Forward Head Posture and Myogenic TMD Association in Smartphone Overuse

February 19, 2024 updated by: Doha Hany Mohamed Labib

Correlation Between Forward Head Posture And Myogenic Temporomandibular Disorder In Addicted Smartphone Users

The goal of this observational study is to determine the correlation between forward head posture and myogenic temporomandibular disorder, pain pressure threshold and endurance of masticatory and neck muscles in addicted smart phone users. The main question it aims to answer is:

• What is the correlation between forward head posture and myogenic temporomandibular disorder, pain pressure threshold and endurance of masticatory and neck muscles in addicted smart phone users?

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Temporomandibular joint (TMJ) and cervical spine are closely related to each other due to their anatomical, mechanical and neurophysiological relationships. That's why pain and dysfunction in the cervical spine can be observed in patients with temporomandibular disorders (TMD) who may suffer from clinical problems in the masticatory muscles, the temporomandibular joint and other associated structures.

Millions of people worldwide use their smartphone devices excessively. Prevalence of smartphone addiction among Egyptian university students was 62.4% revealing that females had a higher addiction than men. This excessive use where subjects downwardly flex their neck to enable them to look at the screen, affects head and neck postures leading to forward head posture (FHP) which consequently alters the position of the mandible along with its functions, resulting in an increase tension in the masticatory muscles causing TMD. Addicted smartphone users contribute to changes in craniocervical region which led to myogenic TMD in young teenagers.

Pain, tenderness in masticatory muscles and cervical muscle endurance are common clinical findings in patients with TMD; where muscle tenderness is reduced and cervical muscle endurance was found to have a shorter duration holding time when performing neck extensor endurance test due to higher fatigability of neck extensor muscles.

Study Type

Observational

Enrollment (Actual)

46

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

23 subjects with myogenic TMD, FHP and addicted to smartphone devices will be assessed for pressure pain threshold on trigger points and muscle endurance in both masticatory and neck muscles

Description

Inclusion Criteria:

  1. Subject's age range from 18 - 40 years.
  2. Both males and females will be recruited.
  3. Subjects diagnosed as myogenic TMD according to the presence of trigger points in masseter, temporalis, upper trapezius and C5-C6 articular pillars according to the myofascial diagnostic criteria that includes a taut band and hypersensitive spot
  4. All subjects are heavy smartphones users, using the SAS-SV, the cuffof value for males is 31 and for females is 33.
  5. All subjects will have forward head posture assessed by CVA less than 49.9 degrees.

Exclusion Criteria:

  1. History of head, neck or TMJ trauma
  2. Patients who underwent orthodontic treatment
  3. Congenital, or acquired postural deformity
  4. No previous neck or spinal or TMJ surgery
  5. Subjects who are on anti-inflammatory or analgesic drugs for pain

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
subjects with myogenic TMD

Subjects diagnosed as myogenic TMD according to the presence of trigger points in masseter, temporalis, upper trapezius and C5-C6 articular pillars Subjects are heavy smartphones users, using the SAS-SV, the cuffof value for males is 31 and for females is 33.

Subjects have forward head posture assessed by CVA <49.9 degrees
Other: Assessment
All subjects will be assessed for FHP by taking a lateral view picture to calculate the CVA using the Kinovea software. Each subject with FHP will be examined for myofascial trigger points done by the therapist finger to palpate bilaterally on tender nodules in masticatory and neck muscles. Then using a pressure algometer, the PPT value will be scored for each trigger in each muscle bilaterally. Masticatory muscle endurance will be measured by asking the subject to bite on load sensor for as long as the subject can until exhaustion. Using a stopwatch, the time will be recorded in seconds. Using the craniocervical extension endurance test, the subject will lie prone with their head unsupported and with a bubble inclinometer attached to their head. Using a stopwatch, time in seconds will be recorded to test how long the subject can sustain the neck in neutral position. Finally, a smartphone addiction scale will be answered by the subject to identify how much they are addicted to its use.
subjects without myogenic TMD

Subjects are heavy smartphones users, using the SAS-SV, the cuffof value for males is 31 and for females is 33.

Subjects have forward head posture assessed by CVA <49.9 degrees
Other: Assessment
All subjects will be assessed for FHP by taking a lateral view picture to calculate the CVA using the Kinovea software. Each subject with FHP will be examined for myofascial trigger points done by the therapist finger to palpate bilaterally on tender nodules in masticatory and neck muscles. Then using a pressure algometer, the PPT value will be scored for each trigger in each muscle bilaterally. Masticatory muscle endurance will be measured by asking the subject to bite on load sensor for as long as the subject can until exhaustion. Using a stopwatch, the time will be recorded in seconds. Using the craniocervical extension endurance test, the subject will lie prone with their head unsupported and with a bubble inclinometer attached to their head. Using a stopwatch, time in seconds will be recorded to test how long the subject can sustain the neck in neutral position. Finally, a smartphone addiction scale will be answered by the subject to identify how much they are addicted to its use.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
pressure pain threshold
Time Frame: 5 mintues
For the masticatory muscles, the subject will be sitting and the therapist will place the pressure algometer on the belly of the masseter and temporalis muscles. A gradual pressure will be applied until the subject experiences pain. The value displayed on the device will be recorded. This will be repeated 3 times on each side. For the upper trapezius muscles, subject will be seated. Using the algometer, a pressure will be applied on midpoint of the trapezius. Then subject will lie prone, to apply pressure by the algometer on a point 1 cm laterally to the midpoint between C6 and C5 spinous processes. A value will be recorded when subject feels pain. This will be repeated 3 times on each side.
5 mintues

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
muscle endurance
Time Frame: 10 minutes
To assess masticatory muscles, subject will sit in an upright position and will bite on the first molar at maximum voluntary contraction until exhaustion on an I load mini bite load cell. Using a stopwatch, time in seconds will be recorded for both sides. long maintenance time means good endurance.Test will be terminated when any pain or discomfort is felt in the masticatory muscles.Craniocervical extension endurance test will assess neck extensors endurance. Subject will lie prone on a plinth with the head and neck unsupported and a bubble inclinometer will be fixed on the head using a strap. Subject will be asked to sustain a neutral position for as long as possible and time in seconds will be recorded. The test will be terminated if pain is felt in the neck or if the head failed to maintain its neutral position or if it moved more than 5 degrees shown by inclinometer.
10 minutes
smartphone addiction scale short version
Time Frame: 2 minutes
Smartphone addiction scale - short version (SAS-SV) is a screening tool to identify individuals that are dependent on smartphone use. Maximum score is 60 and the minimum is 10. The cut off value of smartphone addiction use differ by gender, in males it is 31 and in females it is 33. higher score means patient were addicted on the smartphones.
2 minutes

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Doha Hany Mohamed Labib

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 17, 2023

Primary Completion (Actual)

November 17, 2023

Study Completion (Actual)

December 15, 2023

Study Registration Dates

First Submitted

August 29, 2023

First Submitted That Met QC Criteria

October 1, 2023

First Posted (Actual)

October 4, 2023

Study Record Updates

Last Update Posted (Actual)

February 20, 2024

Last Update Submitted That Met QC Criteria

February 19, 2024

Last Verified

February 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • FHP and MTMD in SMP

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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