Head and neck posture influences masticatory muscle electromyographic amplitude in healthy subjects and patients with temporomandibular disorder: a preliminary study.

BACKGROUND: Despite the association of masticatory function with head posture and mandible movement, the impact of head posture on masseter muscle electrical activity remains unclear. This study aimed to investigate the electrical activity of the anterior temporal, masseter, superior trapezius, and sternocleidomastoid muscles in temporomandibular disorder (TMD) patients in three different head positions and compare the findings with those for healthy subjects.

METHODS: The study included 16 TMD patients and 17 healthy subjects. Surface electromyography (sEMG) was used to assess the bilateral anterior temporalis, masseter, superior trapezius, and sternocleidomastoid muscle activities. The maximal voluntary contraction (MVC) and root mean square (RMS) sequence of each muscle were measured in three head positions. Mixed analysis of variance was used to evaluate the effects of head posture on muscle electrical activity in each group.

RESULTS: The group differences for the bilateral masseter muscles were significant in the relaxation position, neutral head position (NHP), and relaxation position with tooth contact (P<0.05). In both groups, the basal RMSs of the bilateral anterior temporalis muscle in the relaxation position with tooth contact was significantly higher than that in the NHP (P<0.05). In both groups, the basal RMSs of the bilateral masseter muscles in the relaxation position with tooth contact was higher than that in the relaxation position and NHP, with significant differences (P<0.05).

CONCLUSIONS: During the management of TMD patients, physical therapists should focus on patient education regarding maintenance of a relaxed position and establish appropriate rehabilitation programs to reduce muscle activity.