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    Fatty infiltration and morphology of cervical muscles in patients with temporomandibular disorders: A case-control study
    (Wroclaw Medical Univ, 2024) Kaynak, Besime Ahu; Tas, Serkan; Tufek, Muhammed Taha; Dag, Figen; Dikici, Rumeysa
    Background. Changes in the fatty infiltration and/or muscle volume of neck muscles can alter cervical spine alignment and cranial load distribution, which may cause pain in the orofacial region. Objectives. The aim of the study was to examine the muscle volume and fatty infiltration of neck muscles in patients with temporomandibular disorders (TMD). Material and methods. This case-control study included 18 patients with TMD and 18 age- and sex-matched controls. The muscle volume and fatty infiltration of the neck muscles of the participants were measured using magnetic resonance imaging (MRI) and ITK-SNAP software. The 3D models of the sternocleidomastoid (SCM), splenius capitis (SPLC), semispinalis cervicis (SC)-semispinalis capitis (SCP), and multifidus (M) muscles within the C3-C7 range were created using ITK-SNAP, a semi-automatic segmentation software. The models were used to determine the volumes and fatty infiltration levels. The Neck Disability Index (NDI) was used to assess neck pain-related disability. The severity of TMD was determined using the Fonseca Anamnestic Index (FAI), while jaw-related disability was measured with the Jaw Functional Limitation Scale-20 (JFLS-20). Pain levels were recorded at rest and during chewing using the numeric rating scale (NRS). Results. There were no statistically significant differences in total muscle volume, fatty infiltration volume and fatty infiltration percentage of the SCM, SPLC, SCP, SC, and M muscles between the 2 groups (p > 0.05). The patient group had higher NDI scores compared to the controls (p < 0.001). The NDI scores correlated positively with the JFLS-20 (r = 0.831, p < 0.001), FAI (r = 0.815, p < 0.001) and NRS scores at rest (r = 0.753, p < 0.001) and during chewing (r = 0.686, p < 0.001). Conclusions. The present study did not identify any significant differences in the neck muscle volume or fatty infiltration between the TMD patients and controls. However, the severity of neck disability was found to correlate with jaw function, pain and TMD levels.
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    Immediate Effect of Cumulative Transverse Strain via Exercise on the Achilles Tendon in Individuals with and Without Flat Feet
    (Amer Podiatric Med Assoc, 2025) Tas, Serkan; Kocyigit, Murat Fatih; Araci, Ayca; Tufek, Muhammed Taha
    Background: Flat feet change lower-extremity alignment, and they may change the load distribution on the Achilles tendon during exercise. The purpose of this study was to investigate the immediate effect of cumulative transverse strain via resistive ankle plantarflexion exercise on the Achilles tendon in individuals with flat feet. Methods: Fourteen individuals with flat feet and 14 age-matched individuals with normal foot posture were enrolled. Achilles tendon thickness was measured by an ultrasonography device with a linear probe at three points: 1, 2, and 3 cm proximal to the superior aspect of the calcaneus. Ultrasonography measurements were performed before and after participants completed 90 repetitions of double-leg calf raise exercises, which included moving the foot from full ankle dorsiflexion to full ankle plantarflexion. Results: Achilles tendon thickness at all three points measured was thinner in the flat feet group at preexercise and postexercise conditions compared with that of the control group (P < .05). Achilles tendon thickness at all three points decreased after the exercise in both groups (P < .001). The differences in Achilles tendon thickness at all three points measured between preexercise and postexercise conditions were lower in individuals with flat feet than in those of the control group (P < .05). Conclusions: There was a significant decrease in Achilles tendon thickness after exercise in both groups; however, tendon thickness markedly diminished in individuals with normal foot posture. The findings are thought to result from changes in tendon structure and load distribution on the Achilles tendon.