Aim The study aimed to evaluate the accuracy of the maximum bilateral molar bite force and the Root Mean Square (RMS) Electromyography (EMG) index of the masticatory muscles in the maximum bilateral molar bite (MMBMax) of women with myogenic Temporomandibular Disorder (TMD) and asymptomatic. Methods This is a cross-sectional study, composed of 86 women allocated to the TMD Group (n=43) and Control Group (n=43) diagnosis through the Diagnostic Criteria for Temporomandibular Disorders. The maximum bilateral molar bite force was evaluated using a bite dynamometer and the RMS EMG index of the masticatory muscles (anterior temporalis, masseter) during 5 seconds of the MMBMax task. Student t-test was used for data comparison between accuracy of the bite force and RMS EMG of masticatory muscles during the MMBMax. Results The maximum bilateral molar bite force showed high accuracy (AUC=0.99) for the diagnosis of women with myogenic TMD and asymptomatic women, and the RMS EMG index evaluated during the MMBMax showed a moderate level of accuracy for all masticatory muscles (AUC=0.70 to 0.75). Conclusion The bilateral bite dynamometer with a surface EMG during bilateral bite can be used to diagnose TMD in young women.

OBJETIVO: Analisar a postura e a função da região crânio-cervical em sujeitos disfônicos. MÉTODOS: Participaram do estudo 28 mulheres (31,25±8,14 anos), divididas em dois grupos: experimental (N=16 portadoras de disfonia) e controle (N=12 clinicamente normais). As voluntárias foram submetidas à avaliação do Índice de Disfunção Crânio-Cervical (IDCC) e fotogrametria, sendo determinado o ângulo anterior formado entre a sétima vértebra cervical e o tragus, o qual corresponde à posição da cabeça no plano sagital. A análise das fotos foi realizada por três examinadores, duas vezes cada um, com intervalo de uma semana entre elas. A análise dos dados constou do teste de Shapiro-Wilk, seguido do teste t de Student, (p<0,05). RESULTADOS: Em relação à fotogrametria, não houve diferença (p=0,2565) entre os valores médios do ângulo anterior do grupo controle (50,92±5,18 graus) e do grupo experimental (49,63±5,46 graus). O IDCC mostrou que o grupo experimental apresentou disfunção crânio-cervical, sendo 37,5 % leve, 37,5% moderada e 25% severa. Já no grupo controle 100% das voluntárias apresentaram disfunção crânio-cervical leve. CONCLUSÃO: Não houve diferença na posição da cabeça entre os grupos avaliados. Porém, as mulheres disfônicas apresentaram disfunção crânio-cervical mais acentuada que as do grupo controle.

Purpose: To analyze the posture and the function of the craniocervical region in women with dysphonia. METHODS: Twenty eight women participated in the study (31.25±8.14 years), divided into two groups: experimental (N=16, patients with dyphonia) and control (N=12, clinically normal). The volunteers were submitted to evaluation of the Craniocervical Dysfunction Index (CDI) and photogrammetry, determining the anterior angle formed between the seventh cervical vertebra and the tragus, which corresponds to the head position in the sagittal plane. The analysis of the photos was carried out by three examiners, twice each, with an interval of one week between them. Data analysis used the Shapiro-Wilk test, followed by the Student's t-test, (p<0,05). RESULTS: No difference was found between the mean values of the anterior angle of the control (50.92±5.18 degrees) and the experimental (49.63±5.46 degrees) groups in the photogrammetry (p=0.2565). The CDI showed that the experimental group had craniocervical dysfunction, which was mild in 37.5% of the cases, moderate, in 37.5%, and severe in 25%. In the control group, 100% of the volunteers had presented mild craniocervical dysfunction. CONCLUSION: There was no difference between the evaluated groups regarding head position. However, dysphonic women presented more severe craniocervical dysfunction than the group control.

TEMA: estudos mostram correlação entre disfonia e tensão muscular. OBJETIVO: avaliar a atividade elétrica dos músculos supra-hióideos (SH), esternocleidomastóideo (ECM) e trapézio (T) bilateralmente, a dor e a voz, após aplicação da estimulação elétrica nervosa transcutânea (TENS). MÉTODO: participaram dez mulheres com nódulos ou espessamento mucoso bilateral e fenda à fonação. As voluntárias receberam dez sessões de TENS (200µs e 10Hz) por 30 minutos. A dor foi avaliada pela escala visual analógica, a voz por meio de laringoscopia, análise perceptivo-auditiva e acústica e o sinal mioelétrico pela raiz quadrada da média (RMS). A coleta dos dados de voz e EMG deu-se por emissão da vogal /E/ e fala espontânea. A análise estatística constou do teste de Shapiro-Wilk, seguido do teste de Wilcoxon ou t Student ou de Friedman (p < 0,05). RESULTADOS: observou-se que a TENS diminuiu o RMS, pré e pós-tratamento, para TD (2,80 ± 1,36 para 1,77 ± 0,93), TE (3,62 ± 2,10 para 2,10 ± 1,06), ECME (2,64 ± 0,69 para 1,94 ± 0,95) e SH (11,59 ± 7,72 para 7,82 ± 5,95) durante a emissão da vogal /E/, e TD (3,56 ± 2,77 para 1,93 ± 1,13), TE (4,68 ± 2,56 para 3,09 ± 2,31), ECMD (3,94 ± 2,04 para 2,51 ± 1,87) e ECME (3,54 ± 1,04 para 3,12 ± 3,00) durante a fala espontânea (FE), além da diminuição da dor. Quanto à voz, ocorreu diminuição do grau das lesões laríngeas e, na análise perceptivo-auditiva, não houve diferença durante a emissão da vogal /E/, porém durante a FE ocorreu diminuição do grau de disfonia e rouquidão. CONCLUSÃO: a TENS é eficaz na melhora do quadro clínico e funcional de mulheres disfônicas.

BACKGROUND: studies indicate correlation between dysphonia and muscle tension. AIM: to evaluate bilaterally the electrical activity of the suprahyoid muscles (SH), sternocleidomastoid (SCM), and trapezius (T), the presence of pain and the voice, after applying transcutaneous electrical nerve stimulation (TENS). METHOD: ten (10) women with nodules or bilateral mucus thickening, and phonation fissure. Volunteers were submitted to 10 TENS sessions (200µs and 10Hz) for 30 minutes. Pain was evaluated using an analogical visual scale; the voice was evaluated through laryngoscopy and through a perceptive-auditory and acoustic analysis; and the myoelectric signal was converted using the Root Media Square (RMS). Voice and EMG data gathering was performed during the production of the E/vowel and during spontaneous speech (SS). STATISTICAL ANALYSIS: Shapiro-Wilk Test followed by the Wilcoxon Test, or t Student, or Friedman Test (p < 0.05). RESULTS: It was observed that the TENS decreased the RMS readings, pre and pos treatment, for the Right T (RT) (2.80 ± 1.36 to 1.77 ± 0.93), the Left T (LT) (3.62 ± 2.10 to 2.10 ± 1.06), the Left SCM (LSCM) (2.64 ± 0.69 to 1.94 ± 0.95), and the SH (11.59 ± 7.72 to 7.82 ± 5.95) during the production of the E/vowel; and for the RT (3.56 ± 2.77 to 1.93 ± 1.13), the LT (4.68 ± 2.56 to 3.09 ± 2.31), the Right SCM (RSCM) (3.94 ± 2.04 to 2.51 ± 1.87), and the LSCM (3.54 ± 1.04 to 3.12 ± 3.00) during SS. A relieve in pain was also observed. Regarding the voice analysis, there was a decrease in level of laryngeal injuries; no difference was observed during the production of the E/vowel in the perceptive-auditory analysis; there was a decrease in the level of dysphonia and hoarseness during SS. CONCLUSION: TENS is effective in improving the clinical and functional signs of dysphonic women.