Efficacy Of Different Types Of Physiotherapy Approaches In Temporomandibular Disorders

Bitlis Eren University

Status: Completed

Conditions: Temporomandibular Disorder

Treatments: Other: Manuel Pressure Release; Other: Patient Education; Other: Exercise; Other: Low Level Laser Therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT04294602

BitlisErenU1

Details and patient eligibility

About

The aim of this study is to investigate the efficacy of different types of physiotherapy approaches in cases with cervical myofascial painful TMD.

Full description

59 persons with TMD diagnosed by the dentist and with cervical myofascial pain, aged 18-30 years will be randomly allocated, 3 groups. The participants were randomly allocated only exercise group (EG) (n=20), low-level laser therapy plus exercise group (LLLT) (n=17) and manual pressure release plus exercise group (MPR) (n=22). The cases were evaluated and treated by the same physiotherapist for 4 weeks (12 sessions).

Pain, pain pressure threshold, temporomandibular joint (TMJ) mobility and disability, forward head posture, head rotation, neck disability, psychological status and quality of life were evaluated. Evaluations were repeated before and after treatment.

Enrollment: 59 patients

Sex: All

Ages: 18 to 30 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Cases who have 3 or more symptoms related to TMJ problems
• cases who have trigger points in cervical and masticatory muscles
• cases who TMD detected by the dentist,
• being between the ages of 18-30,
• volunteer to participate in the study

Exclusion criteria

• Patients with a positive history of trauma in the face and neck area and neurological disorders
• patients undergoing TMJ or cervical region surgery in the last 3 months,
• patients who used dental orthotics within 1 month,
• patients who have TMJ instability,
• patients who have cervical and upper thoracic region,
• patients who have active infection and chronic pain, such as trigeminal neuralgia

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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59 participants in 3 patient groups

Exercise Program

Experimental group

Description:

This group received therapeutic exercises and patient education. For patients to encounter fewer problems and to reduce their problems, some recommendations were made that should be taken into consideration in daily life. These suggestions were given in writing. The exercise program included muscle stretching, massage of painful muscles, guided opening and closing movements, gentle isometric tension exercises against resistance, correction of body posture and relaxation techniques. All exercises were done in 6 repetitions a set, 3 sets a day, 3 days a week, treatment program lasted 4 weeks.

Treatment:

Other: Exercise

Other: Patient Education

Low Level Laser Therapy Program

Experimental group

Description:

This group received LLLT, therapeutic exercises and patient education in the therapy programs. LLLT (max output power: 1200mW, wavelength: 808 nm, dosage: 10j/ cm2 Electronica Pagani Laser Tower Light, Italy) 2.5-4j/TrP dosage was applied to MTrP or sensitive points. The application was applied to MTrP or sensitive points in the mastication and cervical muscles.LLLT program was done in 3 days a week, the treatment program lasted 4 weeks.

Treatment:

Other: Exercise

Other: Patient Education

Other: Low Level Laser Therapy

Manual Pressure Release Program

Experimental group

Description:

ThisThis group received manual pressure release (MPR), therapeutic exercises and patient education in the therapy programs. MPR technique is a noninvasive method based on pressure on the trigger point in accordance with the patient's tolerance and technique applies supine position relax as much as possible, MTrPs in the mastication and neck muscle. Applied pressure gradually with finger over the MTrPs until the subject reported a 'moderate but easily tolerable' pain value of 7 out of 10. When the pain value decreased to at least 3 or 4 therapist increased pressure again until discomfort and/or pain appeared again. This process was repeated until there was no MTrP tension/tenderness or 60 s had elapsed. MPR program was done in 3 days a week, the treatment program lasted 4 weeks.

Treatment:

Other: Exercise

Other: Manuel Pressure Release

Other: Patient Education