측두하악관절 장애를 가진 환자를 저작근 동통을 가진 환자와 관절강 내 동통을 가진 환자 그룹으로 구분하여, 두 그룹사이의 동통의 정도나 기간의 차이, 그리고 수면질의 차이에 따른 삶의 질의 차이를 비교하였다. 총 61명의 환자는 관절강 내 통증을 가진 환자 24명과 저작근 동통을 가진 환자 37명으로 구성되었다. 상기 환자들은 첫 내원 시 맥길 통증설문지(McGill Pain Questionnaire), 피츠버그 수면 질 평가 (Pittsburgh Sleep Quality Index), SF-36 (Medical Outcome Study 36 Item Short Form Health Survey)을 작성하고 치과적 병력과 의과적 병력을 기록한 후, 전반적인 측두하악관절에 대한 검사를 시행하였다. 두 그룹 사이에는 동통의 강도나 기간에 유의한 차이는 보이지 않았으나, 6개월 이상 측두하악관절장애를 가지는 환자 중에서는 저작근 동통을 가진 환자가 관절강 내 동통을 가지는 환자보다 SF-36의 평균과 정신적인 부분에서의 점수에서 낮은 수치를 보인다(p<0.05). 피츠버그 수면 질 평가에서는 평사시의 수면 효율면에서 저작근 동통을 가진 환자 ($1.9459{\pm}0.8481$)가 관절강내 동통을 가지는 환자 ($1.375{\pm}0.9237$)에 비해 낮은 효율을 보인다. 또한 저작근 동통을 가진 환자군에서 피츠버그 수면 질 평가의 총점이 5이상인 나쁜 수면질을 가지는 군은 맥길 통증 설문지, SF-36에서 높은 동통 정도와 낮은 삶의 질을 가지는 것으로 결과가 도출되었다. 또한 저작근 동통을 가진 환자는 전체적인 삶의 질을 나타내는 SF-36에서는 감정적인 문제로 인한 역할의 제한, 생활력, 신체적 동통에서 관절강 내 동통을 가진 환자에 비해 낮은 수치를 나타내어, 삶의 질이 특히 정신적인 면에서 손상되었다는 것을 나타낸다.
측두하악관절 장애를 가진 환자를 저작근 동통을 가진 환자와 관절강 내 동통을 가진 환자 그룹으로 구분하여, 두 그룹사이의 동통의 정도나 기간의 차이, 그리고 수면질의 차이에 따른 삶의 질의 차이를 비교하였다. 총 61명의 환자는 관절강 내 통증을 가진 환자 24명과 저작근 동통을 가진 환자 37명으로 구성되었다. 상기 환자들은 첫 내원 시 맥길 통증설문지(McGill Pain Questionnaire), 피츠버그 수면 질 평가 (Pittsburgh Sleep Quality Index), SF-36 (Medical Outcome Study 36 Item Short Form Health Survey)을 작성하고 치과적 병력과 의과적 병력을 기록한 후, 전반적인 측두하악관절에 대한 검사를 시행하였다. 두 그룹 사이에는 동통의 강도나 기간에 유의한 차이는 보이지 않았으나, 6개월 이상 측두하악관절장애를 가지는 환자 중에서는 저작근 동통을 가진 환자가 관절강 내 동통을 가지는 환자보다 SF-36의 평균과 정신적인 부분에서의 점수에서 낮은 수치를 보인다(p<0.05). 피츠버그 수면 질 평가에서는 평사시의 수면 효율면에서 저작근 동통을 가진 환자 ($1.9459{\pm}0.8481$)가 관절강내 동통을 가지는 환자 ($1.375{\pm}0.9237$)에 비해 낮은 효율을 보인다. 또한 저작근 동통을 가진 환자군에서 피츠버그 수면 질 평가의 총점이 5이상인 나쁜 수면질을 가지는 군은 맥길 통증 설문지, SF-36에서 높은 동통 정도와 낮은 삶의 질을 가지는 것으로 결과가 도출되었다. 또한 저작근 동통을 가진 환자는 전체적인 삶의 질을 나타내는 SF-36에서는 감정적인 문제로 인한 역할의 제한, 생활력, 신체적 동통에서 관절강 내 동통을 가진 환자에 비해 낮은 수치를 나타내어, 삶의 질이 특히 정신적인 면에서 손상되었다는 것을 나타낸다.
Objectives: To explore the quality of life in patients with temporomandibular disorders and to evaluate it in terms of source and duration of the pain. Methods: A total of 61 patients with temporomandibular disorders participated in this study. According to pain source, they were divided into 2 grou...
Objectives: To explore the quality of life in patients with temporomandibular disorders and to evaluate it in terms of source and duration of the pain. Methods: A total of 61 patients with temporomandibular disorders participated in this study. According to pain source, they were divided into 2 groups, masticatory muscle pain (MMP) group and intracapsular pain (ICP) group. And each group was divided into acute phase group (pain duration <6 months) and chronic phase group (pain duration=6 months). The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) was used to measure patients' quality of life. The scores for eight-scale profile and the physical component summary (PCS) and mental component summary (MCS) of the SF-36 were compared between groups (MMP vs. ICP and acute vs. chronic). Student t-test was used to analyze the difference of the scores of the SF-36 between MMP and ICP groups. Results: MMP group showed significantly lower score in the 3 scales of the SF-36 (Role limitations due to emotional problems, Vitality, Bodily pain) when compared to ICP group. In acute phase there was no significant difference between MMP and ICP group in PCS as well as MCS scores, but in chronic phase MMP group showed significantly lower MCS score than ICP group. Conclusions: The masticatory muscle pain in patients with temporomandibular disorders,negatively influences the quality of life especially in chronic phase, and the mental components of quality of life are significantly interfered in the TMD patients with chronic masticatory muscle pain.
Objectives: To explore the quality of life in patients with temporomandibular disorders and to evaluate it in terms of source and duration of the pain. Methods: A total of 61 patients with temporomandibular disorders participated in this study. According to pain source, they were divided into 2 groups, masticatory muscle pain (MMP) group and intracapsular pain (ICP) group. And each group was divided into acute phase group (pain duration <6 months) and chronic phase group (pain duration=6 months). The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) was used to measure patients' quality of life. The scores for eight-scale profile and the physical component summary (PCS) and mental component summary (MCS) of the SF-36 were compared between groups (MMP vs. ICP and acute vs. chronic). Student t-test was used to analyze the difference of the scores of the SF-36 between MMP and ICP groups. Results: MMP group showed significantly lower score in the 3 scales of the SF-36 (Role limitations due to emotional problems, Vitality, Bodily pain) when compared to ICP group. In acute phase there was no significant difference between MMP and ICP group in PCS as well as MCS scores, but in chronic phase MMP group showed significantly lower MCS score than ICP group. Conclusions: The masticatory muscle pain in patients with temporomandibular disorders,negatively influences the quality of life especially in chronic phase, and the mental components of quality of life are significantly interfered in the TMD patients with chronic masticatory muscle pain.
* AI 자동 식별 결과로 적합하지 않은 문장이 있을 수 있으니, 이용에 유의하시기 바랍니다.
문제 정의
Most of the patients in this study had pain of a more chronic nature, and the fact emphasizes the importance of evaluating psychosocial factors and psychological distress. Also, the clinicians must be recognized that these distress have decreased the quality of life in patient with TMD, these results have suggested the value of evaluating these domains in the management of TMD.
The objective of this research was to identify differences between 2 groups of TMD patients, those with MMP versus ICP, and to compare these differences in terms of pain severity, sleep quality, and life quality.
제안 방법
At the first clinic visit prior to clinical examination, patients completed 3 questionnaires together with a routine pain history questionnaire. These included the Pittsburgh Sleep Quality Index (PSQI), the McGill Pain Questionnaires (MPQ), the Medical Outcomes Study 36-item short-form health survey (SF-36).
Each TMD patient was evaluated for subjective and objective signs and symptoms of MMP and ICP in accord with the Research Diagnostic Criteria12. For this study, the primary diagnosis of MMP or ICP were made when the subjects' chief complaints originated from the masticatory muscles or intracapsule of the TMJ.
It also contains an intensity scale and other items to determine the properties of pain experience. The questionnaire was designed to provide quantitative measures of clinical pain that can be treated statistically. But, these study were used a "Shor Form" of the MPQ (MPQ-SF) which was designed to obtain information from patients when time is limited.
The 2 diagnostic groups were divided into two groups according to pain duration that was divided into the two phase ; acute (within 6 month) phase and chronic (post 6 months) phase. Then, we compared to categories of MPQ, PSQI, SF-36 according to pain duration within each diagnostic group. These results are presented in Table 4,5.
대상 데이터
The subjects were 61 patients with TMD. They were selected from patients referred to the Department of Oral Medicine, Kyungpook National University Hospital for treatment of TMJ problems.
데이터처리
Student t-test were used to analyze separately differences between the ICP group and the MMP group on pain intensity, pain duration, sleep quality, and life quality. When P value was below 0.
이론/모형
The questionnaire was designed to provide quantitative measures of clinical pain that can be treated statistically. But, these study were used a "Shor Form" of the MPQ (MPQ-SF) which was designed to obtain information from patients when time is limited. It was found to correlate highly with and demonstrate differences due to treatment in a manner similar to the long form of the MPQ (MPQ-LF).
성능/효과
But, these study were used a "Shor Form" of the MPQ (MPQ-SF) which was designed to obtain information from patients when time is limited. It was found to correlate highly with and demonstrate differences due to treatment in a manner similar to the long form of the MPQ (MPQ-LF). The MPQ-SF includes 15 words from the Sensory (11 words) and Affective (4 words) categories.
There was no significant difference in the categories of MPQ (T-PRI, evaluation overall intensity of total pain experience), SF-36 (average, PCS, MCS) in the ICP group according to sleep quality. There was significant difference between the good sleeper and the poor sleeper in the MMP group.
The poor sleeper were too. These results revealed that both the MMP group and the ICP group were resembling the pain severity and property, and were not differ in aspect of physical and mental components of the life quality in same sleep quality.
In chronic phase, even though the categories of MPQ, PSQI did not differ between the 2 diagnostic groups, the ICP group had a higher score of average and MCS of SF-36 in comparison to the one in the MMP group. These results revealed that the MMP group had the lower life quality and the diminished mental health than the ICP group when suffered more than 6 months.
The magnitude of the differences in numbers between the groups may also have contributed to the findings we reported. We guess that the result of our research are not significance and reliable because the number of ICP patients and whole subjects was limited.
This finding is inconsistent with the findings of previous investigators11). While the MMP group patients suffering more than 6 months had the lower average mean score and MCS of SF-36 than the ICP group, there was no significant difference between the 2 group in less 6 months. Also, there was no significant difference in each diagnostic group according to pain duration (acute phase and chronic phase).
참고문헌 (24)
Reimer MA, Flemons WW. Quality of life in sleep disorders. Sleep Med Rev 2003;7(4);335-349
Katz N. The impact of pain management on quality of life; proceediings from the roundtable on 'the role of coxibs in successful pain management'. Jour of Pain and Symp Management 2002;24;38-47
Mauro G, Tagliaferro G, Montini M, Zanolla L. Diffusion model of pain language and quality of life in orofacial pain patients. J Orofac Pain 2001;15;36-46
Wittink H, Turk DC, Carr DB, et al. Comparison of the redundancy, reliability, and responsiveness to change among SF-36, Oswestry Disability Indes, and Multidimensional Pain Inventory. Clin J Pain 2004;20;133-142
Joke AM, Christel W, Alice AJ, et al. Stability of pain parameters and pain-related quality of life in adolescents with persistent pain: a three-year follow-up. Clin J Pain 2002;18;99-106
Hunfeld JA, Perquin CW, Duivenvoorden HJ, et al. Chronic pain and its impact on quality of life in adolescents and their families. J Pediatr Psychol 2001;26;145-153
Berker N, Thomasen AB, Olsen AK, et al. Pain epidemiology and health related quality of life in chronic non-malignant pain patients referred to a Danish multidisciplinary pain center. Pain 1997;73;3 93-400
Lindroth JE, Schmidt JE, Carlson CR. A comparion between masticatory muscle pain patient and intracapsular pain patients on behavioral and psychosocial domains. J Orofac Pain 2002;16;277-283
Dworkin SF, LeResche L, Von Korff MR. Research diagnostic criteria. J Cranio Disor Fac & Oral Pain 1992;6(4);327-334
Carlson CR, Reid KI, Curran SL, et al. Psychological and Physiological parameters of masticatoy muscle pain. Pain 1998;76;297-307
Korszum A, HindersteinB, Wong M. Comorbidity of depression with chronic facial pain and temporomandibular disorders. Oral Surg Oral Med Oral Pathol Radiol Endod 1996;82;496-500
Epder J, Gatchel RJ. Coping profile differences in the biopshchosocial functioning of patients with temporomandibular disorder. Psychosom Med 2000; 62;69-75
Yatani H, Studts J, Cordova M, Carlson CR, et al. Comparison of sleep quality and clinical and psychologic characteristics in patient with temporomandibular disorders. J Orofac Pain 2002;16;221-228
Hagberg C, Hagberg M, Kopp S. Musculoskeletal symptoms and psychosocial factors among patients with craniomandibular disorders. Acta Odontol Scand 1994;52;170-177
Nicassio P, Wallston KA. Longitudinal relationships among pain, sleep problems, and depression in rheumatoid arthritis. J Abnorm Psychol 1992;101(3); 514-520
Buysse DJ, Reynolds III CF, Monk TH, Berman SR, Kupfer DJ. The pittsburgh sleep quality Index: a new instrument for psychiatric paractice and research. Psychiatry Res 1988;28;193-213
Melzack R. The McGill pain questionnaire: major properties and scoring methods. Pain 1975;1;277-299
Elliott TE, Renier CM, Palcher JA. Chronic pain, depression, and quality of life: correlation and predictive value of the SF-36. Pain Med 2003;4(4); 331-339
Rudy TE, Turk DC, Kubinski JA, et al. Differential treatment responses of TMD patients as a function of psychological characteristics. Pain 1995;61;103-112
※ AI-Helper는 부적절한 답변을 할 수 있습니다.