Pilot Study: Can Optimal Positioning for Mandibular Occlusion Reduce Risk for Head Concussive Injuries?

Research Objectives: Recent evidence suggests that there may be a significant negative relationship between neck strength/endurance and risk levels for concussion. (Chavarro-Nieto 2021).

Aim: To investigate if optimal mandibular occlusion might influence neck strength and endurance to be considered for concussion risk management.

Design: Cohort Repeated Measures Design

Setting: Study setting was at an outpatient physical therapy clinic.

Participants:

Methods: 12 healthy, community participants (3 females/9 males) ages 8 to 52 yrs. were sampled by convenience. Inclusion criteria: normal cervical spine AROM, no recent head or neck trauma or surgery. Exclusion criteria: active cervical pain and any cervical spine postural abnormalities.

Interventions: Intervention: Participants were tested by a physical therapy orthopedic specialist, using three standardized assessments for neck extension/flexion strength and endurance. Participants were tested in each condition without and then with an interocclusal appliance in place.
Statistical Analysis: SPSS was used for descriptive statistics, paired T-Tests and 2-way repeated measures ANOVA at p = 0.05 with Greenhouse-Geisser correction.

Main Outcome Measures: Each participant was tested using three standardized assessments for neck strength in mmHg (max effort) and endurance: two timed tests for endurance in seconds.

Results:

Results: There were significant differences in endurance in both directions: Neck Flex Endurance Test-Supine, t= -3.149, p= 0.009, Neck Ext Endurance Test-Prone, t= -4.078, p = 0.002. Also, significant differences were found in strength based on Condition (F (1,2)-6.849, p < 0.001) and Trial (F (1,2) = 27.508, p < 0.001).

Conclusions:

Conclusions: Preliminary results suggest significant increases in neck strength and endurance with a jaw interocclusal appliance with optimized positioning compared to no appliance use.
Clinical Relevance: Suggested gains in cervical spine strength and endurance may assist concussion risk management for contact sports at all levels. Preliminary results also suggest the need for further research about how proper jaw alignment might optimize neck muscle strength over a broad spectrum of subjects regardless of sex, ages or athletic ability.

Author(s) Disclosures: Authors have no disclosures of conflict to declare at this time.