Postural habits & awareness and its relationship to pain, functionality, cervical muscle endurance & position sense in temporomandibular joint disorders

Although the pain, functionality, proprioception in temporomandibular disorders (TMD) have been frequently investigated, there has been limited knowledge on postural habits & awareness and relation to musculoskeletal parameters. It was aimed to explore the postural habits and awareness level and to investigate the relationship to temporomandibular pain level & pain pressure threshold, functionality, cervical muscle endurance and position sense in individuals with myogenousTMD. This case–control study included fifty subjects with myogenous TMD and fifty age- and sex-matched controls. Postural habits & awareness levels were assessed using the Postural Habits and Awareness Scale (PHAS). The pain level and pain pressure threshold were assessed by the Numeric Rating Scale (NRS) and an algometer; functionality was assessed using the Helkimo Clinical Dysfunction Index (HCDI) and the Mandibular Function Impairment Questionnaire (MFIQ). Cervical muscle endurance was performed using flexor and extensor endurance tests, while position sense was tested using the Laser Pointer Assisted Angle Reproduction Test (LP-ART). PHAS score were significantly lower in the myogenous TMD group (p < 0.001). Within the myogenous TMD group, a moderate negative correlation was found between PHAS score and activity-related pain level (-0.429). Low-moderate level of negative correlations was observed between the scores of PHAS and the HCDI (-0.337), MFIQ (-0.445 & -0.496). and LP-ART in cervical extension (-0.326) & lateral flexion (-0.406, -0.365). Low level of postural habits & awareness and its relationship with pain level, jaw functionality and cervical proprioception were observed in individuals with myogenous TMD. Current findings highlight the importance of considering postural awareness along with local symptoms in myogenous TMD by the clinicians working with this population.