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Biomedical subjects

J R Fricton

Publications and source records attributed to J R Fricton.

At least 37 records · Page 2Linked to original sources
PubMed1991

Physical therapy for temporomandibular disorders and orofacial pain.

In the past year, physical therapy has been increasingly advocated as a standard part of the multidisciplinary approach to treating temporomandibular disorders and other orofacial pain conditions. This literature has focused primarily on review articles of the characteristics, indications, and efficacy of physical therapy interventions, which generally include exercises and modalities. However, most of the evidence regarding physical therapy is from clinical reports and lacks well-controlled studies. The purpose of this review is to discuss the current literature in the context of past literature supporting the clinical use of physical therapy for orofacial pain.

Cold Temperature↗
PubMed1991

Clinical care for myofascial pain.

Myofascial pain (MFP) is a regional muscle pain disorder characterized by localized tenderness in taut muscle bands and referred pain. Frequently, MFP is overlooked as a common cause of chronic pain because of the frequent association with joint dysfunction and other pain disorders and the multiple behavioral and psychosocial contributing factors that are often present. Nonetheless, studies have reported that MFP is present in a significant number of people. This article describes current concepts for the diagnosis and management of MFP.

Chlorofluorocarbons, Methane↗
PubMed1990

The prevalence and treatment needs of subjects with temporomandibular disorders.

A cross-sectional study of prevalence of temporomandibular joint (TMJ) internal derangements, muscle disorders, and associated TM signs and symptoms was completed on 269 female nursing students. The prevalence of specific stages of internal derangements of the TMJ and muscle disorders was estimated, using established diagnostic criteria. The levels of dysfunction and symptomatology associated with each diagnosis were estimated with previously established indexes. When subjects with symptoms were asked if they had previous treatment for a TMJ problem, 6.7% responded positively. When subjects with symptoms who had not had treatment were asked why they had not sought treatment, most responded that it was not a problem or they could live with the symptoms. Thus, most subjects with clinically detectable dysfunction are functioning adequately without significant symptoms and do not need treatment.

Adult↗
PubMed1989

Clinical vs. arthrographic diagnosis of TMJ internal derangement.

Internal derangements of the temporomandibular joint (TMJ) have gained increased recognition as a potential source of pain and dysfunction of the masticatory system. The objective of this study was to evaluate the reliability of clinicians in predicting an arthrographic diagnosis of articular disc position in a typical patient population presenting for TMJ arthrographic evaluation. Two clinicians utilized a brief history, clinical examination (including evaluation of mandibular movement and TMJ auscultation), and tomographic TMJ imaging in evaluating 60 patients. The radiologist subsequently performed the arthrographic procedures on 102 TMJs (18 unilateral and 42 bilateral). Diagnostic agreement was determined for all possible diagnostic categories including: normal disc position, TMJ internal derangement with reduction, TMJ internal derangement without reduction/acute, TMJ internal derangement without reduction/chronic, and osteoarthrosis. The significance of the diagnostic agreement between the clinicians and arthrography was evaluated with a Kappa Statistical Test, which showed good reliability. For epidemiological studies, it was concluded that clinical and tomographic evaluation would provide sufficient reliability for determination of the presence and stage of TMJ internal derangement. However, in a specific clinical situation, a difficult diagnostic problem may require the use of arthrography, depending on the impact of the diagnosis on subsequent treatment decisions.

Adolescent↗
PubMed1989

Myofascial pain syndrome.

Myofascial pain syndrome is a regional muscle pain disorder that is the most common physical diagnosis causing chronic pain. The complex symptoms, concomitant disorders, and frequent behavioral and psychosocial contributing factors make this disorder frequently overlooked and difficult to treat. Once recognized, management programs involving rehabilitating the affected muscles and controlling the contributing factors are effective if long-term compliance is maintained by the patient.

Humans↗
PubMed1987

The craniomandibular index: validity.

The CMI appears to be valid for use in clinical studies, but users must be aware of its numerous potential errors and its associated strict methodologic guidelines to ensure accuracy and reproducibility of results. The subjective nature of some items demands that the same rater who is unaware of the management status of the patient perform both evaluations. If multiple raters are used, it is recommended that the raters discuss all items, and compare scoring of demonstration subjects before the study and use a pressure algometer for muscle palpation.

Facial Pain↗
PubMed1986

Reliability of a craniomandibular index.

The Craniomandibular Index (CMI) was developed to provide a standardized measure of severity of problems in mandibular movement, TMJ noise, and muscle and joint tenderness for use in epidemiological and clinical outcome studies. The instrument was designed to have clearly defined objective criteria, simple clinical methods, and ease in scoring; it is divided into the Dysfunction Index and the Palpation Index. Inter-rater reliability (three raters) and intra-rater reliability (19 patients examined twice by one rater) were tested to determine whether the instrument has operational definitions sufficiently precise to allow for consistency in use between different raters and with one rater over time. Intraclass Correlation Coefficient for inter-rater reliability was 0.84 for the Dysfunction Index, 0.87 for the Palpation Index, and 0.95 for the CMI. Correlation for intra-rater reliability was 0.92 for the Dysfunction Index, 0.86 for the Palpation Index, and 0.96 for the CMI. These results support the reliability of the CMI for use in epidemiological and clinical studies. Users are cautioned about the subjectivity of numerous items within the CMI and the strict methodological guidelines that must be followed in order to assure accuracy and reproducibility of results.

Humans↗
PubMed1985

Myofascial pain syndrome of the head and neck: a review of clinical characteristics of 164 patients.

Myofascial pain syndrome (MPS) is a common but misunderstood muscular pain disorder involving pain referred from small, tender trigger points within myofascial structures in or distant from the area of pain. Misdiagnosis or inadequate management of this disorder after onset may lead to development of a complex chronic pain syndrome. A review of the clinical characteristics of 164 patients whose chief complaints led to the diagnosis of MPS revealed that these patients had (1) tenderness at points in firm bands of skeletal muscle that were consistent with past reports, (2) specific patterns of pain referral associated with each trigger point, (3) frequent emotional, postural, and behavioral contributing factors, and (4) frequent associated symptoms and concomitant diagnoses.

Adolescent↗
PubMed1985

Myofascial pain syndrome: electromyographic changes associated with local twitch response.

Electromyographic (EMG) recordings of the local twitch response in sixteen subjects with pain from active myofascial trigger points in the upper trapezius muscle were examined and compared with recordings from the contralateral normal muscle bands in the same individual. Needle electromyography and a specific reproducible snapping palpation technique were used to elicit and record the local twitch response. The mean value for the EMG recordings of bands with trigger points versus the normal muscle bands using the visual scoring method were 3.81 and .81 respectively. Mean values for the EMG recordings of muscle bands with trigger points versus the normal muscle using the spike counting method were 31.81 and 8.75 respectively. Both results were statistically compared using student's t-test. The motorunit electrical activity of the bands with trigger points was found to be significantly higher (p less than or equal to 0.001) than that of the normal muscle.

Action Potentials↗
PubMed1982

Practical differential diagnosis of chronic craniofacial pain.

Chronic craniofacial pain afflicts more than one in every ten persons in the United States and Europe. Successful management of chronic craniofacial pain closely follows the thorough evaluation and understanding of the patient and the problem and, subsequently, a correct diagnosis or diagnoses. Evaluation of the patient includes a complete medical, dental, and personal history, physical examination, and appropriate diagnostic studies and consultations. Special consideration should be given the possibility of multiple diagnoses as well as complicating emotional, behavioral, or perceptual factors common in persons with chronic pain. Differential diagnosis is simplified by the use of a practical classification of chronic craniofacial pain.

Chronic Disease↗
PubMedDate not supplied

Masticatory myofascial pain: an explanatory model integrating clinical, epidemiological and basic science research.

Masticatory myofascial pain (MMP) is a regional muscle pain disorder characterized by localized muscle tenderness in taut bands of skeletal muscles and pain and is one of the most common causes of persistent regional pain. The affected muscles may also display an increased fatigability, stiffness, subjective weakness, pain in movement, and slight restricted ROM that is unrelated to joint restriction. Although the exact etiology of MMP is unclear, recent research has improved our understanding of factors that contribute to the development and progression of MMP. Understanding these factors can help to validate an explanatory model for etiology and treatment of MMP. This model includes peripheral mechanisms from local biomechanical strain leading to the onset of early cases of MMP while central mechanisms associated with psychosocial factors lead to increased chronicity of MMP. As MP persists, chronic pain characteristics often precede or follow it's development. Management of the syndrome naturally follows from this model with therapy to rehabilitate the trigger points (TrPs) while focusing effort on reducing all contributing factors.

Adaptation, Psychological↗
PubMedDate not supplied

Musculoskeletal measures of orofacial pain.

Musculoskeletal disorders of the stomatognathic system comprise the majority of diagnoses responsible for chronic orofacial pain. The most common signs for these disorders include tenderness, limitation in range of motion, deviation in range of motion, and joint noise. Although these signs are used routinely for diagnosis, the reliability, validity, and accuracy of their use as diagnostic criteria or outcome measures has not been established. A series of clinical studies on a Craniomandibular Index (CMI) was completed to examine these issues. Interrater and intrarater reliability of the grouped items in the CMI ranged from 0.58-0.98, with an overall correlation coefficient of 0.95 and 0.96, respectively. Pressure algometry improved reliability of muscle and joint palpation for tenderness. Tenderness, but not dysfunction, was correlated with symptom severity. Both tenderness and dysfunction improved with treatment but did not become normal. The percent agreement of these signs as diagnostic criteria for the presence and stage of a temperomandibular joint (TMJ) internal derangement was about 80% compared with arthrotomography. These studies suggest that these clinical characteristics can be used with adequate reliability and validity to diagnose and measure severity if standardized methods are used.

Facial Pain↗