Efeito imediato da TENS na dor, na função muscular e sua correlação com qualidade do sono e grau de catastrofização em indivíduos com disfunção temporomandibular

• Autor(a) principal: Ferreira, Ana Paula de Lima
• Data de Publicação: 2014
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UFS
• Texto Completo: https://ri.ufs.br/handle/riufs/3616
• topic: Articulação temporomandibular; Estimulação elétrica transcutânea do nervo; Eletromiografia; Fadiga muscular; Síndrome da Disfunção Temporomandibular; TENS; Dor; Eletromiografia e fadiga muscular; Temporomandibular Disorder; TENS; Pain; Electromyography; Muscle fatigue; CNPQ::CIENCIAS DA SAUDE

Introduction: Transcutaneous Electrical Nerve Stimulation (TENS) is a recommended therapy as a strategy to control musculoskeletal pain including temporomandibular disorder (TMD). Objective: Analyze the immediate responses of TENS on pain intensity, pressure pain threshold, electromyographic activity and muscle fatigue in subjects diagnosed with muscular TMD. Methods: Were selected 40 subjects of 18-35 years, with signs and symptoms of muscular TMD. The diagnosis it was used Brazilian version of the Research Diagnostic Criteria (RDC) and volunteers were randomly distributed in to two groups: (1) TENS placebo (n=20) and (2) TENS active (n=20). A single application of TENS was performed bilaterally on the temporal anterior and masseter muscles (Dp = 90 μs, time = 50 minutes, the first 25 minutes with frequency of 100 Hz and the last 25 minutes with 4 Hz frequency, high intensity but without allowing muscle contraction). For the placebo TENS group the same parameters were used, but with directed stimulus to voluntary only in the first 40 seconds, which was later diverted to the internal resistance of a placebo circuit. The sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the degree of catastrophizing by Pain Catastrophizing Scale (PCS). Before, immediately and 48 hours after application of TENS were evaluated the intensity of pain using a visual analog scale (VAS), pressure pain threshold (PPT) of masticatory and cervical muscles and electromyographic activity (EMG) in mandibular rest, maximal voluntary contraction and during normal mastication. Results: There was a reduction in pain intensity and increased pain threshold to pressure only in the TENS active group immediately and after 48 hours of treatment. The electromyographic activity showed heterogeneous behavior for the group TENS placebo while in the TENS active group to have more uniform responses. Just TENS active group showed greater resistance to fatigue, being observed a delay of the declining strength time and higher intensity peak of electromyographic signal immediately after therapy. Conclusion: TENS active was superior to TENS placebo on identified hypoalgesia. The masticatory function was more efficient in the TENS active group. Moreover, the active form of TENS contributed so the masticatory muscles could reach higher amplitudes of EMG signal and could last longer in contraction before the onset of muscle fatigue. Furthermore, it was found that the greatest degree of catastrophizing and poor sleep quality can influence hypoalgesic response induced by active TENS.