Estabilização cervical em indivíduos com apneia obstrutiva do sono: ensaio clínico controlado randomizado

Detalhes bibliográficos
Autor(a) principal: Turra, Patrícia
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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spelling 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
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