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Sitnikova V, Kämppi A, Kämppi L, Alvesalo E, Burakova M, Kemppainen P, Teronen O. Clinical benefit of botulinum toxin for treatment of persistent TMD-related myofascial pain: A randomized, placebo-controlled, cross-over trial. Pain Pract 2024. [PMID: 38963228 DOI: 10.1111/papr.13396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2024]
Abstract
BACKGROUND Injections of botulinum toxin type A (BoNT-A) have been proposed as an additional treatment modality for patients suffering chronic temporomandibular disorder (TMD)-related myofascial pain (MFP). BoNT-A impairs muscle function, along with its analgesic effect, and a minimal effective dose should be used. The objective of this randomized placebo-controlled crossover study was to evaluate the clinical benefit of a moderate dose (50 U) of BoNT-A. METHODS Sixty-six subjects were randomized into two groups, one which received BoNT-A first and a second which received a saline solution (SS) first. Follow-ups were performed 2, 11, and 16 weeks after the injections. Diagnostic criteria for temporomandibular disorders (DC/TMD) diagnostic algorithms were used to evaluate characteristic pain intensity (CPI) and pain-related disability based on the Graded Chronic Pain Scale (GCPS). Electromyographic and bite force were also evaluated. RESULTS The within-group analysis showed a significant improvement in pain intensity and pain-related disability after BoNT-A (p < 0.001, p = 0.005, p = 0.011) and SS (p = 0.003, p = 0.005, p = 0.046) injections up to week 16. The between-group analysis of pain-related variables revealed no differences between groups at any time. Nonetheless, BoNT-A, but not SS, caused a significant decline in muscle performance. The number needed to treat (NNT) regarding a clinically significant pain reduction (≥30%) was 6.3, 57.0, and 19.0 at 2, 11, and 16-week follow-ups favoring BoNT-A. CONCLUSIONS Injections of 50 U of BoNT-A might improve MFP symptoms, but the specific effect of the drug on pain compared to the placebo is not obvious.
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Affiliation(s)
- V Sitnikova
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - A Kämppi
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - L Kämppi
- Epilepsia Helsinki (Member of ERN EpiCARE), HUS Neurocenter, Helsinki, Finland
- Department of Neuroscience, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Helsinki University Central Hospital (HYKS), Helsinki, Finland
| | - E Alvesalo
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - M Burakova
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - P Kemppainen
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Helsinki University Central Hospital (HYKS), Helsinki, Finland
| | - O Teronen
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Private Practice Mehiläinen Oy, Helsinki, Finland
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Zhu M, Huang Z, Wang Y, Qin J, Fan M. Effects of botulinum toxin type A in patients with painful temporomandibular joint disorders: a systematic review and meta-analysis. Ann Med Surg (Lond) 2024; 86:4112-4122. [PMID: 38989167 PMCID: PMC11230827 DOI: 10.1097/ms9.0000000000002183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 05/08/2024] [Indexed: 07/12/2024] Open
Abstract
Objective To assess the therapeutic efficacy of botulinum toxin type A (BTX-A) for managing myofascial pain related to temporomandibular disorders (TMDs). Methods This study was conducted according to the PRISMA 2020 statement guidelines. The PubMed, Embase, and Cochrane Library databases were searched. Only randomized controlled trials were included. The primary outcome was a pain score on the visual analog scale, and the secondary outcomes were maximum mouth opening and adverse effects. The Cochrane risk of bias tool was used to assess risk bias. A meta-analysis of studies with the same interventions, controls, assessment methods, and follow-up durations was performed. Results A total of 519 studies were retrieved, of which 20 randomized controlled trials were included in the qualitative analysis and six were included in the meta-analysis. The results showed that, compared with placebo, BTX-A injection was more effective at relieving myofascial pain, and its effect was similar to that of conventional methods. However, there was no difference in maximum mouth opening between the two groups. After the study assessment with the RoB 2.0 tool, six studies showed a low risk of bias, 13 studies showed some concerns regarding the reported results, and only one study showed a high risk of bias. Adverse effects of BTX-A injection were observed in four studies. Conclusions In conclusion, BTX-A is effective at relieving pain in TMD patients but does not improve mouth opening. To minimize adverse effects, we recommend a low dose of BTX-A for TMD patients who do not experience complete pain relief from conservative treatments.
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Affiliation(s)
- Mengjiao Zhu
- Department of Orthodontics, Shanghai Xuhui District Dental Center
| | - Ziwei Huang
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Yeye Wang
- Department of Medical Technology, Shanghai University of Medicine and Health Sciences,Shanghai, Shanghai
| | - Jing Qin
- Department of Orthodontics, Shanghai Xuhui District Dental Center
| | - Mingyue Fan
- Department of Orthodontics, Shanghai Xuhui District Dental Center
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Coraci D, Maccarone MC, Ragazzo L, Tognolo L, Restivo DA, Santilli G, Moreira AL, Ferrara PE, Ronconi G, Masiero S. Botulinum toxin in the rehabilitation of painful syndromes: multiperspective literature analysis, lexical analysis and systematic review of randomized controlled trials. Eur J Transl Myol 2024; 34:12509. [PMID: 38767308 PMCID: PMC11264230 DOI: 10.4081/ejtm.2024.12509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 05/22/2024] Open
Abstract
Pain represents a common symptom of several diseases and is often associated with a reduction in rehabilitation outcomes and recovery. The effectiveness of pain alleviation by botulinum toxin has been recently demonstrated. We searched in PubMed the papers about this topic published in the last ten years, and we selected clinical trials, guidelines, meta-analyses, reviews, and systematic reviews. We used different approaches: multiperspective presentation, lexical evaluation, and systematic review. The systematic review was only performed for the randomized controlled trials. We predominantly found reviews and trials about the rehabilitation of stroke/brain injury and epicondylitis. The most common outcome measures were pain, function, and spasticity. Among the common words, pain was the most frequent and the terms were grouped into different families, especially concerning the outcomes. Rehabilitation showed a relatively low frequency. Finally, the systematic review showed moderate-low levels of bias which confirms the effectiveness of botulinum toxin for pain treatment. The current literature about botulinum toxin is wide and globally diffuse but with some limitations in study strategies and clearness in the formal presentation. The evidence justifies the use of botulinum toxin in treating pain in different diseases.
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Affiliation(s)
- Daniele Coraci
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua.
| | | | - Lisa Ragazzo
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua.
| | - Lucrezia Tognolo
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua.
| | | | - Gabriele Santilli
- Department of Anatomical, Histological and Legal Medical Sciences and Science of the Locomotor System, Rome.
| | - Ana Lucila Moreira
- Department of Neurology, Faculdade de Medicina da Universidade de São Paulo, São Paulo.
| | | | | | - Stefano Masiero
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua.
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Lippi L, Ferrillo M, Losco L, Folli A, Marcasciano M, Curci C, Moalli S, Ammendolia A, de Sire A, Invernizzi M. Aesthetic Rehabilitation Medicine: Enhancing Wellbeing beyond Functional Recovery. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:603. [PMID: 38674249 PMCID: PMC11052208 DOI: 10.3390/medicina60040603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
Although rehabilitation medicine emphasizes a holistic health approach, there is still a large gap of knowledge about potential interventions aimed at improving overall wellbeing through cosmetic interventions. Therefore, this narrative review investigates the role of different rehabilitative techniques in enhancing aesthetics, quality of life, and psychosocial wellbeing for patients with disabilities. The study follows the SANRA framework quality criteria for a narrative review. Literature searches across PubMed/Medline, Web of Science, and Scopus identified articles focusing on rehabilitation strategies within the aesthetic rehabilitation domain. The review identified evidence supporting injection procedures, such as Botulinum Toxin, Platelet-Rich Plasma, Hyaluronic Acid, Ozone, and Carboxytherapy, and assessing their applications in several disabling disorders. Additionally, physical therapies like Extracorporeal Shock Wave Therapy, Laser Therapy, Microcurrent Therapy, Tecar Therapy, and physical exercises were explored for their impact on cutaneous microcirculation, cellulite treatment, wound healing, and scar appearance improvement. Lastly, the manuscript underlines the role of manual therapy techniques in addressing both physical discomfort and aesthetic concerns, discussing their effectiveness in adipose tissue therapy, scar tissue mobilization, and regional fat thickness reduction. Taken together, this review emphasizes the role of a multidisciplinary approach, aiming to provide valuable insights into potential benefits for both functional and aesthetic outcomes.
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Affiliation(s)
- Lorenzo Lippi
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.F.); (S.M.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Martina Ferrillo
- Department of Health Sciences, School of Dentistry, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
| | - Luigi Losco
- Plastic Surgery Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Via Salvador Allende, 43, 84081 Baronissi, Italy;
| | - Arianna Folli
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.F.); (S.M.); (M.I.)
| | - Marco Marcasciano
- Plastic Surgery, Experimental and Clinical Medicine Department, Division of Plastic and Reconstructive Surgery, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy;
| | - Claudio Curci
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100 Mantova, Italy
| | - Stefano Moalli
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.F.); (S.M.); (M.I.)
| | - Antonio Ammendolia
- Physical and Rehabilitative Medicine, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Alessandro de Sire
- Physical and Rehabilitative Medicine, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Marco Invernizzi
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.F.); (S.M.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
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Griswold D, Learman K, Ickert E, Clewley D, Donaldson MB, Wilhelm M, Cleland J. Comparing dry needling or local acupuncture to various wet needling injection types for musculoskeletal pain and disability. A systematic review of randomized clinical trials. Disabil Rehabil 2024; 46:414-428. [PMID: 36633385 DOI: 10.1080/09638288.2023.2165731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 01/03/2023] [Indexed: 01/13/2023]
Abstract
PURPOSE Systematically evaluate the comparative effectiveness of dry needling (DN) or local acupuncture to various types of wet needling (WN) for musculoskeletal pain disorders (MPD). METHODS Seven databases (PubMed, PEDro, SPORTDiscus, CINAHL, Scopus, Embase, and Cochrane Central Register of Controlled Trials) were searched following PROSPERO registration. Randomized clinical trials were included if they compared DN or local acupuncture with WN for MPD. Primary outcomes were pain and/or disability. The Revised Cochrane Collaboration tool (RoB 2.0) assessed the risk of bias. RESULTS Twenty-six studies were selected. Wet Needling types included cortisone (CSI) (N = 5), platelet-rich plasma (PRP) (N = 6), Botox (BoT) (N = 3), and local anesthetic injection (LAI) (N = 12). Evidence was rated as low to moderate quality. Results indicate DN produces similar effects to CSI in the short-medium term and superior outcomes in the long term. In addition, DN produces similar outcomes compared to PRP in the short and long term and similar outcomes as BoT in the short and medium term; however, LAI produces better pain outcomes in the short term. CONCLUSION Evidence suggests the effectiveness of DN to WN injections is variable depending on the injection type, outcome time frame, and diagnosis. In addition, adverse event data were similar but inconsistently reported. PROSPERO Registration: 2019 CRD42019131826Implications for rehabilitationDry needling produces similar effects for pain and disability in the short and medium term compared to cortisone, Botox, and platelet-rich plasma injections. Local anesthetic injection may be more effective at reducing short-term pain.Long-term effects on pain and disability are similar between dry needling and platelet-rich plasma injections, but dry needling may produce better long-term outcomes than cortisone injections.The available adverse event data is similar between dry and wet needling.The conclusions from this study may be beneficial for patients and clinicians for considering risk and cost benefit analyses.
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Affiliation(s)
- David Griswold
- Department of Graduate Studies in Health and Rehabilitation Sciences, Associated Universities: Youngstown State University, Youngstown, OH, USA
| | - Ken Learman
- Department of Graduate Studies in Health and Rehabilitation Sciences, Associated Universities: Youngstown State University, Youngstown, OH, USA
| | - Edmund Ickert
- Department of Graduate Studies in Health and Rehabilitation Sciences, Associated Universities: Youngstown State University, Youngstown, OH, USA
| | - Derek Clewley
- Department of Orthopaedic Surgery, Duke University, Durham, NC, USA
| | | | - Mark Wilhelm
- School of Medicine, Tufts University, Boston, MA, USA
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Menéndez-Torre Á, Pintado-Zugasti AM, Zaldivar JNC, García-Bermejo P, Gómez-Costa D, Molina-Álvarez M, Arribas-Romano A, Fernández-Carnero J. Effectiveness of deep dry needling versus manual therapy in the treatment of myofascial temporomandibular disorders: a systematic review and network meta-analysis. Chiropr Man Therap 2023; 31:46. [PMID: 37924127 PMCID: PMC10625247 DOI: 10.1186/s12998-023-00489-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/01/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Temporomandibular disorders (TMDs) are the most common cause of orofacial pain of non-dental origin, with approximately 42% of diagnoses corresponding to myofascial pain. Manual therapy and dry needling are commonly used interventions for the treatment of myofascial temporomandibular disorders. However, it is unclear whether one of them could be superior to the other. OBJECTIVES The aim of the present systematic review and network meta-analysis was to compare the effectiveness of manual therapy and dry needling in patients with myofascial TMD. METHODS This is a systematic review and network meta-analysis. Randomized clinical trials were searched in the databases of Pubmed, PEDro, CINAHL, Web of Science, Scopus, Cochrane, Google Academic and EMBASE. The methodological quality of studies included in this review was judged using the Physiotherapy Evidence Database (PEDro) scale. A frequentist network meta-analysis was carried out, assuming random effects, to estimate the effects of interventions for temporomandibular joint pain measured on a 10-point visual analogue scale. RESULTS Out of 3190 records identified, 17 met the inclusion criteria for qualitative analysis and eight were included in the network meta-analysis. Indirect comparisons between dry needling and manual therapy showed no significant differences in their effects on pain reduction (Odds Ratio [95%CI]; - 0.263 [- 1.517, 0.992]). The ranking of treatments shows that manual therapy (SUCRA = 0.932) followed by deep dry needling (SUCRA = 0.775) present the highest values of estimation and can be considered the most likely to reduce pain. CONCLUSIONS The results of the network meta-analysis should be considered with caution due to the low quality of the evidence available and the high variability of the study protocols in terms of the method of application of dry needling and manual therapy interventions. PROSPERO under identifier: (CRD42020186470).
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Affiliation(s)
- Ángela Menéndez-Torre
- Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28933, Alcorcón, Spain
- Servicio de Fisioterapia, Centro Médico Gava, 28600, Navalcarnero, Madrid, Spain
| | - Aitor Martín Pintado-Zugasti
- Departamento de Fisioterapia, Facultad de Medicina, Universidad San Pablo-CEU, CEU Universities, 28008, Madrid, Spain
| | - Juan Nicolás Cuenca Zaldivar
- Rehabilitation Service, Guadarrama Hospital, Madrid, Spain.
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute - Segovia de Arana (IDIPHISA), Madrid, Spain.
| | - Paula García-Bermejo
- DINAMIA Clinic. Alfonso VI, 28806, Alcalá de Henares, Madrid, Spain
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670, Madrid, Spain
| | - Diego Gómez-Costa
- Department of Nursing and Estomatology, Faculty of Health Sciences, Rey Juan Carlos University, Avenida de Atemas s/n, Alcorcón, 28922, Madrid, Spain
| | - Miguel Molina-Álvarez
- Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Universidad Rey Juan Carlos, Unidad Asociada I+D+i Instituto de Química Médica (IQM) CSIC-URJC, Madrid, Spain
| | - Alberto Arribas-Romano
- Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28933, Alcorcón, Spain
- Department of Physical and Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922, Madrid, Spain
| | - Josué Fernández-Carnero
- Department of Physical and Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922, Madrid, Spain
- La Paz Hospital Institute for Health Research, IdiPAZ, 28046, Madrid, Spain
- Grupo Multidisciplinar de Investigación y Tratamiento del Dolor, Grupo de Excelencia Investigadora, Universidad Rey Juan Carlos-Banco de Santander, 28922, Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023, Madrid, Spain
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Kim SR, Chang M, Kim AH, Kim ST. Effect of Botulinum Toxin on Masticatory Muscle Pain in Patients with Temporomandibular Disorders: A Randomized, Double-Blind, Placebo-Controlled Pilot Study. Toxins (Basel) 2023; 15:597. [PMID: 37888628 PMCID: PMC10610636 DOI: 10.3390/toxins15100597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/25/2023] [Accepted: 10/02/2023] [Indexed: 10/28/2023] Open
Abstract
This study aimed to evaluate the efficacy of botulinum toxin type A (BoNT/A) in patients with temporomandibular disorders (TMDs) associated with masticatory muscle pain (MMP) and headaches. This randomized, double-blind, placebo-controlled pilot study is the first clinical trial to evaluate both disorders simultaneously. Twenty-one patients with myogenous TMD were randomly assigned to two groups. The experimental and control groups received injections of either BoNT/A or saline into the sites showing tenderness after palpation of a total of 16 muscle areas, including each masseter, a temporalis, splenius capitis, sternocleidomastoid, and trapezius muscle. During each visit, the clinical effects, based on the intensity of orofacial pain (OVAS), headache (HVAS), number of tender points (TPs), maximum mouth opening (MMO), and headache frequency (HF), were evaluated at four time points, namely, pre-injection and 4, 8, and 12 weeks after the injection, in both groups. Friedman and Mann-Whitney tests were used for the analyses. In the experimental group, the reductions in OVAS, TP, HVAS, and HF showed significant differences over time, excluding MMO, whereas there was no significant difference in any of the variables in the control group. In addition, the decline in TPs was significantly different between the experimental and control groups at all time points, especially after 4 and 12 weeks, compared to that during pre-injection. In conclusion, treatment with BoNT/A was relatively effective for masticatory muscle pain caused by TMDs and headache compared to the saline placebo.
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Affiliation(s)
- So Ra Kim
- Department of Orofacial Pain and Oral Medicine, Yonsei University College of Dentistry, Seoul 03722, Republic of Korea; (S.R.K.); (M.C.)
| | - Min Chang
- Department of Orofacial Pain and Oral Medicine, Yonsei University College of Dentistry, Seoul 03722, Republic of Korea; (S.R.K.); (M.C.)
| | - Alec Hyung Kim
- TMJ & Orofacial Pain Center, Los Angeles, CA 90006, USA;
| | - Seong Taek Kim
- Department of Orofacial Pain and Oral Medicine, Yonsei University College of Dentistry, Seoul 03722, Republic of Korea; (S.R.K.); (M.C.)
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Militi A, Bonanno M, Calabrò RS. It Is Time for a Multidisciplinary Rehabilitation Approach: A Scoping Review on Stomatognathic Diseases in Neurological Disorders. J Clin Med 2023; 12:jcm12103528. [PMID: 37240633 DOI: 10.3390/jcm12103528] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Patients affected by neurological disorders can develop stomatognathic diseases (SD) related to decreased bite force and quality of mastication, bruxism, severe clicking and other temporomandibular disorders (TMD), which deeply affect patients' swallowing, masticatory and phonation functions and, therefore, their quality of life. The diagnosis is commonly based on medical history and physical examination, paying attention to the temporomandibular joint (TMJ) range of movements, jaw sounds and mandibular lateral deviation. Diagnostic tools such as computed tomography and magnetic resonance imaging are used instead in case of equivocal findings in the anamnesis and physical evaluation. However, stomatognathic and temporomandibular functional training has not been commonly adopted in hospital settings as part of formal neurorehabilitation. This review is aimed at describing the most frequent pathophysiological patterns of SD and TMD in patients affected by neurological disorders and their rehabilitative approach, giving some clinical suggestions about their conservative treatment. We have searched and reviewed evidence published in PubMed, Google Scholar, Scopus and Cochrane Library between 2010 and 2023. After a thorough screening, we have selected ten studies referring to pathophysiological patterns of SD/TMD and the conservative rehabilitative approach in neurological disorders. Given this, the current literature is still poor and unclear about the administration of these kinds of complementary and rehabilitative approaches in neurological patients suffering from SD and/or TMD.
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Affiliation(s)
- Angela Militi
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, 98125 Messina, Italy
| | - Mirjam Bonanno
- IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo, SS 113, C. Da Casazza, 98123 Messina, Italy
| | - Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo, SS 113, C. Da Casazza, 98123 Messina, Italy
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9
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Shan HH, Chen HF, Lu XH, Zhang XM, Liu SL, Chang XL, Ni HY, Gou XJ. Buccal acupuncture combined with ultrasound-guided dry needle-evoked inactivation of trigger points to treat cervical and shoulder girdle myofascial pain syndrome. J Back Musculoskelet Rehabil 2023; 36:1139-1150. [PMID: 37458014 DOI: 10.3233/bmr-220321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
BACKGROUND Myofascial pain syndrome (MPS) is a common disease with easy persistence and recurrence. In clinical practice, although many methods have been adopted to prevent and treat MPS, the control of MPS is still not satisfactory. OBJECTIVE To compare the safety and effectiveness of buccal acupuncture, inactivation of trigger points (MTrPs), and their combination in the treatment of MPS. METHODS Two hundred MPS patients in the pain clinic were randomly divided into four groups (n= 50) to receive oral drugs (Group A), oral drugs + buccal needle (Group B), oral drugs + MTrP inactivation (Group C), or oral drugs + buccal needle + MTrP inactivation (Group D). RESULTS The visual analogue scale (VAS) and cervical range of motion (ROM) of Group D were significantly lower than those of the other three groups, and the pressure pain threshold (PPT) value of labelled MTrPs was significantly higher than those of the other three groups (P< 0.05). The excellent rate and total effective rate of Group D were significantly higher than those of the other three groups. Group C had the highest pain score and the lowest acceptance score. The results showed that buccal acupuncture combined with ultrasound-guided dry needle-evoked inactivation of MTrPs can significantly reduce the VAS score of MPS patients, improve the range of motion of the cervical spine, and improve patient satisfaction. CONCLUSIONS This study provides a highly accepted and satisfactory treatment for MPS, which is worthy of clinical promotion.
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Affiliation(s)
- Hai-Hua Shan
- Department of Anesthesiology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Department of Anesthesiology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Hong-Fang Chen
- Department of Anesthesiology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Department of Anesthesiology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Xiang-Hong Lu
- Department of Anesthesiology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Department of Anesthesiology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Xin-Mei Zhang
- Department of Anesthesiology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Si-Lan Liu
- Department of Anesthesiology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Xiao-Lan Chang
- Department of Anesthesiology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Hong-Yan Ni
- Department of Anesthesiology and Pain, Siyang County People's Hospital, Suqian, Jiangsu, China
| | - Xiao-Jun Gou
- Central Laboratory, Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine of Shanghai, Shanghai, China
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10
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Myogenous Temporomandibular Disorders: Diagnostic Concepts and Prospective Pilot Study on Extracorporeal Shockwave Therapy. Diagnostics (Basel) 2022; 13:diagnostics13010051. [PMID: 36611343 PMCID: PMC9818132 DOI: 10.3390/diagnostics13010051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
The aims of this article are to discuss the current, and potential future directions, in the diagnosis of myogenous temporomandibular disorders (M-TMD), as well as to report a pilot study to investigate the feasibility and clinical outcomes of extracorporeal shockwave therapy (ESWT) in the treatment of M-TMD. Forty-one adult patients presented with M-TMD were recruited into the study and randomized into two groups: Group 1 received ESWT treatment, whereas Group 2 received placebo treatment. The variables investigated were pain, measured by a numerical rating scale (NRS) and mouth opening. Twenty-six patients (Group 1: n = 14, mean age = 45.3 (16.7) years; Group 2: n = 12, mean age = 46.8 (19.7) years) completed 1-year follow up and were included into the final analysis. In both groups, reduction in pain and increase in MO (unassisted maximum, assisted maximum, and pain-free) were seen at post-treatment 1 year. There were more reduction in pain and increase in all MO in Group 1 than Group 2, but statistical significance was not detected. No major complications were encountered in this study. Although significant differences were not seen between groups, this prospective pilot study provided preliminary evidence that ESWT is safe and potentially beneficial in the treatment of M-TMD.
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Neuralgia and Atypical Facial, Ear, and Head Pain. Otolaryngol Clin North Am 2022; 55:595-606. [DOI: 10.1016/j.otc.2022.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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12
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Pereira IN, Hassan H. Botulinum toxin A in dentistry and orofacial surgery: an evidence-based review - part 1: therapeutic applications. Evid Based Dent 2022:10.1038/s41432-022-0256-9. [PMID: 35624296 DOI: 10.1038/s41432-022-0256-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/31/2021] [Indexed: 11/08/2022]
Abstract
Objective An evidence-based review on the safety and efficacy of botulinum toxin type-A (BoNTA) in orofacial conditions, focusing on the therapeutic applications and role of BoNTA as an adjuvant treatment.Data source and selection Data was collected using PubMed (Medline), Cochrane Library of Systematic Reviews and Cochrane Central Register of Controlled Trials electronic databases. Having satisfied the search parameters, 32 studies for therapeutic applications and 26 for BoNTA as an adjunctive treatment were included. The quality of relevant studies was assessed using the Best Evidence Topics (BETs) Critical Appraisal Tool.Data extraction The highest level of evidence (LOE) behind BoNTA safety and efficacy was for wound healing and scar management in the orofacial surgery context, where BoNTA was presented as an adjunctive modality. Level-I evidence was controversial for temporomandibular disorders and bruxism. However, it showed promising results for painful temporomandibular disorders of myogenic origin refractory to conservative therapies, and to decrease muscle contraction intensity in sleeping bruxism. There was only one level-II study for persistent recurrent aphthous stomatitis. Data showed limited level-III evidence for orofacial pain conditions (temporomandibular joint recurrent dislocation and pain, burning mouth syndrome or atypical odontalgia), oral cancer complications, or as an adjuvant to maxillofacial and orthognathic surgeries. Benefits of BoNTA in prosthodontics had weak level-IV evidence. No evidence was found among the periodontology field.Conclusion There is growing evidence to support the safety and efficacy of BoNTA in the investigated orofacial pathological conditions, with high levels of satisfaction from the patient and clinician perspective. However, there are some inconsistencies and limited high-quality evidence available. Well-designed controlled clinical trials are necessary to evaluate long-term safety, efficacy and cost-effectiveness before BoNTA is widely adopted with irrefutable evidence-based clinical guidelines.
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Affiliation(s)
- Ines Novo Pereira
- Academic Plastic Surgery, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, E1 2AT, UK
| | - Haidar Hassan
- Academic Plastic Surgery, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, E1 2AT, UK.
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Rajfur J, Rajfur K. Selected needling techniques in pain associated with musculoskeletal disorders: a narrative review. MEDICAL SCIENCE PULSE 2022. [DOI: 10.5604/01.3001.0015.8247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Joanna Rajfur
- Institute of Health Sciences, University of Opole, Poland
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Dadjoo S, Michelogiannakis D, Rossouw PE, Javed F. Potential adjunct therapies for the management of temporomandibular disorders: An evidence-based review. Cranio 2022:1-11. [PMID: 35156534 DOI: 10.1080/08869634.2022.2036437] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The aim was to review the role of adjuvant therapies that may potentially contribute toward the management of temporomandibular disorders (TMD). METHODS The addressed focused question was, "Are there any adjuvant therapies that may contribute toward the management of TMD?". Indexed databases were searched up to June 2021. The eligibility criteria were the following: (a) original clinical studies and (b) randomized controlled clinical trials (RCTs). RESULTS Adjuvant therapies were comprised of acupuncture, manual therapy, jaw exercises, dietary modifications, botulinum toxin therapy, and photobiomodulation. Short-term follow-up results from each of these RCTs showed beneficial effects in terms of pain reduction and improvements in jaw movement among patients with TMD. There are no long-term follow-up results in this regard. CONCLUSION The most effective adjunct treatment for managing TMD remains unknown, primarily due to a lack of sufficient scientific evidence.
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Affiliation(s)
- Shaahin Dadjoo
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Dimitrios Michelogiannakis
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - P Emile Rossouw
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Fawad Javed
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
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Fernández-Sanchis D, Brandín-de la Cruz N, Jiménez-Sánchez C, Gil-Calvo M, Herrero P, Calvo S. Cost-Effectiveness of Upper Extremity Dry Needling in Chronic Stroke. Healthcare (Basel) 2022; 10:healthcare10010160. [PMID: 35052323 PMCID: PMC8775940 DOI: 10.3390/healthcare10010160] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/09/2022] [Accepted: 01/12/2022] [Indexed: 02/04/2023] Open
Abstract
Introduction: Dry needling is a non-pharmacological approach that has proven to be effective in different neurological conditions. Objective: The aim of this study was to evaluate the cost-effectiveness of a single dry needling session in patients with chronic stroke. Methods: A cost-effectiveness analysis was performed based on a randomized controlled clinical trial. The results obtained from the values of the EuroQol-5D questionnaire and the Modified Modified Ashworth Scale were processed in order to obtain the percentage of treatment responders and the quality-adjusted life years (QALYs) for each alternative. The cost analysis was that of the hospital, clinic, or health center, including the equipment and physiotherapist. The cost per respondent and the incremental cost-effectiveness ratio of each alternative were assessed. Results: Twenty-three patients with stroke were selected. The cost of DN treatment was EUR 14.96, and the data analysis showed a favorable cost-effectiveness ratio of both EUR/QALY and EUR/responder for IG, although the sensitivity analysis using limit values did not confirm the dominance (higher effectiveness with less cost) of the dry needling over the sham dry needling. Conclusions: Dry needling is an affordable alternative with good results in the cost-effectiveness analysis—both immediately, and after two weeks of treatment—compared to sham dry needling in persons with chronic stroke.
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Affiliation(s)
- Daniel Fernández-Sanchis
- Faculty of Health Sciences, Universidad San Jorge, Autovía A-23 Zaragoza-Huesca Km.299, Villanueva de Gállego, 50830 Zaragoza, Spain; (D.F.-S.); (N.B.-d.l.C.); (C.J.-S.)
| | - Natalia Brandín-de la Cruz
- Faculty of Health Sciences, Universidad San Jorge, Autovía A-23 Zaragoza-Huesca Km.299, Villanueva de Gállego, 50830 Zaragoza, Spain; (D.F.-S.); (N.B.-d.l.C.); (C.J.-S.)
| | - Carolina Jiménez-Sánchez
- Faculty of Health Sciences, Universidad San Jorge, Autovía A-23 Zaragoza-Huesca Km.299, Villanueva de Gállego, 50830 Zaragoza, Spain; (D.F.-S.); (N.B.-d.l.C.); (C.J.-S.)
| | - Marina Gil-Calvo
- IIS Aragon, University of Zaragoza, Avda. San Juan Bosco, 13, 50009 Zaragoza, Spain; (M.G.-C.); (S.C.)
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n., 50009 Zaragoza, Spain
| | - Pablo Herrero
- IIS Aragon, University of Zaragoza, Avda. San Juan Bosco, 13, 50009 Zaragoza, Spain; (M.G.-C.); (S.C.)
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n., 50009 Zaragoza, Spain
- Correspondence:
| | - Sandra Calvo
- IIS Aragon, University of Zaragoza, Avda. San Juan Bosco, 13, 50009 Zaragoza, Spain; (M.G.-C.); (S.C.)
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n., 50009 Zaragoza, Spain
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BATISTA JFDOL, VILA-NOVA TEL, MORAES SLD, PELLIZZER EP, VASCONCELOS BCDE, GOMES JMDL, LEMOS CAA, HEIMER MV. Are exercises with or without occlusal splints more effective in the reduction of pain in patients with temporomandibular disorders of myogenic origin? A systematic review. J Appl Oral Sci 2022. [DOI: 10.1590/1678-7757-2022-0298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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DE LA Torre Canales G, Câmara-Souza MB, Poluha RL, Grillo CM, Conti PCR, Sousa MDLRD, Rodrigues Garcia RCM, Rizzatti-Barbosa CM. Botulinum toxin type A and acupuncture for masticatory myofascial pain: a randomized clinical trial. J Appl Oral Sci 2021; 29:e20201035. [PMID: 34105695 PMCID: PMC8232932 DOI: 10.1590/1678-7757-2020-1035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 02/25/2021] [Indexed: 11/24/2022] Open
Abstract
BoNT-A has been widely used for TMD therapy. However, the potential benefits compared to dry needling techniques are not clear.
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Affiliation(s)
| | - Mariana Barbosa Câmara-Souza
- Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Prótese e Periodontia, Piracicaba, SP, Brasil
| | - Rodrigo Lorenzi Poluha
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese, Bauru, SP, Brasil
| | - Cassia Maria Grillo
- Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Saúde Coletiva, Piracicaba, SP, Brasil
| | | | - Maria da Luz Rosário de Sousa
- Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Saúde Coletiva, Piracicaba, SP, Brasil
| | | | - Célia Marisa Rizzatti-Barbosa
- Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Prótese e Periodontia, Piracicaba, SP, Brasil.,UNINGA, Departmento de Odontologia, Maringá, PR, Brasil
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Li DTS, Leung YY. Temporomandibular Disorders: Current Concepts and Controversies in Diagnosis and Management. Diagnostics (Basel) 2021; 11:diagnostics11030459. [PMID: 33800948 PMCID: PMC8000442 DOI: 10.3390/diagnostics11030459] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 12/17/2022] Open
Abstract
Temporomandibular disorders (TMD) are a group of orofacial pain conditions which are the most common non-dental pain complaint in the maxillofacial region. Due to the complexity of the etiology, the diagnosis and management of TMD remain a challenge where consensus is still lacking in many aspects. While clinical examination is considered the most important process in the diagnosis of TMD, imaging may serve as a valuable adjunct in selected cases. Depending on the type of TMD, many treatment modalities have been proposed, ranging from conservative options to open surgical procedures. In this review, the authors discuss the present thinking in the etiology and classification of TMD, followed by the diagnostic approach and the current trend and controversies in management.
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Dommerholt J, Mayoral O, Thorp JN. A critical overview of the current myofascial pain literature - January 2021. J Bodyw Mov Ther 2021; 25:261-271. [PMID: 33714506 DOI: 10.1016/j.jbmt.2020.12.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Myofascial pain syndrome (MPS), trigger points (TrPs), and dry needling (DN) continue to be of interest to researchers and clinicians worldwide. In this quarterly overview, we included studies from 19 countries, including Pakistan, Iran, Spain, Israel, the US, Australia, Turkey, the UK, China, Italy, Germany, Brazil, Denmark, Canada, Saudi Arabia, Egypt, India, New Zealand, and Thailand. As encouraging as it may be that myofascial pain is being considered worldwide, it is frustrating how many studies do not include a proper control group making them not very useful. It is not clear why researchers would go through the trouble of setting up a study, which requires many hours of work and dedication, and not produce a meaningful paper for clinicians and researchers alike. Fortunately, several papers are high quality studies. This overview covers 39 basic research studies, systematic reviews and meta-analyses, clinical studies, and a few case reports.
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Affiliation(s)
- Jan Dommerholt
- Bethesda Physiocare, Bethesda, MD, USA; Myopain Seminars, Bethesda, MD, USA.
| | - Orlando Mayoral
- Physical Therapy Unit, Hospital Provincial de Toledo, Toledo, Spain; Seminarios Travell & Simons, Toledo, Spain.
| | - Jacob N Thorp
- Myopain Seminars, Bethesda, MD, USA; Charleston Southern University, North Charleston, SC, USA.
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Martín-Corrales C, Bautista IV, Méndez-Mera JE, Fernández-Matías R, Achalandabaso-Ochoa A, Gallego-Izquierdo T, Nuñez-Nagy S, Pecos-Martín D. Benefits of Adding Gluteal Dry Needling to a Four-Week Physical Exercise Program in a Chronic Low Back Pain Population. A Randomized Clinical Trial. PAIN MEDICINE 2020; 21:2948-2957. [PMID: 33580803 DOI: 10.1093/pm/pnaa279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To determine if adding dry needling to a four-week exercise program has an additional benefit compared with adding sham dry needling to the same exercise program in subjects with chronic low back pain. DESIGN Randomized clinical trial. SETTING Physiotherapy and Pain Clinic of Alcala University. SUBJECTS Forty-six patients with chronic low back pain. METHODS Subjects were randomized to two groups: the dry needling group (N = 23) or sham dry needling group (N = 23). Both groups received a four-week exercise program and before the exercise started a session of dry needling or sham dry needling. Pain (visual analog scale), disability (Roland-Morris Questionnaire), and fear avoidance beliefs (Fear Avoidance Beliefs Questionnaire) were assessed at baseline, after treatment, and at three-month follow-up. Pressure pain thresholds (algometer) were measured at baseline, after the dry needling or the sham dry needling, and after treatment. RESULTS Both groups showed significant improvements for all variables. In the between-group comparison, the dry needling group improved significantly in pain at three-month follow-up and pressure pain thresholds at the end of treatment for all measures, and at three-month follow-up there was no improvement in gluteus medium. CONCLUSIONS In chronic low back patients, adding dry needling to a four-week exercise program has an additional benefit in pain and sensitivity compared with adding sham dry needling to the same exercise program.
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Affiliation(s)
| | | | | | | | | | - Tomás Gallego-Izquierdo
- Research Institute of Physiotherapy and Pain. Universidad de Alcalá, Alcalá, Spain.,Department of Physical Therapy and Nursing, Universidad de Alcalá, Alcalá, Spain.,Physiotherapy and Pain Group, Universidad de Alcalá, Alcalá, Spain
| | - Susana Nuñez-Nagy
- Department of Physical Therapy and Nursing, Universidad de Alcalá, Alcalá, Spain
| | - Daniel Pecos-Martín
- Research Institute of Physiotherapy and Pain. Universidad de Alcalá, Alcalá, Spain.,Department of Physical Therapy and Nursing, Universidad de Alcalá, Alcalá, Spain.,Physiotherapy and Pain Group, Universidad de Alcalá, Alcalá, Spain
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Núñez-Cortés R, Cruz-Montecinos C, Latorre-García R, Pérez-Alenda S, Torres-Castro R. Effectiveness of Dry Needling in the Management of Spasticity in Patients Post Stroke. J Stroke Cerebrovasc Dis 2020; 29:105236. [PMID: 33066920 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105236] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/24/2020] [Accepted: 08/03/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To determine the effectiveness of the dry needling technique (DNT) in the treatment of spasticity for individuals with stroke. DESIGN We reviewed the Embase, Pubmed/MEDLINE, Web of Science and Cochrane Central Register of Controlled Trials (CENTRAL) databases. We also performed a manual search of the references that are included in the selected articles. Studies included were: i) randomized clinical trials (RCTs); ii) involving patients with a diagnosis of stroke; and iii) using DNT alone or in a multimodal treatment. Muscular spasticity was the primary outcome of the study. The additional outcomes included were: pressure pain sensitivity, range of motion and perception of pain. The analysis of the certainty of the evidence was analyzed using GRADE. The risk of bias of the included studies was assessed with the Cochrane Risk of Bias Tool for Randomized Controlled Trials. RESULTS A total of six RCTs with 221 patients were included in this systematic review, where a significant decrease in spasticity was observed in most of the muscles evaluated, though the certainty of the evidence was low. The effects were only evaluated in the short term in all included studies and the sample size was small. CONCLUSION These results should be taken with caution because the included studies are few in number and have different comparators. More RCTs are needed to cover aspects of biases found in the literature, in particular the blinding of participants and personnel.
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Affiliation(s)
- Rodrigo Núñez-Cortés
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.; Hospital Clínico La Florida, Santiago, Chile
| | - Carlos Cruz-Montecinos
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile..
| | - Rodrigo Latorre-García
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Sofía Pérez-Alenda
- Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain
| | - Rodrigo Torres-Castro
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
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Al‐Moraissi EA, Alradom J, Aladashi O, Goddard G, Christidis N. Needling therapies in the management of myofascial pain of the masticatory muscles: A network meta‐analysis of randomised clinical trials. J Oral Rehabil 2020; 47:910-922. [DOI: 10.1111/joor.12960] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/31/2020] [Accepted: 03/04/2020] [Indexed: 02/07/2023]
Affiliation(s)
| | - Jabr Alradom
- Department of Oral and Maxillofacial Surgery Thamar University Thamar Yemen
| | - Omar Aladashi
- Department of Oral and Maxilofacial Surgery Cairo University Cairo Egypt
| | - Greg Goddard
- Center for Orofacial Pain University of California at San Francisco San Francisco CA USA
| | - Nikolaos Christidis
- Division of Oral Diagnostics and Rehabilitation Department of Dental Medicine Karolinska Institutet Huddinge Sweden
- Scandinavian Center for Orofacial Neuroscience Huddinge Sweden
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