Estabilização cervical em indivíduos com apneia obstrutiva do sono: ensaio clínico controlado randomizado
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Manancial - Repositório Digital da UFSM |
dARK ID: | ark:/26339/001300000hvjz |
Texto Completo: | http://repositorio.ufsm.br/handle/1/18581 |
Resumo: | This study aims to evaluate the cervical flexor and extensor muscles strength, craniocervical posture, pain sensitivity to pressure and sleep quality, and to investigate the presence of craniocervical dysfunction (CCD) and temporomandibular dysfunction (TMD) in individuals with and without obstructive sleep apnea (OSA). The study also purposes to verify the effects of cervical stabilization in subjects with OSA on these variables. An observational (case-control) and an interventional (clinical trial) studies were performed. Men and women aged from 20 to 60 years old, with OSA diagnosis confirmed by polysomnography were invited to participate. The observational study sample consisted of 51 subjects, 26 in the AOS group (GAOS) and 25 in the non-OSA group (GsAOS). In the intervention study, the sample consisted of 22 patients with OSA, 11 in the treatment group (GT) and 11 in the control group (CG). At baseline, an anamnesis was carried out and participants answered the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), and the STOP-Bang questionnaire, which identifies OSA risk. In addition, muscle strength was assessed by manual dynamometry, craniocervical posture by biophotogrammetry (SAPo v 0.68®), pain sensitivity by algometry, CCD by Craniocervical Dysfunction Score (CDS) and presence and severity of TMD, by the Diagnostic Criteria for Dysfunction Temporomandibular Index and Temporomandibular Index. In the interventional study, after the first evaluation, the GT participants underwent cervical stabilization treatment using pressure biofeedback (Stabilizer, Chattanooga, USA), with two weekly sessions and, after six weeks they were reassessed by the same questionnaires and instruments. GC was reassessed six weeks after initial assessment, when they underwent the same treatment. The main results found in the observational study were the lower values of cervical flexion range of motion (p <0.01), evaluated by the CDS, and pain threshold of the posterior mandibular region in GAOS (p <0.05), compared to GsAOS. Sleep quality presented moderate and significant correlation (r> 0.30, p <0.05) with TMD severity and with pain pressure threshold of temporal (middle and posterior region) and upper trapezius muscles. The interventional study showed that sleep quality, cervical flexor and extensor muscles strength, craniocervical posture, pain sensitivity and CCD did not differ between groups and between evaluations pre and post intervention (p> 0.05). The conclusion is that individuals with OSA had no difference in muscle strength, craniocervical posture and sleep quality, compared to GsAOS. OSA had repercussions on cervical dysfunction and mobility and craniocervical pain sensitivity. It was observed that the worse the quality of sleep, greater severity of TMD and greater pain sensitivity in the craniocervical region. Strength training of the deep cervical flexor muscles did not modify the variables related to sleep quality, muscle strength, craniocervical posture, pain sensitivity to pressure and CCD, which is attributed to their good condition before treatment and moderate degree of OSA. |
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Estabilização cervical em indivíduos com apneia obstrutiva do sono: ensaio clínico controlado randomizadoCervical stabilization in individuals with obstructive sleep apneia: randomized controlled clinical trialApneia obstrutiva do sonoEstabilização cervicalForça muscularObstructive sleep apneaCervical stabilizationMuscle strengthCNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONALThis study aims to evaluate the cervical flexor and extensor muscles strength, craniocervical posture, pain sensitivity to pressure and sleep quality, and to investigate the presence of craniocervical dysfunction (CCD) and temporomandibular dysfunction (TMD) in individuals with and without obstructive sleep apnea (OSA). The study also purposes to verify the effects of cervical stabilization in subjects with OSA on these variables. An observational (case-control) and an interventional (clinical trial) studies were performed. Men and women aged from 20 to 60 years old, with OSA diagnosis confirmed by polysomnography were invited to participate. The observational study sample consisted of 51 subjects, 26 in the AOS group (GAOS) and 25 in the non-OSA group (GsAOS). In the intervention study, the sample consisted of 22 patients with OSA, 11 in the treatment group (GT) and 11 in the control group (CG). At baseline, an anamnesis was carried out and participants answered the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), and the STOP-Bang questionnaire, which identifies OSA risk. In addition, muscle strength was assessed by manual dynamometry, craniocervical posture by biophotogrammetry (SAPo v 0.68®), pain sensitivity by algometry, CCD by Craniocervical Dysfunction Score (CDS) and presence and severity of TMD, by the Diagnostic Criteria for Dysfunction Temporomandibular Index and Temporomandibular Index. In the interventional study, after the first evaluation, the GT participants underwent cervical stabilization treatment using pressure biofeedback (Stabilizer, Chattanooga, USA), with two weekly sessions and, after six weeks they were reassessed by the same questionnaires and instruments. GC was reassessed six weeks after initial assessment, when they underwent the same treatment. The main results found in the observational study were the lower values of cervical flexion range of motion (p <0.01), evaluated by the CDS, and pain threshold of the posterior mandibular region in GAOS (p <0.05), compared to GsAOS. Sleep quality presented moderate and significant correlation (r> 0.30, p <0.05) with TMD severity and with pain pressure threshold of temporal (middle and posterior region) and upper trapezius muscles. The interventional study showed that sleep quality, cervical flexor and extensor muscles strength, craniocervical posture, pain sensitivity and CCD did not differ between groups and between evaluations pre and post intervention (p> 0.05). The conclusion is that individuals with OSA had no difference in muscle strength, craniocervical posture and sleep quality, compared to GsAOS. OSA had repercussions on cervical dysfunction and mobility and craniocervical pain sensitivity. It was observed that the worse the quality of sleep, greater severity of TMD and greater pain sensitivity in the craniocervical region. Strength training of the deep cervical flexor muscles did not modify the variables related to sleep quality, muscle strength, craniocervical posture, pain sensitivity to pressure and CCD, which is attributed to their good condition before treatment and moderate degree of OSA.O objetivo desse estudo foi avaliar a qualidade do sono, a força dos músculos flexores e extensores cervicais, a postura craniocervical e a sensibilidade dolorosa à pressão, além de investigar a presença de disfunção craniocervical (DCC) e a disfunção temporomandibular (DTM) em indivíduos com e sem apneia obstrutiva do sono (AOS). O estudo ainda se propôs a verificar os efeitos da estabilização cervical em indivíduos com AOS sobre estas variáveis. Foram realizados um estudo observacional (caso-controle) e um intervencional (ensaio clínico). Foram convidados a participar homens e mulheres entre 20 e 60 anos de idade, com diagnóstico de AOS, confirmado pela polissonografia. A amostra do estudo observacional foi de 51 sujeitos, 26 no grupo AOS (GAOS) e 25 no grupo sem AOS (GsAOS). No estudo intervencional, a amostra foi de 22 pacientes com AOS, 11 no grupo tratamento (GT) e 11 no grupo controle (GC). Na avaliação inicial foi realizada uma anamnese e os participantes responderam a Escala de Sonolência de Epworth (ESE), o Índice de Qualidade do Sono de Pittsburgh (PSQI) e o questionário STOP-Bang, que identifica o risco de AOS. Também, avaliou-se a força muscular pela dinamometria manual, a postura craniocervical pela biofotogrametria (SAPo v 0.68®), a sensibilidade dolorosa pela algometria, a DCC pelo Índice de Disfunção Craniocervical (IDCC) e a presença e gravidade da DTM pelos instrumentos Critérios de Diagnóstico em Pesquisa para Disfunções Temporomandibulares e Índice Temporomandibular. No estudo intervencional, após a primeira avaliação, o GT foi submetido ao tratamento de estabilização cervical, com uso do biofeedback por pressão (Stabilizer; Chattanooga, USA), com dois atendimentos semanais e, após seis semanas, foram reavaliados pelos mesmos questionários e instrumentos da avaliação inicial. O GC foi reavaliado após as seis semanas, quando foi submetido ao mesmo tratamento. Os principais resultados encontrados no estudo observacional foram os menores valores de amplitude de movimento de flexão cervical (p<0,01) e do limiar de dor da região mandibular posterior (p<0,05) no GAOS, quando comparados ao GsAOS. A qualidade do sono apresentou correlação moderada (r>0,30) e significativa (p<0,05) com a gravidade da DTM e com o limiar de sensibilidade dolorosa à pressão dos músculos temporal (região média e posterior) e trapézio superior. O estudo intervencional mostrou que a qualidade do sono, a força dos músculos flexores e extensores cervicais, a postura craniocervical, a sensibilidade dolorosa e a DCC não apresentaram diferença entre os grupos e entre as avaliações pré e pós intervenção (p>0,05). Conclui-se que os indivíduos com AOS não apresentaram diferença na força muscular, na postura craniocervical e na qualidade do sono, em relação ao GsAOS. A AOS repercutiu na disfunção e mobilidade cervical e na sensibilidade dolorosa craniocervical. Observou-se que, quanto pior a qualidade do sono, maior a gravidade da DTM e maior a sensibilidade dolorosa na região craniocervical. O treinamento de força dos músculos flexores profundos cervicais não modificou as variáveis relacionadas com a qualidade do sono, a força muscular, a postura craniocervical, a sensibilidade dolorosa à pressão e a DCC, o que se atribui às boas condições destas antes do tratamento e ao grau moderado de AOS.Universidade Federal de Santa MariaBrasilCiências da SaúdeUFSMPrograma de Pós-Graduação em Reabilitação FuncionalCentro de Ciências da SaúdeCorrêa, Eliane Castilhos Rodrigueshttp://lattes.cnpq.br/5452478035034361Trevisan, Maria Elainehttp://lattes.cnpq.br/1780992166277180Biasotto-Gonzalez, Daniela Aparecidahttp://lattes.cnpq.br/6741738316587978Turra, Patrícia2019-10-14T17:08:12Z2019-10-14T17:08:12Z2017-08-07info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfhttp://repositorio.ufsm.br/handle/1/18581ark:/26339/001300000hvjzporAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessreponame:Manancial - Repositório Digital da UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSM2019-10-15T06:02:05Zoai:repositorio.ufsm.br:1/18581Biblioteca Digital de Teses e Dissertaçõeshttps://repositorio.ufsm.br/ONGhttps://repositorio.ufsm.br/oai/requestatendimento.sib@ufsm.br||tedebc@gmail.comopendoar:2019-10-15T06:02:05Manancial - Repositório Digital da UFSM - Universidade Federal de Santa Maria (UFSM)false |
dc.title.none.fl_str_mv |
Estabilização cervical em indivíduos com apneia obstrutiva do sono: ensaio clínico controlado randomizado Cervical stabilization in individuals with obstructive sleep apneia: randomized controlled clinical trial |
title |
Estabilização cervical em indivíduos com apneia obstrutiva do sono: ensaio clínico controlado randomizado |
spellingShingle |
Estabilização cervical em indivíduos com apneia obstrutiva do sono: ensaio clínico controlado randomizado Turra, Patrícia Apneia obstrutiva do sono Estabilização cervical Força muscular Obstructive sleep apnea Cervical stabilization Muscle strength CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
title_short |
Estabilização cervical em indivíduos com apneia obstrutiva do sono: ensaio clínico controlado randomizado |
title_full |
Estabilização cervical em indivíduos com apneia obstrutiva do sono: ensaio clínico controlado randomizado |
title_fullStr |
Estabilização cervical em indivíduos com apneia obstrutiva do sono: ensaio clínico controlado randomizado |
title_full_unstemmed |
Estabilização cervical em indivíduos com apneia obstrutiva do sono: ensaio clínico controlado randomizado |
title_sort |
Estabilização cervical em indivíduos com apneia obstrutiva do sono: ensaio clínico controlado randomizado |
author |
Turra, Patrícia |
author_facet |
Turra, Patrícia |
author_role |
author |
dc.contributor.none.fl_str_mv |
Corrêa, Eliane Castilhos Rodrigues http://lattes.cnpq.br/5452478035034361 Trevisan, Maria Elaine http://lattes.cnpq.br/1780992166277180 Biasotto-Gonzalez, Daniela Aparecida http://lattes.cnpq.br/6741738316587978 |
dc.contributor.author.fl_str_mv |
Turra, Patrícia |
dc.subject.por.fl_str_mv |
Apneia obstrutiva do sono Estabilização cervical Força muscular Obstructive sleep apnea Cervical stabilization Muscle strength CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
topic |
Apneia obstrutiva do sono Estabilização cervical Força muscular Obstructive sleep apnea Cervical stabilization Muscle strength CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
description |
This study aims to evaluate the cervical flexor and extensor muscles strength, craniocervical posture, pain sensitivity to pressure and sleep quality, and to investigate the presence of craniocervical dysfunction (CCD) and temporomandibular dysfunction (TMD) in individuals with and without obstructive sleep apnea (OSA). The study also purposes to verify the effects of cervical stabilization in subjects with OSA on these variables. An observational (case-control) and an interventional (clinical trial) studies were performed. Men and women aged from 20 to 60 years old, with OSA diagnosis confirmed by polysomnography were invited to participate. The observational study sample consisted of 51 subjects, 26 in the AOS group (GAOS) and 25 in the non-OSA group (GsAOS). In the intervention study, the sample consisted of 22 patients with OSA, 11 in the treatment group (GT) and 11 in the control group (CG). At baseline, an anamnesis was carried out and participants answered the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), and the STOP-Bang questionnaire, which identifies OSA risk. In addition, muscle strength was assessed by manual dynamometry, craniocervical posture by biophotogrammetry (SAPo v 0.68®), pain sensitivity by algometry, CCD by Craniocervical Dysfunction Score (CDS) and presence and severity of TMD, by the Diagnostic Criteria for Dysfunction Temporomandibular Index and Temporomandibular Index. In the interventional study, after the first evaluation, the GT participants underwent cervical stabilization treatment using pressure biofeedback (Stabilizer, Chattanooga, USA), with two weekly sessions and, after six weeks they were reassessed by the same questionnaires and instruments. GC was reassessed six weeks after initial assessment, when they underwent the same treatment. The main results found in the observational study were the lower values of cervical flexion range of motion (p <0.01), evaluated by the CDS, and pain threshold of the posterior mandibular region in GAOS (p <0.05), compared to GsAOS. Sleep quality presented moderate and significant correlation (r> 0.30, p <0.05) with TMD severity and with pain pressure threshold of temporal (middle and posterior region) and upper trapezius muscles. The interventional study showed that sleep quality, cervical flexor and extensor muscles strength, craniocervical posture, pain sensitivity and CCD did not differ between groups and between evaluations pre and post intervention (p> 0.05). The conclusion is that individuals with OSA had no difference in muscle strength, craniocervical posture and sleep quality, compared to GsAOS. OSA had repercussions on cervical dysfunction and mobility and craniocervical pain sensitivity. It was observed that the worse the quality of sleep, greater severity of TMD and greater pain sensitivity in the craniocervical region. Strength training of the deep cervical flexor muscles did not modify the variables related to sleep quality, muscle strength, craniocervical posture, pain sensitivity to pressure and CCD, which is attributed to their good condition before treatment and moderate degree of OSA. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-08-07 2019-10-14T17:08:12Z 2019-10-14T17:08:12Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://repositorio.ufsm.br/handle/1/18581 |
dc.identifier.dark.fl_str_mv |
ark:/26339/001300000hvjz |
url |
http://repositorio.ufsm.br/handle/1/18581 |
identifier_str_mv |
ark:/26339/001300000hvjz |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Brasil Ciências da Saúde UFSM Programa de Pós-Graduação em Reabilitação Funcional Centro de Ciências da Saúde |
publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Brasil Ciências da Saúde UFSM Programa de Pós-Graduação em Reabilitação Funcional Centro de Ciências da Saúde |
dc.source.none.fl_str_mv |
reponame:Manancial - Repositório Digital da UFSM instname:Universidade Federal de Santa Maria (UFSM) instacron:UFSM |
instname_str |
Universidade Federal de Santa Maria (UFSM) |
instacron_str |
UFSM |
institution |
UFSM |
reponame_str |
Manancial - Repositório Digital da UFSM |
collection |
Manancial - Repositório Digital da UFSM |
repository.name.fl_str_mv |
Manancial - Repositório Digital da UFSM - Universidade Federal de Santa Maria (UFSM) |
repository.mail.fl_str_mv |
atendimento.sib@ufsm.br||tedebc@gmail.com |
_version_ |
1821325942209904640 |