BackgroundThe objective was to compare and correlate disability, pain intensity, the impact of headache on daily life and the fear of movement between subgroups of patients with chronic temporomandibular disorder (TMD).MethodsA cross-sectional study was conducted in patients diagnosed with chronic painful TMD. Patients were divided into: 1) joint pain (JP); 2) muscle pain (MP); and 3) mixed pain. The following measures were included: Craniomandibular pain and disability (Craniofacial pain and disability inventory), neck disability (Neck Dsiability Index), pain intensity (Visual Analogue Scale), impact of headache (Headache Impact Test 6) and kinesiophobia (Tampa Scale of Kinesiophobia-11).ResultsA total of 154 patients were recruited. The mixed pain group showed significant differences compared with the JP group or MP group in neck disability (p < 0.001, d = 1.99; and p < 0.001, d = 1.17), craniomandibular pain and disability (p < 0.001, d = 1.34; and p < 0.001, d = 0.9, respectively), and impact of headache (p < 0.001, d = 1.91; and p < 0.001, d = 0.91, respectively). In addition, significant differences were observed between JP group and MP group for impact of headache (p < 0.001, d = 1.08). Neck disability was a significant covariate (37 % of variance) of craniomandibular pain and disability for the MP group (β = 0.62; p < 0.001). In the mixed chronic pain group, neck disability (β = 0.40; p < 0.001) and kinesiophobia (β = 0.30; p = 0.03) were significant covariate (33 % of variance) of craniomandibular pain and disability.ConclusionMixed chronic pain patients show greater craniomandibular and neck disability than patients diagnosed with chronic JP or MP. Neck disability predicted the variance of craniofacial pain and disability for patients with MP. Neck disability and kinesiophobia predicted the variance of craniofacial pain and disability for those with chronic mixed pain.

The purpose of this study was to evaluate the effectiveness of a treatment for patients with cervicogenic dizziness that consisted of therapeutic education and exercises. The Dizziness Handicap Inventory and Neck Disability Index were used. Secondary outcomes included range of motion, postural control, and psychological variables. Seven patients (two males and five females) aged 38.43±14.10 with cervicogenic dizziness were included. All the participants received eight treatment sessions. The treatment was performed twice a week during a four weeks period. Outcome measures included a questionnaire (demographic data, body chart, and questions about pain) and self-reported disability, pain, and psychological variables. Subjects were examined for cervical range of motion and postural control. All of these variables were assessed pre- and postintervention. Participants received eight sessions of therapeutic education patient and therapeutic exercise. The majority of participants showed an improvement in catastrophism (mean change, 11.57±7.13; 95% confidence interval [CI], 4.96–18.17; d=1.60), neck disability (mean change, 5.14±2.27.28; 95% CI, 3.04–7.24; d=1.32), and dizziness disability (mean change, 9.71±6.96; 95% CI, 3.26–16.15; d=1.01). Patients also showed improved range of motion in the right and left side. Therapeutic patient education in combination with therapeutic exercise was an effective treatment. Future research should investigate the efficacy of therapeutic patient education and exercise with larger sample sizes of patients with cervicogenic dizziness.

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Background: Low back pain (LBP) is the most prevalent musculoskeletal problem among adults. Individuals with chronic LBP (CLBP) can present a psychological disorder and a lack of pain self-efficacy. Objectives: The objective of this study was to compare the process of repetition-induced summation of activity-related pain, the lumbar range of motion, and the postural stability of patients with non-specific LBP (NSLBP) based on their level of self-efficacy. Study Design: This research used a descriptive, cross-sectional study design. Methods: This research included 60 patients with NSCLBP. Patients were classified as having “high” or “low” self-efficacy based on a median split of scores on the Chronic Pain Self-Efficacy Scale. All patients received a sociodemographic questionnaire, a psychological self-reported measures (Tampa scale of Kinesiophobia; Pain Catastrophizing Scale; Rumination subscale, Magnification subscale; Helplessness subscale; Roland-Morris Disability Questionnaire; FearAvoidance Belief Questionnaire; Physical Activity subscale; Work subscale); and completed the Temporal Summation Lifting Task, Lumbar Range of Motion, and Multi-Directional Functional Reach Test (MDFRT). Results: The results indicated that the low self-efficacy group had a shorter lumbar range of motion and lower postural stability, in addition to greater pain intensity in the temporal summation lifting task, compared with the high self-efficacy group. The analysis showed that the strongest correlation for the high self-efficacy was between fear of movement and the temporal summation lifting task, and greater scores at the psychological questionnaires, compared with the high selfefficacy group (r = 0.711; P < 0.01). The strongest correlations found for the low self-efficacy group, showed a positive relationship between pain catastrophizing and the temporal summation lifting task (r = 0.765; P < 0.01), and a strong negative association between pain catastrophizing for the magnification subscale and lumbar range of motion (r = -0.759; P < 0.01). Limitations: The results of this study should be interpreted with caution because of its crosssectional design, and therefore causal relationships cannot be established. A significant limitation of the study is that patients’ physical activity levels were not assessed, which could have influenced their ability to perform motor tasks at the perceived difficulty and fear level. Conclusions: The high self-efficacy group had less pain in the temporal summation lifting task, a greater range of motion, and a greater functional range, in addition to a lower influence of psychological factors. Key words: Low back pain, chronic pain, self-efficacy, temporal summation, range of motion, postural stability, fear of movement, pain catastrophizing, low back disability

Introduction. Psychosocial and somatosensory factors are involved in the pathophysiology of chronic migraine (CM) and chronic temporomandibular disorders (TMD). Objective. To compare and assess the relationship between pain catastrophizing and kinesiophobia in patients with CM or chronic TMD. Method. Cross-sectional study of 20 women with CM, 19 with chronic TMD, and 20 healthy volunteers. Pain catastrophizing and kinesiophobia were assessed. The level of education, pain intensity, and magnitude of temporal summation of stimuli in the masseter (STM) and tibialis (STT) muscles were also evaluated. Results. There were significant differences between the CM and chronic TMD groups, compared with the group of asymptomatic subjects, for all variables (p < .05) except kinesiophobia when comparing patients with CM and healthy women. Moderate correlations between kinesiophobia and catastrophizing (r = 0.46; p < .01) were obtained, and the strongest association was between kinesiophobia and magnification (r = 0.52; p < .01). The strongest associations among physical variables were found between the STM on both sides (r = 0.93; p < .01) and between the left and right STT (r = 0.76; p < .01). Conclusion. No differences were observed in pain catastrophizing and kinesiophobia between women with CM and with chronic TMD. Women with CM or chronic TMD showed higher levels of pain catastrophizing than asymptomatic subjects.

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Objective To compare the effectiveness of a biobehavioral approach with and without orthopedic manual physical therapy on the intensity and frequency of pain in patients diagnosed with nonspecific chronic low back pain. Methods A single-blind randomized controlled trial. Fifty patients were randomly allocated into two groups: one group received biobehavioral therapy with orthopedic manual physical therapy, and the other group received only biobehavioral therapy. Both groups completed a total of eight sessions, with a frequency of two sessions per week. The somatosensory, physical, and psychological variables were recorded at baseline and during the first and third month after initiation of treatment. Results In both groups, the treatment was effective, presenting significant differences for all the variables in the time factor. There were no significant differences between groups in intensity or frequency of pain, with a large effect size (&gt;0.80), but there were intragroup differences for both intervention groups at one- and three-month follow-up. There were also no significant differences between groups in the secondary variables during the same follow-up period. Conclusions The results of this study suggest that orthopedic manual physical therapy does not increase the effects of a treatment based on biobehavioral therapy in the short or medium term, but these results should be interpreted with caution.

Both motor imagery (MI) and action observation (AO) trigger the activation of the neurocognitive mechanisms that underlie the planning and execution of voluntary movements in a manner that resembles how the action is performed in a real way. The main objective of the present study was to compare the autonomic nervous system (ANS) response in an isolated MI group compared to a combined MI + AO group. The mental tasks were based on two simple movements that are recorded in the revised movement imagery questionnaire in third-person perspective. The secondary objective of the study was to test if there was any relationship between the ANS variables and the ability to generate mental motor imagery, the mental chronometry and the level of physical activity. The main outcomes that were measured were heart rate, respiratory rate and electrodermal activity. A Biopac MP150 system, a measurement device of autonomic changes, was used for the quantification and evaluation of autonomic variables. Forty five asymptomatic subjects were selected and randomized in three groups: isolated MI, MI + AO and control group (CG). In regards to the activation of the sympathetic nervous system (SNS), no differences were observed between MI and MI + AO groups (p > .05), although some differences were found between both groups when compared to the CG (p < .05). Additionally, even though no associations were reported between the ANS variables and the ability to generate mental motor imagery, moderate-strong positive associations were found in mental chronometry and the level of physical activity. Our results suggest that MI and MI + AO, lead to an activation of the SNS, although there are no significant differences between the two groups. Based on results obtained, we suggest that tasks of low complexity, providing a visual input through the AO does not facilitates their subsequent motor imagination. A higher level of physical activity as well as a longer time to perform mental task, seem to be associated with a greater increase in the ANS response.