The effects of manual therapy applied to the cervical and thoracic region on the temperature of the masticatory muscles and on the signs and symptoms of temporomandibular dysfunction: randomized clinical trial, placebo controlled

Autor: El Hage, Yasmin
Přispěvatelé: Biasotto-Gonzalez, Daniela Aparecida, Politti, Fabiano, Angelis, Katia de, Ferrari, Raquel Agnelli Mesquita, Bigaton, Delaine Rodrigues, Witzel, Andrea Lusvarghi
Jazyk: portugalština
Rok vydání: 2016
Předmět:
Zdroj: Biblioteca Digital de Teses e Dissertações da Uninove
Universidade Nove de Julho (UNINOVE)
instacron:UNINOVE
Popis: Submitted by Nadir Basilio (nadirsb@uninove.br) on 2018-07-16T21:50:43Z No. of bitstreams: 1 Yasmin El Hage.pdf: 1970287 bytes, checksum: a115ee670601d955883a00022faa7af9 (MD5) Made available in DSpace on 2018-07-16T21:50:43Z (GMT). No. of bitstreams: 1 Yasmin El Hage.pdf: 1970287 bytes, checksum: a115ee670601d955883a00022faa7af9 (MD5) Previous issue date: 2016-12-12 Introduction: Temporomandibular dysfunction (TMD) is a complex multifactorial dysfunction commonly associated with other conditions such as cervical spine disorders. Although there is evidence of the correlation between a TMD and neck dysfunctions, treatment approaches address local and direct. Since TMD etiology is multidimensional, the present study hypothetize that a cervical and thoracic approach could reduce the signs and symptoms of TMD. Purpose: To evaluate the effects of a manual therapy protocol applied to the cervical and thoracic region on the signs and symptoms of TMD, as well as the temperature of the temporomandibular joint (TMJ), masticatory and cervical muscles. Methods: 30 subjects with a diagnosis of TMD according to RDC/TMD classified as severe or moderate, according to the Fonseca???s Anamnestic Index (FAI) were randomized into two groups: experimental (miofacial release and joint mobilization) and placebo ultrassound. The interventions were performed twice a week, 8 sessions total. Volunteers were assessed for TMD severity by FAI; Pain in TMJ and masticatory muscles, using a Numerical Pain Scale (END); Mandibular range of motion (ROM), through pachymetry; Level of pain and craniofacial dysfunction, according to the Craniofacial Pain and Dysfunction Index (CF-IDD); Cervical dysfunction level, according to Neck Disorders Index (NDI); Regarding the surface temperature of the TMJ and the anterior temporal muscles, masseter and upper trapezius, under pre and post intervention conditions, and under a 30 days follow-up. The study was approved by the Ethics and Research Committee of Universidade Nove de Julho and is registered in Clinical Trials under the number NCT02822469.Statistical analysis: Data distribution was normal. ANOVA was performed followed by Tukey's multiple comparison for group versus time interaction. The category changes between the moments and the groups were analyzed following a contingency table using the proportional comparison test for each category. The level of significance of 5% was considered. Results: Of the 186 volunteers screened, only 28 complete the study. No statistically significant difference was found between groups for any of the variables studied. Conclusion: The proposed treatment protocol applied to the thoracic and cervical region did not alter pain, ROM, TMD severity, cervical dysfunction level and superficial temperature of the TMJ and the masseter, anterior temporal and upper trapezius muscles in patients with severe and/or moderate TMD. Introdu????o: Disfun????o temporomandibular (DTM) ?? uma disfun????o complexa e multifatorial comumente associada ?? outras condi????es como desordens da coluna cervical. Apesar de haver evid??ncias da correla????o entre a DTM e disfun????es cervicais, as propostas de tratamento incluem abordagem local e direta. Uma vez que a etiologia da DTM ?? multidimensional, o presente estudo hipotetiza que uma abordagem cervical e tor??cica poderia reduzir os sinais e sintomas de DTM. Objetivo: Avaliar os efeitos de um protocolo de terapia manual aplicado sobre a regi??o cervical e tor??cica sobre os sinais e sintomas da DTM, bem como sobre a temperatura da articula????o temporomandibular (ATM), m??sculos mastigat??rios e cervicais. Metodologia: 30 sujeitos com diagn??stico de DTM conforme o RDC/TMD, classificada como grave ou moderada, de acordo com o ??ndice Anamn??sico de Fonseca (IAF) foram randomizados em 2 grupos: experimental (libera????o miofascial e mobiliza????o articular) e ultrassom placebo. As interven????es foram aplicadas 2 vezes por semana, totalizando 8 sess??es. Os sujeitos foram avaliados quanto ?? gravidade da DTM, pelo IAF; dor na ATM e nos m??sculos mastigat??rios, utilizando a escala num??rica de dor (END); amplitude de movimento mandibular (ADM), por meio da paquimetria; n??vel de dor e disfun????o craniofacial, de acordo com o ??ndice de Dor e Disfun????o Craniofacial (IDD-CF); n??vel de disfun????o do cervical, conforme o ??ndice de Disfun????o Cervical (NDI); e quanto a temperatura da superf??cie da ATM e dos m??sculos temporal anterior, masseter e trap??zio superior, nas condi????es pr?? interven????o, p??s interven????o e follow-up ap??s 30 dias do t??rmino do protocolo. O estudo foi aprovado pelo comit?? de ??tica e cadastrado no clinical trials sob o n??mero NCT02822469. An??lise estat??stica: Os dados apresentaram distribui????o normal e foram analisados utilizando a ANOVA seguido de compara????o m??ltipla de Tukey para a intera????o grupo versus momento. As mudan??as de categorias entre os momentos e os grupos foram analisadas seguindo uma tabela de conting??ncia por meio do teste de compara????o de propor????es para cada categoria. Considerou-se o n??vel de signific??ncia de 5%. Resultados: Dos 186 volunt??rios triados, apenas 28 completaram o estudo. N??o foi encontrada diferen??a estatisticamente significante entre os grupos para nenhuma das vari??veis estudadas. Conclus??o: O protocolo de tratamento proposto, aplicado sobre a regi??o tor??cica e cervical n??o alterou a dor, ADM, gravidade da DTM, n??vel de disfun????o cervical e temperatura superficial da ATM e dos m??sculos masseter, temporal anterior e trap??zio superior em pacientes com DTM grave e moderada.
Databáze: OpenAIRE
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