Avaliação Biodinâmica dos Músculos Temporal e Masseter em Indivíduos com Síndrome de Down
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Data
2018-10-17
Autores
Mancilha, Gabriela Pinto de [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
A Síndrome de Down (SD), também conhecida Trissomia do 21, é uma anomalia cromossômica, referente a presença de um cromossomo 21 extranumerário, decorrente de uma duplicação do mesmo. Descrita no século XIX, a SD é caracterizada por particularidades fenotípicas e morfológicas, tais como: cardiopatias congênitas, deficiências neuromotoras, clinodactilia do 5º dedo das mãos, presença de prega palmar única, aumento da distância entre o 1º e o 2º artelhos nos pés, dentre outras. Em relação às características orofaciais, esses indivíduos têm frequentemente expressão facial sindrômica, pálpebras oblíquas craniolateral, língua protruída repousando sobre os incisivos inferiores (pseudomacroglossia), salivação aumentada, maxilar hipoplásico e protrusão mandibular. Outra condição é a hipotonia muscular generalizada, resultando em uma sinergia muscular prejudicada. Isto pode desencadear disfunção mastigatória, desordem na fala e disfagia. Portanto, o objetivo desta pesquisa foi realizar um estudo comparativo dos padrões eletromiográficos dos músculos mastigatórios masseter direito e esquerdo (porção superficial); e temporal direito e esquerdo (porção anterior); por meio da eletromiografia de superfície, em indivíduos com SD. A atividade muscular foi avaliada quando os músculos mastigatórios estavam nos estados de repouso (REP), Contração Máxima Voluntária (CMV), Máxima Intercuspidação Habitual (MIH) e também dados obtidos por meio da Força Mandibular Total (FMT), sendo comparada com os registros de uma amostra controle formada por indivíduos sem deficiência. Assim, 34 indivíduos adultos jovens, sem distinção de gênero foram selecionados aleatoriamente e divididos em 2 grupos: 24 indivíduos com Síndrome de Down (Grupo SD) e 10 indivíduos normais (Grupo Controle). Os dados foram submetidos à análise estatística, expressos em média ± desvio-padrão e, para comparação dos parâmetros, foram utilizados o teste de Mann-Whitney e análise da Correlação de Pearson (r). Os resultados demonstraram menor atividade elétrica nos músculos estudados do grupo SD. Na análise de Correlação observou-se que as relações unilaterais em REP e MIH nos indivíduos com SD com valores menores e insignificantes encontram-se mais comprometidas, bem como as relações interlaterais desses pacientes em REP, isto não acontecendo nos indivíduos normais do grupo controle, onde suas correlações podem ser consideradas de média e alta intensidade. Portanto, na biodinâmica de ambos os músculos, temporal e masseter, evidenciamos uma menor participação na ação muscular nos indivíduos com SD.
Down Syndrome (SD), also known as Trisomy 21, is a chromosomal anomaly, referring to the presence of a supernumerary chromosome 21, due to a duplication of the same. Described in the 19th century, SD is characterized by phenotypic and morphological features such as: congenital heart defects, neuromotor deficiencies, clinodactyly of the 5th finger, presence of a single palmar fold, increased distance between the 1st and 2nd toes on the feet, among others. Regarding orofacial characteristics, these individuals often have syndromic facial expression, craniolateral oblique eyelids, protruding tongue resting on the lower incisors (pseudomacroglossia), increased salivation, hypoplastic maxillary and mandibular protrusion. Another condition is generalized muscle hypotonia, resulting in impaired muscle synergy. This can trigger masticatory dysfunction, speech disorder and dysphagia. Therefore, the objective of this research was to perform a comparative study of the electromyographic patterns of the right and left masseter masticatory muscles (superficial portion); and right and left temporal (anterior portion); by means of surface electromyography, in individuals with DS. Muscle activity was assessed when the masticatory muscles were in rest states (REP), Maximum Voluntary Contraction (CMV), Maximum Habitual Intercuspation (MIH) and also data obtained through Total Mandibular Force (FMT), compared to the records of a control sample formed by individuals without disability. Thus, 34 young adult individuals, without gender distinction were randomly selected and divided into 2 groups: 24 individuals with Down Syndrome (SD Group) and 10 normal individuals (Control Group). The data were submitted to statistical analysis, expressed as mean ± standard deviation, and the Mann-Whitney test and Pearson's correlation (r) were used to compare the parameters. The results showed lower electrical activity in the muscles studied in the SD group. In the correlation analysis it was observed that the unilateral relationships in REP and MIH in the individuals with SD with smaller and insignificant values are more compromised, as well as the interlateral relationships of these patients in REP, this not happening in the normal individuals of the control group, where its correlations can be considered medium and high intensity. Therefore, in the biodynamics of both muscles, temporal and masseter, we evidenced a smaller participation in the muscular action in the individuals with SD.
Down Syndrome (SD), also known as Trisomy 21, is a chromosomal anomaly, referring to the presence of a supernumerary chromosome 21, due to a duplication of the same. Described in the 19th century, SD is characterized by phenotypic and morphological features such as: congenital heart defects, neuromotor deficiencies, clinodactyly of the 5th finger, presence of a single palmar fold, increased distance between the 1st and 2nd toes on the feet, among others. Regarding orofacial characteristics, these individuals often have syndromic facial expression, craniolateral oblique eyelids, protruding tongue resting on the lower incisors (pseudomacroglossia), increased salivation, hypoplastic maxillary and mandibular protrusion. Another condition is generalized muscle hypotonia, resulting in impaired muscle synergy. This can trigger masticatory dysfunction, speech disorder and dysphagia. Therefore, the objective of this research was to perform a comparative study of the electromyographic patterns of the right and left masseter masticatory muscles (superficial portion); and right and left temporal (anterior portion); by means of surface electromyography, in individuals with DS. Muscle activity was assessed when the masticatory muscles were in rest states (REP), Maximum Voluntary Contraction (CMV), Maximum Habitual Intercuspation (MIH) and also data obtained through Total Mandibular Force (FMT), compared to the records of a control sample formed by individuals without disability. Thus, 34 young adult individuals, without gender distinction were randomly selected and divided into 2 groups: 24 individuals with Down Syndrome (SD Group) and 10 normal individuals (Control Group). The data were submitted to statistical analysis, expressed as mean ± standard deviation, and the Mann-Whitney test and Pearson's correlation (r) were used to compare the parameters. The results showed lower electrical activity in the muscles studied in the SD group. In the correlation analysis it was observed that the unilateral relationships in REP and MIH in the individuals with SD with smaller and insignificant values are more compromised, as well as the interlateral relationships of these patients in REP, this not happening in the normal individuals of the control group, where its correlations can be considered medium and high intensity. Therefore, in the biodynamics of both muscles, temporal and masseter, we evidenced a smaller participation in the muscular action in the individuals with SD.
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Palavras-chave
Síndrome de down, Músculos mastigatórios, Hipotonia muscular, Eletromiografia de superfície, Down syndrome, Mastigatory muscles, Muscular hypotonia, Surface electromyography