Smartphone-Based Physical Performance and Multidimensional Determinants of Self-Reported Knee Pain in Community-Dwelling Older Adults: Cross-Sectional Machine Learning and Network Analysis Study.
Authors: Hwang UJ, Xia P, Fan T, Wong AY, Kwon OY, Fu SN
Journal: JMIR mHealth and uHealth
mental health
psychology
open access
Abstract
Temporomandibular disorders (TMD) have been defined as “a heterogeneous group
of conditions affecting the temporomandibular joints (TMJ), the jaw muscles, and
the related structures” []. They represent one of the most common causes of
non-dental orofacial pain and may affect approximately 30% of the global
population, with a higher prevalence in women [, ]. The main clinical
manifestations include orofacial pain, limitation of mandibular movement,
mandibular deviation, and joint noise, all of which may substantially impair
patients’ quality of life [, ]. The current understanding of TMD is based on a biopsychosocial model, involving
complex interactions between biomechanical, neuromuscular, psychosocial, and
behavioural factors [, ]. A growing body of evidence highlights the central
role of psychological factors (such as stress, anxiety, and depression) in the
onset, persistence, and chronification of TMD [, , , ]. This complexity has led to
recommendations that favour multimodal, conservative, and patient-centred
therapeutic approaches that integrate physical, educational, and psychological
interventions [, , , ]. Accordingly, non-pharmacological strategies aimed at
modulating stress, pain perception, and emotional responses have attracted
increasing attention []. Hypnosis, defined as “a state of consciousness involving focused attention and
reduced peripheral awareness characterized by an enhanced capacity for response
to suggestion” [], and relaxation therapy, which aims to induce a passive mode
of thinking by focusing attention on some neutral target, such as a body part or
breathing [, ] are consistent with this biopsychosocial perspective. These
approaches seek to modulate pain perception, reduce muscle hyperactivity, enhance
coping skills, and promote patient self-management []. They are already used in
the management of other chronic pain conditions, including musculoskeletal pain
such as low back pain and cancer-related pain, with variable but generally
encouraging results [, ]. However, their use in the management of TMD remains
less clearly defined []. Indeed, available studies differ substantially in
terms of study populations, intervention protocols, and outcome measures, thereby
hindering data synthesis and the formulation of clear clinical recommendations
[].
of conditions affecting the temporomandibular joints (TMJ), the jaw muscles, and
the related structures” []. They represent one of the most common causes of
non-dental orofacial pain and may affect approximately 30% of the global
population, with a higher prevalence in women [, ]. The main clinical
manifestations include orofacial pain, limitation of mandibular movement,
mandibular deviation, and joint noise, all of which may substantially impair
patients’ quality of life [, ]. The current understanding of TMD is based on a biopsychosocial model, involving
complex interactions between biomechanical, neuromuscular, psychosocial, and
behavioural factors [, ]. A growing body of evidence highlights the central
role of psychological factors (such as stress, anxiety, and depression) in the
onset, persistence, and chronification of TMD [, , , ]. This complexity has led to
recommendations that favour multimodal, conservative, and patient-centred
therapeutic approaches that integrate physical, educational, and psychological
interventions [, , , ]. Accordingly, non-pharmacological strategies aimed at
modulating stress, pain perception, and emotional responses have attracted
increasing attention []. Hypnosis, defined as “a state of consciousness involving focused attention and
reduced peripheral awareness characterized by an enhanced capacity for response
to suggestion” [], and relaxation therapy, which aims to induce a passive mode
of thinking by focusing attention on some neutral target, such as a body part or
breathing [, ] are consistent with this biopsychosocial perspective. These
approaches seek to modulate pain perception, reduce muscle hyperactivity, enhance
coping skills, and promote patient self-management []. They are already used in
the management of other chronic pain conditions, including musculoskeletal pain
such as low back pain and cancer-related pain, with variable but generally
encouraging results [, ]. However, their use in the management of TMD remains
less clearly defined []. Indeed, available studies differ substantially in
terms of study populations, intervention protocols, and outcome measures, thereby
hindering data synthesis and the formulation of clear clinical recommendations
[].