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Critical analysis of diagnostic tools for the temporomandibular joint

100%
Marciniak T.
|
2018
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vol. 32
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issue 3
45-52
EN
The prevalence of temporomandibular disorder (TMD) in the general population is difficult to identify. Depending on the source, values range from 3% to 48.9%. These large discrepancies occur because of two main reasons. The first one is connected with the evolution of the definition and diagnostic criteria of TMD, while the second one concerns the use of different diagnostic tools, protocols, etc. Temporomandibular joint (TMJ) diagnosis is both quantitative and qualitative. Quantitative measurements used in the field of scientific research are highly accurate motion capture systems used for kinematic analysis, while an electronic caliper is applied in a clinical setting. MRI seems optimal in TMJ disc and its dysfunction imaging. In more difficult cases, ultrasound imaging can be used. On the other hand, CT is the best examination for joint imaging. In recent years, qualitative measurements have been dominated by vibroarthrography (VAG), which shows good diagnostic value. Research Diagnostic Criteria for Temporomandibular Joint Disorders (RDC/TMD) is the most complex systematized diagnostic tool for TMD. The proposed procedure allows us to differentiate a real TMJ dysfunction from other systemic problems that can manifest themselves in this region of TMJ, such as depression, chronic pain or psychosomatic disorders. RDC/TMD are constantly evaluated and modified in terms of their diagnostic or clinical value by experts associated in the International RDC-TMD Consortium. Currently it is the best tool available for TMD diagnostics. The RDC/TMD questionnaire was translated into Polish, culturally adapted and officially approved by the Consortium. The aim of the study is to review selected TMD diagnostic tools and to assess their diagnostic value.
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Ultrasound guided joint space distance changes during manual traction of acromioclavicular joint in young and healthy adults

51%
Marciniak T., Brożyński M., Wit A.
Advances in Rehabilitation
|
2015
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vol. 29
|
issue 3
13-19
EN
Introduction: Manual traction is a commonly used technique in manual therapy. However, depicting changes in joint space distance via real time imaging during traction is seldomly applied. The aims of the study were to identify ACJ joint space distance changes during manual traction and creation of a classification of the techniques upon the largest change in the resultant parameter (l) representing joint space distance. Material and methods: Thirteen healthy volunteers were examined unilaterally. Acromioclavicular joint space distance changes were measured with dynamic ultrasound imaging during followingmanual traction techniques: International Academy of Orthopedic Medicine technique (IAOM AC), Karel Lewit’s Prague School of Manual Medicine & Rehabilitation technique (LAC) and author’s own proposition (B AC). The differences in joint space distance between resting position (RP) and the traction technique position, created three parameters of displacement - horizontal (x), vertical (y) and (l) - the resultant component. Results: Parameters were not coherent with normal distribution. Statistical differences showed significance in the (x) parameter for IAOM AC compared with L AC (p<0,0183) and B AC (p<0,02). All techniques presented a significant increase of the resultant distance (l), compared with RP as the reference value - IAOM AC p<0,0036, L AC and B AC p<0,0000. In few cases L AC decreased the distance in the (x) parameter, but not significantly. Conclusions: 1.Significant changes of (x) parameter did not correspond with the significance of the resultant parameter (l), which prevented authors from creating a classification of the techniques. 2.All traction techniques used in the study increased the joint space distance compared to RP, which confirms traction’s theoretical assumptions. 3.For clinical purpose the change of (x) parameter may prove crucial for therapy’s effectiveness, despite lack of change in the joint space distance in the resultant parameter (l) by itself.
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Analiza Parametrów Czasowo-Przestrzennych Chodu Osób Starszych w Aspekcie Treningu / Elders’ Gait Analysis Using Spatiotemporal Parameters in Aspects of Training

51%
Marciniak T., Wiszomirska I., Kaczmarczyk K., Kozdroń E.
Advances in Rehabilitation
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2011
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vol. 25
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issue 2
19-25
EN
Introduction. The involutive changes of humans’ gait are multifactoral and they have negative influence on its quality. Among other symptoms, decrease in muscle strength and range of motion are the most frequently mentioned. These factors have an impact on some spatiotemporal gait parameters, such as decrease in gait velocity and step length and increase in step width. Study Aim. The aim of the study was to assess the influence of two different forms of training on spatiotemporal parameters of elders’ gait. Material. Fifty-nine participants joined the project. Medical examination and stress test were conducted to exclude any health contraindications. Participants were divided into two groups: versatile training (TW), and training in low positions (TN). Fourteen participants in each group finished the research protocol. Method. FDM Zebris platform was used to register the spatiotemporal parameters of subjects’ gait. Their task was to walk through it with their natural velocity three times. The training protocol took 12 weeks, twice a week meetings lasting 45 minutes. The main difference between the training groups was that the exercises of locomotion and in high positions were excluded in the TN group. Statistical analysis was conducted with Statistica software. Results. As a result of TW group, six parameters changed statistically significantly. step length of the right lower extremity step length of the right lower extremity (as a % of leg lenght) and step time of the left and right lower extremity, stride time and cadence. The other parameters showed different tendencies, but their changes cannot be assigned to the training protocol. TN subjects did not show any significant changes in the parameters considered. Conclusions. Changes of gaits’ quality are multifactor therefore they require future investigation. They need to be identified in order to be modified in the course of training or therapy. The exercise selection should include structurally similar tasks to the ones’ they desire to develop.
4
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Evaluation of static and dynamic postural stability in young, elderly and with vision loss women

39%
Wiszomirska I., Kaczmarczyk K., Zdrodowska A., Błażkiewicz M., Ilnicka L., Marciniak T.
Advances in Rehabilitation
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2013
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vol. 27
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issue 3
29-35
EN
Introduction: Balance difficulties are one of the factors that have a negative impact on the daily activity of elderly people, which in turn lowers their quality of life. Aim: evaluation of the differences in static and dynamic postural stability in young, elderly and with vision loss women. Material and methods: Eighty-three female volunteers were divided into three groups: 26 young women (20,2 ± 1,75), 26 elderly (68,7 ± 7,55) and 15 pupils with vision loss (19,2±1,78). The following parameters were analysed from Accusway and BBS platforms. Results: A comparison of results with visual inspection between a group of young and elderly women showed statistically significant differences in terms of stabilogram ellipse area and maximal postural s way in ML direction. These two groups differ significantly in all parameters from BBS platform. The greatest differences are observed on a dynamic ground (p<0,001). Women with visual loss achieved the best results of path COP with eyes closed (37,01±6,73), the worst results were observed in a group of elderly women (49,59±21,04). They also did not perform any tasks on a dynamic ground without visual inspection. Women with visual loss achieved significantly worse results than young group. Conclusions: Greater balance control system involvement is observed in dynamic tests, which seem to be more appropriate and can detect disturbances earlier than static tests. Tests with changeable stability of the platform and without visual inspection that differentiate the groups seem to be particularly useful.
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