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This cross-sectional study investigates neck-related disability in individuals with chronic neck pain by examining the combined influence of temporomandibular disorders, sleep quality, and cervical sensorimotor function within a single analytical model. Although these factors have previously been investigated separately, their combined contribution to disability has not been sufficiently explored. By integrating these clinical variables within one framework, our study aims to provide a multidimensional clinical perspective relevant to assessment and rehabilitation planning in musculoskeletal practice. Given the increasing clinical recognition of the interaction between temporomandibular and cervical systems, this study may help clinicians better understand multidimensional contributors to disability in chronic neck pain.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TMD-positive | TMD-negative | ||
| TMD-negative |
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| Measure | Description | Time Frame |
|---|---|---|
| neck disability | Neck disability was evaluated by The Neck Disability Index (NDI) total score The NDI consists of 10 questions in total, and each question evaluates a different area of daily life. Each question is scored between 0 and 5 points: 0 = no problem at all, 5 = maximum limitation. The total score range can be: Minimum: 0 and Maximum: 50. | Primary outcome (NDI) was measured once at baseline during the cross-sectional assessment. |
| Measure | Description | Time Frame |
|---|---|---|
| Sleep quality | Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The sleep-related assessment consists of 7 components, each scored between 0 and 3: 0 = no problem and 3 = serious problem. The total score can range from a minimum of 0 to a maximum of 21. As the score increases, sleep quality deteriorates: ≤5 good sleep quality and >5 poor sleep quality. | at baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Cervical Proprioception, Deep Neck Flexor Endurance, and Posture | Cervical proprioception was assessed using the joint position error (JPE) test. Participants were seated in an upright position with a laser pointer securely attached to the head. A target point was marked on a wall at eye level to represent the neutral head position. With their eyes closed, participants were instructed to actively move their head into flexion, extension, and right and left rotation, and then return to the initial neutral position. The deviation of the laser point from the target was recorded for each movement direction. Absolute error values were calculated and expressed in degrees (°). The mean of the absolute errors obtained from the four movement directions was used for statistical analysis, with higher values indicating poorer cervical proprioceptive accuracy. |
Inclusion Criteria:
Exclusion Criteria:
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individuals presenting with chronic neck pain to the Physical Medicine and Rehabilitation outpatient clinic of our hospital.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Istanbul Medipol University | Istanbul | Turkey (Türkiye) |
The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request. But we can share IPD after publication of our article.
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| ID | Term |
|---|---|
| D013705 | Temporomandibular Joint Disorders |
| D019547 | Neck Pain |
| ID | Term |
|---|---|
| D017271 | Craniomandibular Disorders |
| D008336 | Mandibular Diseases |
| D007571 | Jaw Diseases |
| D009140 | Musculoskeletal Diseases |
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| at baseline |
| Deep neck flexor muscle endurance | Deep neck flexor muscle endurance was assessed using the craniocervical flexion test protocol. Participants were positioned supine with knees flexed and instructed to perform a gentle craniocervical flexion (chin tuck) without lifting the head from the surface. The position was maintained isometrically, and the duration for which the participant could sustain the correct posture without compensation was recorded. Test duration was measured in seconds. Higher values indicate greater deep neck flexor muscle endurance. Unit of Measure: Seconds | at baseline |
| D007592 |
| Joint Diseases |
| D009135 | Muscular Diseases |
| D009057 | Stomatognathic Diseases |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |