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Effect of Manual Therapy and Therapeutic Exercise Applied to the Cervical Region on Pain and Pressure Pain Sensitivity in Patients with Temporomandibular Disorders: A Systematic Review and Meta-analysis.
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- Author(s): Touche, Roy La; García, Sergio Martínez; García, Beatriz Serrano; Acosta, Alejandro Proy; Juárez, Daniel Adraos; Pérez, Juan José Fernández; Angulo-Díaz-Parreño, Santiago; Cuenca-Martínez, Ferran; Paris-Alemany, Alba; Suso-Martí, Luis
- Source:
Pain Medicine; Oct2020, Vol. 21 Issue 10, p2373-2384, 12p- Subject Terms:
CERVICAL vertebrae; EXERCISE therapy; INFORMATION storage & retrieval systems; MEDICAL databases; MEDICAL information storage & retrieval systems; MANIPULATION therapy; MASSETER muscle; MEDLINE; META-analysis; MOUTH; ONLINE information services; PHYSICAL therapy; TEMPOROMANDIBULAR disorders; PAIN management; SYSTEMATIC reviews; PAIN measurement; TREATMENT effectiveness; PAIN threshold - Source:
- Additional Information
- Abstract: Objective To assess the effectiveness of cervical manual therapy (MT) on patients with temporomandibular disorders (TMDs) and to compare cervico-craniomandibular MT vs cervical MT. Design Systematic review and meta-analysis (MA). Methods A search in PubMed, EMBASE, PEDro, and Google Scholar was conducted with an end date of February 2019. Two independent reviewers performed the data analysis, assessing the relevance of the randomized clinical trials regarding the studies' objectives. The qualitative analysis was based on classifying the results into levels of evidence according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Results Regarding cervical MT, MA included three studies and showed statistically significant differences in pain intensity reduction and an increase in masseter pressure pain thresholds (PPTs), with a large clinical effect. In addition, the results showed an increase in temporalis PPT, with a moderate clinical effect. MA included two studies on cervical MT vs cervico-craniomandibular MT interventions and showed statistically significant differences in pain intensity reduction and pain-free maximal mouth opening, with a large clinical effect. Conclusions Cervical MT treatment is more effective in decreasing pain intensity than placebo MT or minimal intervention, with moderate evidence. Cervico-craniomandibular interventions achieved greater short-term reductions in pain intensity and increased pain-free MMO over cervical intervention alone in TMD and headache, with low evidence. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Pain Medicine is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Abstract:
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