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van der Meer HA, van der Wal AC, van Hinte G, Speksnijder CM. Counselling for patients with a temporomandibular disorder: A scoping review and concept analysis. J Oral Rehabil 2024. [PMID: 39225165 DOI: 10.1111/joor.13827] [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: 07/14/2023] [Revised: 07/24/2024] [Accepted: 07/29/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND An integral component of comprehensive temporomandibular disorder (TMD) treatment involves what is commonly referred to in literature as patient counselling or patient education. Despite its importance, a clear definition of the concept is lacking. OBJECTIVES To describe the concept of counselling (i.e. what is it, what should it consist of, and when should it be given) through a concept analysis of the literature. ELIGIBILITY CRITERIA All papers that include a description of counselling or education for TMD are included. SOURCES OF EVIDENCE Literature searches were performed in the electronic databases PubMed, Cinahl, and PsycInfo. CHARTING METHODS A qualitative analysis was done using the principle-based concept analysis approach, where descriptions of counselling from the included papers were analysed by the researchers. RESULTS A total of 71 articles were included. Based on the qualitative analysis of the included articles and descriptions of counselling, the following content themes were identified: (1) general information on TMD; (2) overuse of the masticatory system; (3) posture education; (4) lifestyle and psychosocial factors; (5) exercise- and thermotherapy; and (6) additional information and therapies. CONCLUSIONS A definition and framework of counselling for TMD has been provided, which can be used in the clinic, research, and educational programs.
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Affiliation(s)
- Hedwig A van der Meer
- SOMT University of Physiotherapy, Softwareweg, Amersfoort, The Netherlands
- Department of Orofacial Pain and Disfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit (VU) University Amsterdam, Amsterdam, The Netherlands
- Department of Oral-Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Annemarie C van der Wal
- SOMT University of Physiotherapy, Softwareweg, Amersfoort, The Netherlands
- Department of Orofacial Pain and Disfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit (VU) University Amsterdam, Amsterdam, The Netherlands
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Gerben van Hinte
- SOMT University of Physiotherapy, Softwareweg, Amersfoort, The Netherlands
- Department of Rehabilitation, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Caroline M Speksnijder
- SOMT University of Physiotherapy, Softwareweg, Amersfoort, The Netherlands
- Department of Oral-Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Gong Y, Liu Y, Yin D. Effect of the application of digital technology-assisted optimization in the process of adjusting jaw position. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2024; 42:268-276. [PMID: 38597088 PMCID: PMC11034415 DOI: 10.7518/hxkq.2024.2023327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/17/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVES The aim of this study was to demonstrate a novel jaw position adjustment technique derived from digital twins and evaluate the application effect of digital technology-assisted optimization in the process of adjusting jaw position on patients with temporomandibular disorders (TMD). METHODS A total of 74 patients with TMD who attended the Department of Temporomandibular Joint, West China Hospital of Stomatology, Si-chuan University, between June 2022 and May 2023 were selected. The patient's initial computed tomography (CT) and bilateral temporomandibular joint data obtained by magnetic resonance imaging (MRI) were collected. The 148 joints were divided into the normal disc-condyle relationship (N) group, disc displacement with reduction (DDWR) group, and disc displacement without reduction (DDWoR) group. Assisted by digital technology, the patient's CT data were reconstructed, and a personalized reference plane was established to adjust the jaw position. A three-point bite guiding splint was designed by the adjusted occlusal space and then fabricated by 3D printing technology. It was worn by the patients and then reviewed by MRI. Before and after the adjustment of jaw position, the amount and direction of condyle and disc displacement and the angle between condyle and disc were measured as the evaluation indexes of the effect of the adjustment. The correlation with condylar displacement was evaluated. RESULTS In the N group, the disc moved backward and downward along the X and Z axes by (-0.60±0.62) and (0.51±0.71) mm, respectively. In the DDWR group, the disc moved backward and upward along the X and Z axes by (-1.33±1.38) and (-0.09±1.31) mm, respectively. In the DDWoR group, the disc moved forward and downward along the X and Z axes by (0.49±1.76) and (1.35±1.76) mm, respectively. The angle between the condyle and the disc decreased after adjustment of the jaw position in all three groups. All patients showed improvement in symptoms after adjustment. CONCLUSIONS Digital technology-assisted jaw position adjustment can simplify the process, reduce the sensitivity of the technique, and improve patients' disc-condyle structure and symptoms. Therefore, its application in the treatment of patients with TMD is of great clinical significance.
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Affiliation(s)
- Yanji Gong
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yang Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Deqiang Yin
- Dept. of Engineering Mechanics, College of Aerospace Engineering, Chongqing University, Chong-qing 400044, China
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Justribó-Manion C, Mesa-Jiménez J, Bara-Casaus J, Zuil-Escobar JC, Wachowska K, Álvarez-Bustins G. Additional effects of therapeutic exercise and education on manual therapy for chronic temporomandibular disorders treatment: a randomized clinical trial. Physiother Theory Pract 2024:1-16. [PMID: 38353484 DOI: 10.1080/09593985.2024.2316305] [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: 10/06/2023] [Accepted: 01/25/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Previous studies have evaluated the implementation of behavioral approaches in individuals with chronic temporomandibular disorders (TMDs). OBJECTIVE To evaluate the benefits of a behavioral approach to craniofacial pain. Second, we assessed the benefits of kinesiophobia, catastrophizing, mouth opening without pain, and forward head posture. METHODS Individuals with chronic TMDs were treated for five weeks. The intervention group (n = 17) underwent pain neuroscience education, manual therapy, and therapeutic exercise, whereas the control group (n = 17) underwent manual therapy only. Outcomes were evaluated immediately, at seven and 19 weeks follow-up. The assessment tools used were the Craniofacial Pain Disability Inventory, Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, Mandibular Range of Motion Scale, and Cervical Range of Motion Tool. RESULTS The interventions did not influence the differences in the improvements between the groups observed for craniofacial pain disability (inter-subject p 0.4). The intervention had a moderate influence on the improvement of kinesiophobia and catastrophizing (Inter-subject p 0.09 and 0.1 respectively) with a clinically significant effect size (Estimated mean (EM) -8.6 standard deviation (SD) ±3.48 p 0.019; and EM -7.6 SD ± 5.11 p 0.15 respectively). CONCLUSION The behavioral approach improved catastrophizing and kinesiophobia outcomes in individuals with chronic TMDs.
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Affiliation(s)
- Cristian Justribó-Manion
- Escuela Internacional de Doctorado (CEINDO), Universitat Abat Oliva CEU, CEU Universities, Barcelona, Spain
- Spain National Centre, Foundation COME Collaboration, Barcelona, Spain
- Craniofacial Disorder Academy, Barcelona, Spain
| | - Juan Mesa-Jiménez
- Departamento de Fisioterapia, Facultad de Medicina, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Spain
- Integrative Craniofacial Therapy (Incraft Lab), Madrid, Spain
| | - Javier Bara-Casaus
- Group Quiron Salud, Sagrado Corazón University Hospital, Barcelona, Spain
| | - Juan-Carlos Zuil-Escobar
- Departamento de Fisioterapia, Facultad de Medicina, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Spain
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Basra M, Patel H, Stern-Harbutte A, Lee D, Gregg RK, Waters HB, Potter AK. A Narrative Review on the Viability of Osteopathic Manipulative Medicine in Treating Irritable Bowel Syndrome With Constipation (IBS-C). Cureus 2024; 16:e54180. [PMID: 38496183 PMCID: PMC10941805 DOI: 10.7759/cureus.54180] [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: 12/11/2023] [Accepted: 02/13/2024] [Indexed: 03/19/2024] Open
Abstract
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by chronic abdominal pain and alterations in bowel habits, with global prevalence. The etiology of the disease is likely multifactorial; however, autonomic nervous system (ANS) dysfunction and immune-mediated inflammation may contribute the most to the hallmark symptoms of abdominal pain and altered motility of the gut. Current pharmacological therapies operate to modulate intestinal transit, alter the composition of the gut flora and control pain. Non-pharmacological approaches include dietary changes, increased physical activity, or fecal microbiota transplants. None of these therapies can modulate ANS dysfunction or impact the underlying inflammation that is likely perpetuating the symptoms of IBS. Osteopathic Manipulative Medicine (OMM) is a clinical approach focused on physical manipulation of the body's soft tissues to correct somatic dysfunctions. OMM can directly target the pathophysiology of IBS through many approaches such as ANS modulation and lymphatic techniques to modify the inflammatory mechanisms within the body. Particular OMM techniques of use are lymphatic manipulation, myofascial release, sympathetic ganglia treatment, sacral rocking, counterstrain, and viscerosomatic treatment. The aim of this study is to identify OMM treatments that can be used to potentially reduce the inflammation and ANS dysfunction associated with IBS symptoms, thereby providing a new non-pharmacological targeted approach for treating the disease.
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Affiliation(s)
- Mahi Basra
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Hemangi Patel
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Alison Stern-Harbutte
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - David Lee
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Randal K Gregg
- Research, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Holly B Waters
- Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Anna K Potter
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
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Ortiz-Comino L, Martín-Martín L, Galiano-Castillo N, Castro-Martín E, Fernández-Gualda MÁ, Lozano-Lozano M, Fernández-Lao C. The effects of myofascial induction therapy in survivors of head and neck cancer: a randomized, controlled clinical trial. Support Care Cancer 2022; 31:49. [PMID: 36526871 PMCID: PMC9758021 DOI: 10.1007/s00520-022-07482-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE We aim to evaluate the effects of myofascial induction therapy (MIT) on the sequelae suffered by the survivors of HNC (sHNC). METHODS We enrolled 46 sHNC in a randomized controlled trial (RCT), of whom 20 received a MIT protocol and 23 were placed on a waitlist while receiving the recommended treatment for 6 weeks. The MIT protocol included a total of 18 sessions, 3 days a week on alternate days for 6 weeks. Maximal mouth opening, the presence of temporomandibular dysfunction, cervical endurance, active range of motion (AROM), shoulder AROM, handgrip strength, and perceived physical fitness were assessed. RESULTS Maximal mouth opening, temporomandibular dysfunction, cervical endurance, and AROM, affected shoulder abduction and unaffected shoulder flexion and external rotation significantly improved (p < .05) after an MIT protocol, but only cervical AROM and affected shoulder abduction changes were clinically meaningful. No statistically significant changes were observed in the other shoulder AROM, handgrip strength, or physical fitness perception (p > .05). CONCLUSION A 6-week MIT protocol improves mouth opening, TMD, cervical function (endurance and AROM), affected shoulder abduction and unaffected shoulder flexion, and external rotation AROM in the sHNC. However, no changes were observed in most of the shoulder AROM, muscular strength, or perceived physical fitness. Future studies should perform longer follow-up designs, increase the sample size, and include multimodal treatments to address these sequelae in the sHNC.
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Affiliation(s)
- Lucía Ortiz-Comino
- Department of Physical Therapy. Health Sciences Faculty, University of Granada, Melilla, Spain
| | - Lydia Martín-Martín
- Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
- Unit of Excellence On Exercise and Health (UCEES), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
| | - Noelia Galiano-Castillo
- Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
- Unit of Excellence On Exercise and Health (UCEES), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
| | - Eduardo Castro-Martín
- Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
- Unit of Excellence On Exercise and Health (UCEES), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
| | - Miguel Ángel Fernández-Gualda
- Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
| | - Mario Lozano-Lozano
- Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
- Unit of Excellence On Exercise and Health (UCEES), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
| | - Carolina Fernández-Lao
- Department of Physical Therapy, Health Sciences Faculty, University of Granada, Granada, Spain
- Sport and Health Research Center (IMUDs), Granada, Spain
- Unit of Excellence On Exercise and Health (UCEES), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
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Facial Pain: RCT between Conventional Treatment and Fascial Manipulation ® for Temporomandibular Disorders. Bioengineering (Basel) 2022; 9:bioengineering9070279. [PMID: 35877330 PMCID: PMC9312324 DOI: 10.3390/bioengineering9070279] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022] Open
Abstract
Background: To investigate the effectiveness of a specific manual therapy, Fascial Manipulation® (FM), in comparison with conventional treatments in temporomandibular disorders (TMD) patients using a two-arm randomized controlled trial. Methods: The study consisted of 28 patients that were divided in two groups (Group 1: Fascial Manipulation® vs. Group 2: conventional TMD treatment). The Verbal Rating Scale (VRS), RDC/TMD, electromyography (EMG) and Pression/Pain Evaluation on Masseter and Temporalis Muscle were assessed with different times. Results: In both groups, the improvement in pain was evident on the VRS scale (p < 0.0001) and pain-free opening (p < 0.001). In Group 1, the recovery of the function was faster; maximum unassisted opening T0 vs. T1 (p = 0.001). Conclusions: FM® can be used as an effective method for facial pain, being a rapid, safe and cost-effective approach to reduce pain, gain function and mouth opening that can be used prior to occlusion stabilization appliances.
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Asquini G, Pitance L, Michelotti A, Falla D. The effectiveness of manual therapy applied to craniomandibular structures in temporomandibular disorders: a systematic review. J Oral Rehabil 2021; 49:442-455. [PMID: 34931336 DOI: 10.1111/joor.13299] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/13/2021] [Accepted: 12/15/2021] [Indexed: 12/01/2022]
Abstract
Within physical therapy, manual therapy is known to be effective for managing temporomandibular disorders (TMDs). However, manual therapy is a broad term including different approaches applied to different body regions. This is the first systematic review that aims to evaluate the effectiveness of manual therapy applied specifically to the craniomandibular structures (Cranio-Mandibular Manual Therapy (CMMT)) on pain and maximum mouth opening in people with TMD. This systematic review was developed based on a pre-determined published protocol which was prospectively registered with PROSPERO (CRD42019160213). A search of MEDLINE, Embase, CINAHL, ZETOC, Web of Science, SCOPUS, PEDro, PubMed, Cochrane Library and Best Evidence, EBM reviews-Cochrane Central Register of Controlled Trials, Index to Chiropractic Literature ChiroAccess and Google Scholar databases was conducted from inception until October 2020. Randomised controlled trials comparing the effect of CMMT on pain and maximum mouth opening versus other types of treatment in TMDs were included. Two reviewers independently screened articles for inclusion, extracted data, assessed risk of bias with the revised Cochrane risk of bias tool for randomised trials and evaluated the overall quality of evidence with the Grading of Recommendations, Assessment, Development and Evaluations. A total of 2720 records were screened, of which only 6 (293 participants) satisfied the inclusion criteria. All studies showed some concerns in risk of bias, except for one, which was high risk of bias. The overall quality of evidence was very low for all outcomes because of high heterogeneity and small sample sizes. All studies showed a significant improvement in pain and maximum mouth opening for CMMT from baseline in the mid-term, but only two showed superiority compared to other interventions. Given the high heterogeneity and small sample sizes of the included studies, a quantitative synthesis was not performed. There is the need for future high methodology research investigating different manual therapy techniques applied to different regions and different populations (e.g., chronic versus acute TMD) to determine what is most effective for pain and maximum mouth opening in patients with TMDs.
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Affiliation(s)
- Giacomo Asquini
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom
| | - Laurent Pitance
- Institute of Experimental and Clinical Research, Health Sciences division, Neuro-Musculo-Skeletal-Lab (NMSK), Université Catholique de Louvain, Brussels, Belgium
| | - Ambra Michelotti
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Orthodontics, University of Naples 'Federico II'
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom
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Effects of Therapeutic and Aerobic Exercise Programs on Pain, Neuromuscular Activation, and Bite Force in Patients with Temporomandibular Disorders. J Pers Med 2021; 11:jpm11111170. [PMID: 34834522 PMCID: PMC8623244 DOI: 10.3390/jpm11111170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/08/2021] [Accepted: 11/08/2021] [Indexed: 02/05/2023] Open
Abstract
Pain in masticatory muscles is one of the most frequent symptoms in patients with temporomandibular disorders (TMD) and can lead to changes in the patterns of neuromuscular activity of masticatory muscles and decrease in bite force. This study assesses the effects of three eight-week exercise programs on pain intensity, neuromuscular activation, and bite force of masticatory muscles in patients with TMD. Forty-five patients were divided into three groups: a therapeutic exercise program (G1), a therapeutic and aerobic exercise program (G2), and an aerobic exercise program (G3). The masticatory muscles’ pain was evaluated using the numeric pain rating scale (NPRS), surface electromyographic (sEMG) activity of the masseter was recorded during maximum voluntary contraction and at rest, and bite force was evaluated using a dynamometer. These parameters were evaluated twice at baseline (A01/A02), at the end of the eight-week intervention period (A1), and 8–12 weeks after the end of the intervention (A2). After intervention, G2 showed the best results, with a significantly decrease in masticatory muscles’ pain and increase in bite force. These results suggest that interventions to reduce pain in patients with TMD should be multimodal.
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Castro-Martín E, Galiano-Castillo N, Fernández-Lao C, Ortiz-Comino L, Postigo-Martin P, Arroyo-Morales M. Myofascial Induction Therapy Improves the Sequelae of Medical Treatment in Head and Neck Cancer Survivors: A Single-Blind, Placebo-Controlled, Randomized Cross-Over Study. J Clin Med 2021; 10:jcm10215003. [PMID: 34768520 PMCID: PMC8584513 DOI: 10.3390/jcm10215003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 01/09/2023] Open
Abstract
Head and neck cancer (HNC) is the sixth most common cancer worldwide. Yet, less than 60% of HNC survivors receive adequate therapy for treatment-related sequelae. The objective of this study was to determine the efficacy of myofascial induction therapy (MIT) in improving cervical and shoulder pain and range of motion, maximal mouth opening, and cervical muscle function in HNC survivors. This crossover, blinded, placebo-controlled study involved 22 HNC survivors (average age 56.55 ± 12.71) of which 13 were males (59.1%) who received, in a crossover fashion, both a single 30-min session of MIT in the form of manual unwinding and simulated pulsed shortwave therapy (placebo), with a 4-week washout interval between the two. Cervical and shoulder pain (visual analogue scale) and range of motion (cervical range of motion device and goniometer), maximum mouth opening (digital caliper), and cervical muscle function (deep cervical flexor endurance test) were measured before and after the treatment and placebo sessions. A single session of MIT improved cervical and affected side shoulder pain, cervical range of motion, maximum mouth opening, and cervical muscle function. The associated effect sizes ranged from moderate to large. The present study suggests that MIT, in the form of manual unwinding, improves cervical (−3.91 ± 2.77) and affected-side shoulder (−3.64 ± 3.1) pain, cervical range of motion (flexion: 8.41 ± 8.26 deg; extension: 12.23 ± 6.55; affected-side rotation: 14.27 ± 11.05; unaffected-side rotation: 11.73 ± 8.65; affected-side lateroflexion: 7.95 ± 5.1; unaffected-side lateroflexion: 9.55 ± 6.6), maximum mouth opening (3.36 ± 3.4 mm), and cervical muscle function (8.09 ± 6.96 s) in HNC survivors.
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Affiliation(s)
- Eduardo Castro-Martín
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (E.C.-M.); (N.G.-C.); (P.P.-M.); (M.A.-M.)
- Sport and Health University Research Institute (iMUDS), 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, 18014 Granada, Spain
- ‘Cuídate’ Support Unit for Oncology Patients, 18016 Granada, Spain
| | - Noelia Galiano-Castillo
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (E.C.-M.); (N.G.-C.); (P.P.-M.); (M.A.-M.)
- Sport and Health University Research Institute (iMUDS), 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, 18014 Granada, Spain
- ‘Cuídate’ Support Unit for Oncology Patients, 18016 Granada, Spain
| | - Carolina Fernández-Lao
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (E.C.-M.); (N.G.-C.); (P.P.-M.); (M.A.-M.)
- Sport and Health University Research Institute (iMUDS), 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, 18014 Granada, Spain
- ‘Cuídate’ Support Unit for Oncology Patients, 18016 Granada, Spain
- Correspondence: (C.F.-L.); (L.O.-C.)
| | - Lucía Ortiz-Comino
- ‘Cuídate’ Support Unit for Oncology Patients, 18016 Granada, Spain
- Department of Physical Therapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, 52005 Melilla, Spain
- Correspondence: (C.F.-L.); (L.O.-C.)
| | - Paula Postigo-Martin
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (E.C.-M.); (N.G.-C.); (P.P.-M.); (M.A.-M.)
- Sport and Health University Research Institute (iMUDS), 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, 18014 Granada, Spain
- ‘Cuídate’ Support Unit for Oncology Patients, 18016 Granada, Spain
| | - Manuel Arroyo-Morales
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (E.C.-M.); (N.G.-C.); (P.P.-M.); (M.A.-M.)
- Sport and Health University Research Institute (iMUDS), 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, 18014 Granada, Spain
- ‘Cuídate’ Support Unit for Oncology Patients, 18016 Granada, Spain
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Moleirinho-Alves PMM, Almeida AMCSD, Exposto FG, Oliveira RANDS, Pezarat-Correia PLCD. Effects of therapeutic exercise and aerobic exercise programmes on pain, anxiety and oral health-related quality of life in patients with temporomandibular disorders. J Oral Rehabil 2021; 48:1201-1209. [PMID: 34370327 DOI: 10.1111/joor.13239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/18/2021] [Accepted: 07/23/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pain and anxiety contribute to decreasing quality of life related to oral health in patients with temporomandibular disorders (TMD). Evidence-based practice has shown that therapeutic and aerobic exercise programmes are adequate strategies for modifying these factors. OBJECTIVE To assess the effects of aerobic exercise on pain, anxiety and quality of life related to oral health in patients with TMD. METHODS Forty-five patients diagnosed with TMD were divided into three groups of 15 participants: a therapeutic exercise programme (G1, mean 26.9 ± 5.5 years), a therapeutic and aerobic exercise programme (G2, mean 26 ± 4.4 years) and an aerobic exercise programme (G3, mean 24.9 ± 3.4 years). Pain intensity was assessed using a numerical rating scale (NRS), anxiety level and quality of life related to oral health through GAD-7 and OHIP-14, respectively. These parameters were evaluated twice at baseline (T0a/T0b), ending 8-week intervention period (T1) and 8-12 weeks after ending intervention (T2). RESULTS NRS significantly decreased in G1 (mean difference T0a/T1 = 5.2, p ˂ .001), G2 (mean difference T0a/T1 = 6.0, p ˂ .001) and G3 (mean difference T0a/T1 = 2.2, p = 0.001). OHIP-14 significantly decreased in G1 (mean difference T0a/T1 = 13.5, p ˂ .001) and G2 (mean difference T0a/T1 = 15.8, p ˂ 0.001) but not in G3 (mean difference T0a/T1 = 1.2, p = 0.55). There were no significant differences between groups regarding GAD-7. Between T1 and T2, there were no significant differences in variables. CONCLUSION Therapeutic exercises and therapeutic excercises combined with aerobic exercise groups had a significant decrease in pain and oral health-related quality of life at 8 and 12 weeks. These decreases were not seen for the aerobic exercise group.
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Affiliation(s)
- Paula Manuela Mendes Moleirinho-Alves
- CIPER Neuromuscular Research Lab, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.,Center of Interdisciplinary Research Egas Moniz (CiiEM), Egas Moniz Higher School of Health, Monte de Caparica, Portugal.,Cuf Infante Santo Hospital, Lisbon, Portugal
| | - André Mariz Coelho Santos de Almeida
- Cuf Infante Santo Hospital, Lisbon, Portugal.,Center of Interdisciplinary Research Egas Moniz (CiiEM), Egas Moniz Higher Institute of Health Science, Monte de Caparica, Portugal
| | - Fernado Gustavo Exposto
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,Scandinavian Center for Orofacial Neurosciences (SCON, Aarhus, Denmark
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11
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von Piekartz H, Schwiddessen J, Reineke L, Armijo-Olivio S, Bevilaqua-Grossi D, Biasotto Gonzalez DA, Carvalho G, Chaput E, Cox E, Fernández-de-Las-Peñas C, Gadotti IC, Gil Martínez A, Gross A, Hall T, Hoffmann M, Julsvoll EH, Karegeannes M, La Touche R, Mannheimer J, Pitance L, Rocabado M, Strickland M, Stelzenmüller W, Speksnijder C, van der Meer HA, Luedke K, Ballenberger N. International consensus on the most useful assessments used by physical therapists to evaluate patients with temporomandibular disorders: A Delphi study. J Oral Rehabil 2020; 47:685-702. [PMID: 32150764 DOI: 10.1111/joor.12959] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 02/11/2020] [Accepted: 02/25/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To identify assessment tools used to evaluate patients with temporomandibular disorders (TMD) considered to be clinically most useful by a panel of international experts in TMD physical therapy (PT). METHODS A Delphi survey method administered to a panel of international experts in TMD PT was conducted over three rounds from October 2017 to June 2018. The initial contact was made by email. Participation was voluntary. An e-survey, according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES), was posted using SurveyMonkey for each round. Percentages of responses were analysed for each question from each round of the Delphi survey administrations. RESULTS Twenty-three experts (completion rate: 23/25) completed all three rounds of the survey for three clinical test categories: 1) questionnaires, 2) pain screening tools and 3) physical examination tests. The following was the consensus-based decision regarding the identification of the clinically most useful assessments. (1) Four of 9 questionnaires were identified: Jaw Functional Limitation (JFL-8), Mandibular Function Impairment Questionnaire (MFIQ), Tampa Scale for Kinesiophobia for Temporomandibular disorders (TSK/TMD) and the neck disability index (NDI). (2) Three of 8 identified pain screening tests: visual analog scale (VAS), numeric pain rating scale (NRS) and pain during mandibular movements. (3) Eight of 18 identified physical examination tests: physiological temporomandibular joint (TMJ) movements, trigger point (TrP) palpation of the masticatory muscles, TrP palpation away from the masticatory system, accessory movements, articular palpation, noise detection during movement, manual screening of the cervical spine and the Neck Flexor Muscle Endurance Test. CONCLUSION After three rounds in this Delphi survey, the results of the most used assessment tools by TMD PT experts were established. They proved to be founded on test construct, test psychometric properties (reliability/validity) and expert preference for test clusters. A concordance with the screening tools of the diagnostic criteria of TMD consortium was noted. Findings may be used to guide policymaking purposes and future diagnostic research.
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Affiliation(s)
- Harry von Piekartz
- Department Physical Therapy and Rehabilitation science, University of Applied Science Osnabrück, Osnabrück, Germany
| | - Julius Schwiddessen
- Department Physical Therapy and Rehabilitation science, University of Applied Science Osnabrück, Osnabrück, Germany
| | - Lukas Reineke
- Department Physical Therapy and Rehabilitation science, University of Applied Science Osnabrück, Osnabrück, Germany
| | - Susan Armijo-Olivio
- Faculty of Rehabilitation Medicine, Faculty of Medicine and Dentistry Rehabilitation Research Center, University of Alberta, Edmonton Institute of Health Economics (IHE), Edmonton, AB, Canada
| | | | | | - Gabriela Carvalho
- Lübeck University and Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.,University of São Paulo, São Paulo, Brazil
| | - Eve Chaput
- University of Montreal and Western University, Montreal, QC, Canada.,Quebec Association of Orthopedic Manual Physiotherapy (AQPMO), Montreal, QC, Canada
| | - Erin Cox
- Kinatex Sports Physio, Laval, QC, Canada
| | - Cesar Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain.,Cátedra de Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico - University Rey Juan Carlos of Madrid, Madrid, Spain
| | - Inae Caroline Gadotti
- Department of Physical Therapy, Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami, FL, USA
| | | | - Anita Gross
- Rehabilitation Sciences - McMaster University, Hamilton, ON, Canada
| | - Toby Hall
- Curtin University, Perth, WA, Australia.,University of Western Australia, Perth, WA, Australia
| | | | | | | | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios - Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Grupo de Investigación Motion in Brains, Instituto de Neurociencia y Ciencias del Movimiento (INCIMOV), Centro Superior de Estudios, Universitarios La Salle - Universidad Autónoma de Madrid, Madrid, Spain.,Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, Spain
| | - Jeffrey Mannheimer
- Delaware Valley Physical Therapy Associates, New Jersey, NJ, USA.,Department of Regenerative and Rehabilitation Medicine, Columbia University, New York, NY, USA.,Physical Therapy Board of Craniofacial & Cervical Therapeutics Office for physical therapy, Lawrenceville, NJ, USA
| | - Laurent Pitance
- Faculté des Sciences de la Motricité FSM, Institut de Recherche Expetimentale et Clinique (IREC), Laboratoire de Neuro musculo squelettique (NMSK) - University catholic of Louvain, Neuve, Belgium
| | - Mariano Rocabado
- Dean Faculty of Rehabilitation Science, University Andrés Bello, Santiago, Chile
| | - Mark Strickland
- Operations Central Texas, For Health Sciences - University of St. Augustine, St. Augustine, FL, USA
| | | | - Caroline Speksnijder
- Division Surgical Specialty, Oral and Maxillofacial Surgery and Special Dental Care, Head and Neck Surgical Oncology - University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hedwig Aleida van der Meer
- Centre for Applied Research on Education - Amsterdam University of Applied Sciences, Amsterdam Centre for Innovative Health Practice (ACHIEVE), Amsterdam, The Netherlands
| | - Kerstin Luedke
- Department of Physical Therapy, University Lübeck, Lübeck, Germany
| | - Nicolaus Ballenberger
- Department Physical Therapy and Rehabilitation science, University of Applied Science Osnabrück, Osnabrück, Germany
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Rodrigues dos Santos BM, Mendes C. Manual therapy and its role in occupational health: Reducing absenteeism and presenteeism by treating chronic pain with spinal manipulation and mobilization in the workplace. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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13
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Lee KS, Oh DW, Lee JH. Effects of patient-specific mobility therapy for TMJ, neck, and shoulder dysfunction after submandibular gland tumor surgery: a case report. Physiother Theory Pract 2020; 37:1491-1496. [PMID: 31916875 DOI: 10.1080/09593985.2019.1710882] [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: 10/25/2022]
Abstract
Aims: This case report describes a patient-specific mobility therapy (PSMT) program to restore range of motion (ROM) and overcome functional limitations of the temporomandibular joint (TMJ), neck, and shoulder in a 48-year-old man who underwent submandibular gland tumor surgery.Methods: The patient also received transcutaneous electrical stimulation and ultrasound to relieve pain. Treatment was provided four sessions per week for four weeks. The measured outcomes included the Neck Disability Index (NDI), Patient-Specific Functional Scale (PSFS), and mobility of the TMJ, neck, and shoulder.Outcomes: The ROM of the TMJ, neck, and shoulder improved from 4.00 mm to 21.00 mm, 1.67 cm to 6.40 cm, and 9.75° to 56.00°, respectively, during the 1st intervention phase when compared with the baseline phase, and these gains were also maintained in the later phases. Furthermore, the NDI and PSFS scores improved by 12.75 points (24.50 to 11.75) and 5.25 points (2.00 to 7.25), respectively.Conclusion: These findings demonstrate the success of PSMT in conjunction with transcutaneous electrical stimulation and ultrasound in alleviating pain and improving targeted impairments for this patient following submandibular gland tumor surgery.
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Affiliation(s)
- Keun-Su Lee
- Department of Physical Therapy, Cheongju St. Mary's Hospital, Cheongju, Republic of Korea
| | - Duck-Won Oh
- Department of Physical Therapy, College of Health and Medical Science, Cheongju University, Cheongju, Republic of Korea
| | - Joon-Hee Lee
- Department of Physical Therapy, College of Health and Medical Science, Cheongju University, Cheongju, Republic of Korea
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14
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Asquini G, Bianchi AE, Heneghan NR, Rushton AB, Borromeo G, Locatelli M, Falla D. Predictors of pain reduction following manual therapy in patients with temporomandibular disorders: a protocol for a prospective observational study. BMJ Open 2019; 9:e032113. [PMID: 31722951 PMCID: PMC6858120 DOI: 10.1136/bmjopen-2019-032113] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Temporomandibular disorders (TMDs) are principally characterised by pain in the craniomandibular area and probable limitations of jaw opening. Manual therapy, like other recommended conservative treatments included in clinical guidelines, is commonly used to treat patients with TMD to reduce pain and improve function. However, outcomes may be variable. The aim of this study is to identify predictors associated with pain reduction in patients with TMD following manual therapy by analysing a combination of patient-reported outcome measures and clinical tests. Such knowledge will support a more personalised management approach by facilitating clinical decision-making. METHODS/ANALYSIS An observational prospective design will recruit a cohort of 100 adults with a diagnosis of TMD (according to Axis I of the Diagnostic Criteria for TMD) at a Dental Hospital in Italy. Patients will be treated with four weekly sessions of manual therapy applied to craniomandibular structures. An array of predictors has been chosen based on previous research on prognostic factors for TMD and altered pain modulation in musculoskeletal disorders. Candidate predictors including demographic variables, general health variables, psychosocial features, TMD characteristics and clinical tests of the temporomandibular joint and masticatory muscles will be collected at baseline. Definition of good outcome is a clinically significant reduction of pain intensity over the last week (≥30% reduction Visual Analogue Scale) immediately following the four week intervention. Exploratory factor analysis will be applied to analyse factor loading of candidate predictors for good outcome at four weeks. Subsequently, a logistic multivariable regression model will be performed to calculate low and high risk of good outcome. ETHICS AND DISSEMINATION Ethical approval has been obtained from the 'Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico' and University of Birmingham Ethics Committee. The results will be submitted for publication in a peer-reviewed journal and presented at conferences. TRIAL REGISTRATION NUMBER NCT03990662; Pre-results.
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Affiliation(s)
- Giacomo Asquini
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Department of Craniomandibular Disorders, Italian Stomatologic Institute, Milan, Italy
| | | | - Nicola R Heneghan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Alison B Rushton
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Giulia Borromeo
- Department of Craniomandibular Disorders, Italian Stomatologic Institute, Milan, Italy
| | - Matteo Locatelli
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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Abstract
BACKGROUND Numerous treatment modalities have been attempted for masticatory muscle pain in patients with temporomandibular disorders (TMD). To compare the treatment efficacy of more than 2 competing treatments, a network meta-analysis (NMA) was conducted. METHODS This study was reported with reference to the extended Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for reporting of systematic reviews incorporating network meta-analyses. Medline via Pubmed, Embase via OVID, and Cochrane Library Central were searched (up to February 11, 2019). Axis I protocol of Diagnostic Criteria or Research Diagnostic Criteria for Temporomandibular Disorders (DC/TMD, RDC/TMD) were chosen as diagnostic standards. The PICOS (Problem/patient, Intervention, Comparison, Outcome, Study design) method was used to screen trials under eligibility criteria. And the NMA was performed with mvmeta commands in Stata (StataCorp, Tex). RESULTS Of 766 studies searched, 12 randomized clinical trials (RCTs) were finally included. Nineteen different therapies were found and further categorized into 9 treatment modalities. The general heterogeneity was not found among included trials. But predictive intervals (PrIs) were conspicuously wider than confidential intervals (CIs) of all pairwise comparisons, indicating that heterogeneity may exist between studies. Complementary therapy showed the greatest probability (42.7%) to be the best intervention. It also had the highest mean rank (2.3) in the rankogram and the biggest value of surface under the cumulative ranking (SUCRA, 84.1%). CONCLUSIONS Based on the limited evidence of available trials, complementary therapy seemed to be slightly more effective than remaining treatment modalities for pain reduction in TMD patients with masticatory muscle pain. High-quality randomized controlled trials are expected to validate the findings.
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Denneny D, Frawley HC, Petersen K, McLoughlin R, Brook S, Hassan S, Williams AC. Trigger Point Manual Therapy for the Treatment of Chronic Noncancer Pain in Adults: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2019; 100:562-577. [DOI: 10.1016/j.apmr.2018.06.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 06/05/2018] [Accepted: 06/07/2018] [Indexed: 11/25/2022]
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17
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Shimada A, Ishigaki S, Matsuka Y, Komiyama O, Torisu T, Oono Y, Sato H, Naganawa T, Mine A, Yamazaki Y, Okura K, Sakuma Y, Sasaki K. Effects of exercise therapy on painful temporomandibular disorders. J Oral Rehabil 2019; 46:475-481. [DOI: 10.1111/joor.12770] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 12/30/2018] [Accepted: 01/13/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Akiko Shimada
- Department of Oral Rehabilitation Osaka Dental University Hospital Osaka Japan
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Faculty of Health Aarhus University Aarhus Denmark
- Scandinavian Center for Orofacial Neurosciences Aarhus Denmark
| | - Shoichi Ishigaki
- Department of Fixed Prosthodontics Osaka University Graduate School of Dentistry Suita Japan
| | - Yoshizo Matsuka
- Department of Stomatognathic Function and Occlusal Reconstruction, Graduate School of Biomedical Sciences Tokushima University Tokushima Japan
| | - Osamu Komiyama
- Department of Oral Function and Rehabilitation Nihon University School of Dentistry at Matsudo Chiba Japan
| | - Tetsurou Torisu
- Department of Prosthetic Dentistry, Graduate School of Biomedical Sciences Nagasaki University Nagasaki Japan
| | - Yuka Oono
- Division of Dental Anesthesiology, Department of Diagnostic and Therapeutic Sciences Meikai University School of Dentistry Saitama Japan
| | - Hitoshi Sato
- Department of Oral and Maxillofacial Surgery, School of Dentistry Showa University Tokyo Japan
| | - Takuya Naganawa
- Department of Oral and Maxillofacial Surgery, School of Medicine Tokyo Women's Medical University Tokyo Japan
| | - Atsushi Mine
- Department of Fixed Prosthodontics Osaka University Graduate School of Dentistry Suita Japan
| | - Yoko Yamazaki
- Orofacial Pain Clinic, Tokyo Medical and Dental University Hospital of Dentistry Tokyo Japan
| | - Kazuo Okura
- Department of Stomatognathic Function and Occlusal Reconstruction, Graduate School of Biomedical Sciences Tokushima University Tokushima Japan
| | - Yasushi Sakuma
- Department of Anesthesiology Osaka Dental University Graduate School Osaka Japan
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry Tohoku University Graduate School of Dentistry Sendai Japan
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Kim KW, Ha IH, Lee YJ, Kim MR, Shin BC, Song MY, Cho JH. A clinical practice guideline for temporomandibular disorders in traditional Korean medicine: An evidence-based approach. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2018.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Brochado FT, Jesus LHD, Carrard VC, Freddo AL, Chaves KD, Martins MD. Comparative effectiveness of photobiomodulation and manual therapy alone or combined in TMD patients: a randomized clinical trial. Braz Oral Res 2018; 32:e50. [PMID: 29995062 DOI: 10.1590/1807-3107bor-2018.vol32.0050] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 04/25/2018] [Indexed: 12/22/2022] Open
Abstract
The effectiveness of photobiomodulation (PBM) and manual therapy (MT), alone or combined (CT), were evaluated in pain intensity, mandibular movements, psychosocial aspects, and anxiety symptoms of temporomandibular disorder (TMD) patients. Fifty-one TMD patients were randomly assigned to three groups: the PBM group (n = 18), which received PBM with 808 nm, 100 mW, 13.3 J/cm2, and 4 J per point; the MT group (n=16) for 21 minutes each session on masticatory muscles and temporomandibular joint TMJ; and the CT group (n = 17), applied during twelve sessions. Seven evaluations were performed in different moments using visual analogue scale (VAS), Research Diagnosis Criteria for Temporomandibular Disorders (RDC/TMD) Axis I and II, and Beck anxiety inventory (BAI). All groups demonstrated reductions in pain and improvement in jaw movements during treatment and at follow-up (< 0.001). The assessment of psychosocial aspects of TMD, comparing baseline and follow-up in all treatment groups, revealed that treatment did not promote modification in the intensity of chronic pain (p > 0.05). However, depression symptoms showed a reduction in PBM and CT groups (p≤0.05). All treatments promoted reduction in physical symptoms with and without pain and enhancement of jaw disabilities (p ≤ 0.05). MT promotes improvement in 5 functions, PBM in 2, and CT in 1 (p < 0.001). BAI analysis revealed that all treatments lead to a reduction in anxiety symptoms (p≤0.05). All protocols tested were able to promote pain relief, improve mandibular function, and reduce the negative psychosocial aspects and levels of anxiety in TMD patients. However, the combination of PBM and MT did not promote an increase in the effectiveness of both therapies alone.
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Affiliation(s)
- Fernanda Thomé Brochado
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Oral Pathology, Porto Alegre, RS, Brazil
| | - Luciano Henrique de Jesus
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Oral Pathology, Porto Alegre, RS, Brazil
| | - Vinicius Coelho Carrard
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Oral Pathology, Porto Alegre, RS, Brazil
| | - Angelo Luiz Freddo
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Buco Maxillofacial Surgery and Traumatology, Porto Alegre, RS, Brazil
| | - Karen Dantur Chaves
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Conservative Dentistry, Porto Alegre, RS, Brazil
| | - Manoela Domingues Martins
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Oral Pathology, Porto Alegre, RS, Brazil
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López-de-Uralde-Villanueva I, Beltran-Alacreu H, Fernández-Carnero J, La Touche R. Pain management using a multimodal physiotherapy program including a biobehavioral approach for chronic nonspecific neck pain: a randomized controlled trial. Physiother Theory Pract 2018; 36:45-62. [PMID: 29889599 DOI: 10.1080/09593985.2018.1480678] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Objective: To determine the effectiveness of a therapeutic patient education (TPE) intervention based on a biobehavioral approach combined with manual therapy (MT) to reduce pain in patients with chronic nonspecific neck pain (CNSNP). In addition, this study intended to assess the effectiveness of a multimodal physiotherapy program including TPE to reduce pain in patients with CNSNP. Design: Single-blind randomized controlled trial. Interventions: A total of 47 patients with CNSNP were randomized into three groups: (1) MT (control group); (2) MT plus TPE based on a biobehavioral approach (Exp1); and (3) MT plus TPE based on a biobehavioral approach, and therapeutic exercise (Exp2). Main Outcome Measurements: The clinical outcomes were recorded at baseline and at 1 and 4 months after the initiation of treatment. The primary outcome was pain intensity (Visual Analog Scale), and the secondary outcomes were pain catastrophizing (Pain Catastrophizing Scale), illness severity and global improvement (Clinical Global Impression Scale), and mechanosensitivity of the median nerve (Upper Limb Neural Test) and the cervical region (Modified Passive Neck Flexion Test). Results: Statistically significant differences in pain intensity were found when Exp2 was compared with Exp1 and the control group at 4 months (p = 0.015 and p = 0.001, respectively), but no difference was found between Exp1 and the control group at the same follow-up period (p = 0.86). Exp2 showed statistically significant differences in all of the secondary outcomes except for pain catastrophizing when compared with the control group at 4 months. Conclusions: The Exp2 group was more effective than Exp1 and the control group in terms of reducing pain intensity at 4 months; at post-treatment, only Exp2 was more effective than the control group.
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Affiliation(s)
- Ibai López-de-Uralde-Villanueva
- Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autonóma de Madrid, Madrid, Spain.,Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain.,Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain
| | - Hector Beltran-Alacreu
- Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autonóma de Madrid, Madrid, Spain.,Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain
| | - Josué Fernández-Carnero
- Motion in Brains Research Group, Institute of Neuroscience and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autonóma de Madrid, Madrid, Spain.,Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain.,Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Roy La Touche
- Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autonóma de Madrid, Madrid, Spain.,Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain.,Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain
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Crawford C, Boyd C, Paat CF, Price A, Xenakis L, Yang E, Zhang W. The Impact of Massage Therapy on Function in Pain Populations-A Systematic Review and Meta-Analysis of Randomized Controlled Trials: Part I, Patients Experiencing Pain in the General Population. PAIN MEDICINE (MALDEN, MASS.) 2016; 17:1353-1375. [PMID: 27165971 PMCID: PMC4925170 DOI: 10.1093/pm/pnw099] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE Pain is multi-dimensional and may be better addressed through a holistic, biopsychosocial approach. Massage therapy is commonly practiced among patients seeking pain management; however, its efficacy is unclear. This systematic review and meta-analysis is the first to rigorously assess the quality of massage therapy research and evidence for its efficacy in treating pain, function-related and health-related quality of life outcomes across all pain populations. METHODS Key databases were searched from inception through February 2014. Eligible randomized controlled trials were assessed for methodological quality using SIGN 50 Checklist. Meta-analysis was applied at the outcome level. A diverse steering committee interpreted the results to develop recommendations. RESULTS Sixty high quality and seven low quality studies were included in the review. Results demonstrate massage therapy effectively treats pain compared to sham [standardized mean difference (SMD) = -.44], no treatment (SMD = -1.14), and active (SMD = -0.26) comparators. Compared to active comparators, massage therapy was also beneficial for treating anxiety (SMD = -0.57) and health-related quality of life (SMD = 0.14). CONCLUSION Based on the evidence, massage therapy, compared to no treatment, should be strongly recommended as a pain management option. Massage therapy is weakly recommended for reducing pain, compared to other sham or active comparators, and improving mood and health-related quality of life, compared to other active comparators. Massage therapy safety, research challenges, how to address identified research gaps, and necessary next steps for implementing massage therapy as a viable pain management option are discussed.
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Armijo-Olivo S, Pitance L, Singh V, Neto F, Thie N, Michelotti A. Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis. Phys Ther 2016; 96:9-25. [PMID: 26294683 PMCID: PMC4706597 DOI: 10.2522/ptj.20140548] [Citation(s) in RCA: 174] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 08/01/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Manual therapy (MT) and exercise have been extensively used to treat people with musculoskeletal conditions such as temporomandibular disorders (TMD). The evidence regarding their effectiveness provided by early systematic reviews is outdated. PURPOSE The aim of this study was to summarize evidence from and evaluate the methodological quality of randomized controlled trials that examined the effectiveness of MT and therapeutic exercise interventions compared with other active interventions or standard care for treatment of TMD. DATA SOURCES Electronic data searches of 6 databases were performed, in addition to a manual search. STUDY SELECTION Randomized controlled trials involving adults with TMD that compared any type of MT intervention (eg, mobilization, manipulation) or exercise therapy with a placebo intervention, controlled comparison intervention, or standard care were included. The main outcomes of this systematic review were pain, range of motion, and oral function. Forty-eight studies met the inclusion criteria and were analyzed. DATA EXTRACTION Data were extracted in duplicate on specific study characteristics. DATA SYNTHESIS The overall evidence for this systematic review was considered low. The trials included in this review had unclear or high risk of bias. Thus, the evidence was generally downgraded based on assessments of risk of bias. Most of the effect sizes were low to moderate, with no clear indication of superiority of exercises versus other conservative treatments for TMD. However, MT alone or in combination with exercises at the jaw or cervical level showed promising effects. LIMITATIONS Quality of the evidence and heterogeneity of the studies were limitations of the study. CONCLUSIONS No high-quality evidence was found, indicating that there is great uncertainty about the effectiveness of exercise and MT for treatment of TMD.
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Affiliation(s)
- Susan Armijo-Olivo
- S. Armijo-Olivo, PT, BScPT, MScPT, PhD, Department of Physical Therapy, Faculty of Rehabilitation Medicine, 3-48 Corbett Hall, University of Alberta, Edmonton, Alberta, Canada T6G 2G4.
| | - Laurent Pitance
- L. Pitance, PT, MT, PhD, Université Catholique de Louvain-Institute of Neuroscience, Brussels, Belgium, and Stomatology and Maxillofacial Surgery Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Vandana Singh
- V. Singh, DDS, MS, MSc, Department of Dentistry, Faculty of Medicine, TMD/Orofacial Pain Clinic, Kaye Edmonton Clinic, Edmonton, Alberta, Canada
| | - Francisco Neto
- F. Neto, PT, FisioNeto-Terapia Manual Ortopédica and Pilates Clínico, Póvoa de Varzim, Portugal
| | - Norman Thie
- N. Thie, BSc, MSc, MMSc, DDS, School of Dentistry, Faculty of Medicine and Dentistry, TMD/Orofacial Pain Graduate Program, Edmonton Clinic Health Academy, Edmonton, Alberta, Canada
| | - Ambra Michelotti
- A. Michelotti, BSc, DDS, Orthodontic Post-Graduate Program and TMD/Orofacial Pain Master Program, School of Medicine Federico II-Dental School, Naples, Italy
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Martins WR, Blasczyk JC, Aparecida Furlan de Oliveira M, Lagôa Gonçalves KF, Bonini-Rocha AC, Dugailly PM, de Oliveira RJ. Efficacy of musculoskeletal manual approach in the treatment of temporomandibular joint disorder: A systematic review with meta-analysis. ACTA ACUST UNITED AC 2015; 21:10-7. [PMID: 26144684 DOI: 10.1016/j.math.2015.06.009] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 06/02/2015] [Accepted: 06/16/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND Temporomandibular joint disorder (TMD) requires a complex diagnostic and therapeutic approach, which usually involves a multidisciplinary management. Among these treatments, musculoskeletal manual techniques are used to improve health and healing. OBJECTIVES To assess the effectiveness of musculoskeletal manual approach in temporomandibular joint disorder patients. DESIGN A systematic review with meta-analysis. METHODS During August 2014 a systematic review of relevant databases (PubMed, The Cochrane Library, PEDro and ISI web of knowledge) was performed to identify controlled clinical trials without date restriction and restricted to the English language. Clinical outcomes were pain and range of motion focalized in temporomandibular joint. The mean difference (MD) or standard mean difference (SMD) with 95% confidence intervals (CIs) and overall effect size were calculated at every post treatment. The PEDro scale was used to demonstrate the quality of the included studies. RESULTS/FINDINGS From the 308 articles identified by the search strategy, 8 articles met the inclusion criteria. The meta-analysis showed a significant difference (p < 0.0001) and large effect on active mouth opening (SMD, 0.83; 95% CI, 0.42 to 1.25) and on pain during active mouth opening (MD, 1.69; 95% CI, 1.09 to 2.30) in favor of musculoskeletal manual techniques when compared to other conservative treatments for TMD. CONCLUSIONS Musculoskeletal manual approaches are effective for treating TMD. In the short term, there is a larger effect regarding the latter when compared to other conservative treatments for TMD.
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Affiliation(s)
| | | | | | | | | | - Pierre-Michel Dugailly
- Université Libre de Bruxelles, Faculté des Sciences de la Motricité, Department of Osteopathic Sciences, Research Unit in Osteopathy, Route de Lennik 808, Campus Erasme (CP 640) Bât. N.4.117 - 1070, Bruxelles, Belgique.
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Ajimsha M, Al-Mudahka NR, Al-Madzhar J. Effectiveness of myofascial release: Systematic review of randomized controlled trials. J Bodyw Mov Ther 2015; 19:102-12. [DOI: 10.1016/j.jbmt.2014.06.001] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 06/04/2014] [Accepted: 06/06/2014] [Indexed: 01/27/2023]
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Muir B, Brown C, Brown T, Tatlow D, Buhay J. Immediate changes in temporomandibular joint opening and pain following vibration therapy: a feasibility pilot study. THE JOURNAL OF THE CANADIAN CHIROPRACTIC ASSOCIATION 2014; 58:467-480. [PMID: 25550672 PMCID: PMC4262808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The purpose of this pilot study was to determine the scientific and process feasibility in an effort to direct future larger trials. METHODS Scientific Feasibility: Twelve subjects were randomly allocated to an intervention and a control group. The intervention protocol consisted of intraoral vibration therapy on the muscles of mastication bilaterally for a period of 1 minute per muscle. Process Feasibility: Several feasibility outcomes were examined including recruitment and retention rates and consent. RESULTS Scientific Feasibility: Large effect sizes were generated for both mouth opening and VAS in favour of the intervention group. Process Feasibility: a recruitment ratio of 2.3 respondents to 1 participant was determined, along with a retention to loss ratio of 13:1 and a consent to loss ratio of 12:0. CONCLUSION Scientific Feasibility: The scientific results should be interpreted with caution due to the small sample sizes employed. The study seems to support the scientific feasibility of a future larger single treatment trial. Process Feasibility: Recruitment and retention rates and ratios seem to support future studies. Utilizing the feasibility results of the current study to direct a future larger multiple treatment trial consistent with other comparable TMD studies however is limited.
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Affiliation(s)
- Brad Muir
- Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Canada
- Associate Professor, Faculty of Clinical Education, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Canada
| | - Courtney Brown
- Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Canada
- Sports Sciences Resident, Department of Graduate Studies, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Canada
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Haldeman S, Chapman-Smith D. Award-winning articles and posters from the World Federation of Chiropractic's 12th Biennial Congress 2013. J Manipulative Physiol Ther 2014; 37:1-6. [PMID: 24373381 DOI: 10.1016/j.jmpt.2013.11.001] [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: 10/25/2022]
Abstract
This editorial reviews the original research submissions to the World Federation of Chiropractic's 12th Biennial Congress held in Durban, South Africa from April 10 - 13, 2013, and the four award-winning scientific articles in the NCMIC Louis Sportelli Research Awards competition at the Congress which are published in this issue of the Journal of Manipulative and Physiological Therapeutics.
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Affiliation(s)
- Scott Haldeman
- Chairman, Research Council, World Federation of Chiropractic, Department of Neurology, University of California, Irvine, Calif.
| | - David Chapman-Smith
- Secretary General, World Federation of Chiropractic, Toronto, Ontario, Canada
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Rubis LM, Rubis D, Winchester B. A collaborative approach between chiropractic and dentistry to address temporomandibular dysfunction: a case report. J Chiropr Med 2014; 13:55-61. [PMID: 24711786 DOI: 10.1016/j.jcm.2013.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 07/14/2013] [Accepted: 07/15/2013] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE The purpose of this case report is to describe the chiropractic and dental comanagement of a patient with temporomandibular dysfunction, headaches, and myalgia. CLINICAL FEATURES A 38-year-old black female patient presented for chiropractic care with a chief concern of jaw pain, tinnitus, headaches, and neck and shoulder soreness of 8 months' duration. The patient rated the pain a 6/10. The patient had a maximum mouth opening of 42 mm, graphed evidence of disk displacement, loss of translation on opening of the right temporomandibular joint viewed on the lateral radiograph, and numerous areas of point tenderness on the Kinnie-Funt Chief Complaint Visual Index. She had decreased lateral cervical flexion. INTERVENTION AND OUTCOME Dental treatment consisted of an anterior repositioning splint. Chiropractic care consisted of Activator treatment to the pelvis and the thoracic and cervical spine. Manual manipulation of the temporomandibular joint was performed along with a soft tissue technique intraorally on the lateral pterygoid. Postisometric relaxation in the head and neck region was also done. The patient was treated 6 times over 3 weeks. At the end of treatment, the patient had a pain rating of 0/10, maximum mouth opening of 49 mm, no tender points on the follow-up Kinnie-Funt, and increased cervical range of motion. CONCLUSION The patient demonstrated increased mouth opening, decreased pain rating, improved Kinnie-Funt visual index, and an increased cervical lateral flexion range of motion after 3 weeks of a combination of chiropractic and dental care.
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Affiliation(s)
- Lisa M Rubis
- Chiropractor, ANEW Medical and Rehabilitation, Joliet, IL
| | - David Rubis
- Dentist, Advanced Family Dental, Crest Hill, IL
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Clar C, Tsertsvadze A, Court R, Hundt GL, Clarke A, Sutcliffe P. Clinical effectiveness of manual therapy for the management of musculoskeletal and non-musculoskeletal conditions: systematic review and update of UK evidence report. Chiropr Man Therap 2014; 22:12. [PMID: 24679336 PMCID: PMC3997823 DOI: 10.1186/2045-709x-22-12] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 02/24/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND This systematic review updated and extended the "UK evidence report" by Bronfort et al. (Chiropr Osteopath 18:3, 2010) with respect to conditions/interventions that received an 'inconclusive' or 'negative' evidence rating or were not covered in the report. METHODS A literature search of more than 10 general medical and specialised databases was conducted in August 2011 and updated in March 2013. Systematic reviews, primary comparative studies and qualitative studies of patients with musculoskeletal or non-musculoskeletal conditions treated with manual therapy and reporting clinical outcomes were included. Study quality was assessed using standardised instruments, studies were summarised, and the results were compared against the evidence ratings of Bronfort. These were either confirmed, updated, or new categories not assessed by Bronfort were added. RESULTS 25,539 records were found; 178 new and additional studies were identified, of which 72 were systematic reviews, 96 were randomised controlled trials, and 10 were non-randomised primary studies. Most 'inconclusive' or 'moderate' evidence ratings of the UK evidence report were confirmed. Evidence ratings changed in a positive direction from inconclusive to moderate evidence ratings in only three cases (manipulation/mobilisation [with exercise] for rotator cuff disorder; spinal mobilisation for cervicogenic headache; and mobilisation for miscellaneous headache). In addition, evidence was identified on a large number of non-musculoskeletal conditions not previously considered; most of this evidence was rated as inconclusive. CONCLUSIONS Overall, there was limited high quality evidence for the effectiveness of manual therapy. Most reviewed evidence was of low to moderate quality and inconsistent due to substantial methodological and clinical diversity. Areas requiring further research are highlighted.
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Affiliation(s)
- Christine Clar
- Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, England
| | - Alexander Tsertsvadze
- Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, England
| | - Rachel Court
- Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, England
| | - Gillian Lewando Hundt
- Social Science and Systems in Health, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, England
| | - Aileen Clarke
- Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, England
| | - Paul Sutcliffe
- Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, England
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Intra-oral myofascial therapy versus education and self-care in the treatment of chronic, myogenous temporomandibular disorder: a randomised, clinical trial. Chiropr Man Therap 2013; 21:17. [PMID: 23738586 PMCID: PMC3706243 DOI: 10.1186/2045-709x-21-17] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 05/29/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Myogenous temporomandibular disorders (TMD) are considered to be a common musculoskeletal condition. No studies exist comparing intra-oral myofascial therapies to education, self-care and exercise (ESC) for TMD. This study evaluated short-term differences in pain and mouth opening range between intra-oral myofascial therapy (IMT) and an ESC program. METHODS Forty-six participants with chronic myogenous TMD (as assessed according to the Research Diagnostic Criteria Axis 1 procedure) were consecutively block randomised into either an IMT group or an ESC group. Each group received two sessions per week (for five weeks) of either IMT or short talks on the anatomy, physiology and biomechanics of the jaw plus instruction and supervision of self-care exercises. The sessions were conducted at the first author's jaw pain and chiropractic clinic in Sydney, Australia. Primary outcome measures included pain at rest, upon opening and clenching, using an eleven point ordinal self reported pain scale. A secondary outcome measure consisted of maximum voluntary opening range in millimetres. Data were analysed using linear models for means and logistic regression for responder analysis. RESULTS After adjusting for baseline, the IMT group had significantly lower average pain for all primary outcomes at 6 weeks compared to the ESC group (p < 0.001). These differences were not clinically significant but the IMT group had significantly higher odds of a clinically significant change (p < 0.045). There was no significant difference in opening range between the IMT and ESC groups. Both groups achieved statistically significant decreases in all three pain measures at six weeks (p ≤ 0.05), but only the IMT group achieved clinically significant changes of 2 or more points. CONCLUSION This study showed evidence of superiority of IMT compared to ESC over the short-term but not at clinically significant levels. Positive changes over time for both IMT and ESC protocols were noted. A longer term, multi-centre study is warranted. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry ACTRN12610000508077.
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Brantingham JW, Cassa TK, Bonnefin D, Pribicevic M, Robb A, Pollard H, Tong V, Korporaal C. Manipulative and multimodal therapy for upper extremity and temporomandibular disorders: a systematic review. J Manipulative Physiol Ther 2013; 36:143-201. [PMID: 23697915 DOI: 10.1016/j.jmpt.2013.04.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2012] [Revised: 02/09/2013] [Accepted: 02/20/2013] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The purpose of this study was to complete a systematic review of manual and manipulative therapy (MMT) for common upper extremity pain and disorders including the temporomandibular joint (TMJ). METHODS A literature search was conducted using the Cumulative Index of Nursing Allied Health Literature, PubMed, Manual, Alternative, and Natural Therapy Index System (MANTIS), Physiotherapy Evidence Database (PEDro), Index to Chiropractic Literature, Google Scholar, and hand search inclusive of literature from January 1983 to March 5, 2012. Search limits included the English language and human studies along with MeSH terms such as manipulation, chiropractic, osteopathic, orthopedic, and physical therapies. Inclusion criteria required an extremity peripheral diagnosis (for upper extremity problems including the elbow, wrist, hand, finger and the (upper quadrant) temporomandibular joint) and MMT with or without multimodal therapy. Studies were assessed using the PEDro scale in conjunction with modified guidelines and systems. After synthesis and considered judgment scoring was complete, evidence grades of "A, B, C and I" were applied. RESULTS Out of 764 citations reviewed, 129 studies were deemed possibly to probably useful and/or relevant to develop expert consensus. Out of 81 randomized controlled or clinical trials, 35 were included. Five controlled or clinical trials were located and 4 were included. Fifty case series, reports and/or single-group pre-test post-test prospective case series were located with 32 included. There is Fair (B) level of evidence for MMT to specific joints and the full kinetic chain combined generally with exercise and/or multimodal therapy for lateral epicondylopathy, carpal tunnel syndrome, and temporomandibular joint disorders, in the short term. CONCLUSION The information from this study will help guide practitioners in the use of MMT, soft tissue technique, exercise, and/or multimodal therapy for the treatment of a variety of upper extremity complaints in the context of the hierarchy of published and available evidence.
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Kalamir A, Bonello R, Graham P, Vitiello AL, Pollard H. Intraoral myofascial therapy for chronic myogenous temporomandibular disorder: a randomized controlled trial. J Manipulative Physiol Ther 2011; 35:26-37. [PMID: 22079052 DOI: 10.1016/j.jmpt.2011.09.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2011] [Revised: 06/02/2011] [Accepted: 06/02/2011] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Studies investigating the efficacy of intraoral myofascial therapies (IMTs) for chronic temporomandibular disorder (TMD) are rare. The present study was an expansion of a previously published pilot study that investigated whether chiropractic IMT and the addition of education and self-care were superior to no-treatment or IMT alone for 5 outcome measures-interincisal opening range, jaw pain at rest, jaw pain upon opening, jaw pain upon clenching, and global reporting of change-over the course of 1 year. METHODS Ninety-three participants with myogenous TMD between the ages of 18 and 50 years experiencing chronic jaw pain of longer than 3 months in duration were recruited for the study. Successful applicants were randomized into 1 of 3 groups: (1) IMT consisting of 2 treatment interventions per week for 5 weeks, (2) IMT plus education and "self-care" exercises (IMTESC), and (3) wait-list control. The main outcome measures were used. Range of motion findings were measured by vernier callipers in millimeters, and pain scores were quantified using an 11-point self-reported graded chronic pain scale. Global reporting of change was a 7-point self-reported scale, balanced positively and negatively around a zero midpoint. RESULTS There were statistically significant differences in resting, opening and clenching pain, opening scores, and global reporting of change (P < .05) in both treatment groups compared with the controls at 6 months and 1 year. There were also significant differences between the 2 treatment groups at 1 year. CONCLUSIONS The study suggests that both chiropractic IMT and IMTESC were superior to no-treatment of chronic myogenous TMD over the course of 1 year, with IMTESC also being superior to IMT at 1 year.
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Affiliation(s)
- Allan Kalamir
- Faculty of Science, Macquarie University, Sydney, Australia.
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