The following somatosensory test were performed: mechanical pain threshold (MPT), temporal summation (WUR), pressure pain threshold (PPT), and the conditioned pain modulation test (CPM). The Chi-square test was used to identify possible associations between the categorical variables of the study (on a nominal or ordinal scale), comparisons among categories of Physical activity level were made by the Kruskal-Wallis test, followed by Mann-Whitney with Bonferroni correction. A logistic regression was made to evaluate the binary categories of presence of chronic pain and pain modulation capability (assuming a -10% cutoff). All statistical inferences were performed considering a significance level of 5%. Chronic TMD pain patients presented higher values for anxiety traits (p=0,008), catastrophizing (p<0,001) and Pittsburgh scores (p=0,002) as well as lower mechanical (p=0,012) and pressure pain thresholds (p<0,001), and reported a lower lifestyle quality (p<0,001) than healthy individuals. Somatosensory evaluation revealed lower pain thresholds (MPT, PPT) for individuals with chronic pain. Similar values for pain modulation were found when comparing healthy and chronic TMD pain patients and different levels of physical activity did not seem to alter pain modulation levels, but may seem to have a positive effect on anxiety levels, sleep quality, and lifestyle quality. Higher levels of anxiety, catastrophizing, and worse sleep and lifestyle quality were associated with the chronic pain group. Somatosensory evaluation revealed lower pain thresholds for individuals with chronic pain. |
publishDate |
2020 |
dc.date.issued.fl_str_mv |
2020-11-05 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.11606/T.25.2020.tde-25102021-155125 |
url |
https://doi.org/10.11606/T.25.2020.tde-25102021-155125 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo |
dc.publisher.program.fl_str_mv |
Ciências Odontológicas Aplicadas |
dc.publisher.initials.fl_str_mv |
USP |
dc.publisher.country.fl_str_mv |
BR |
publisher.none.fl_str_mv |
Universidade de São Paulo |
dc.source.none.fl_str_mv |
reponame:Biblioteca Digital de Teses e Dissertações da USP instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Biblioteca Digital de Teses e Dissertações da USP |
collection |
Biblioteca Digital de Teses e Dissertações da USP |
repository.name.fl_str_mv |
Biblioteca Digital de Teses e Dissertações da USP - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
virginia@if.usp.br|| atendimento@aguia.usp.br||virginia@if.usp.br |
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1794503051904548864 |