Manual Therapy and Exercises Applied to Cervical Spine in Patients With Temporomandibular Disorders
The objective of this study was to investigate the effect of a manual therapy and exercise program, focused on the rehabilitation of cervical function, on clinical signs and mandibular function in subjects with TMD.
Temporomandibular Joint Dysfunction Syndrome
Other: Manual therapy
Device: Pressure biofeedback device
|Study Design:||Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Effects of Manual Therapy and Exercises Applied to Cervical Spine in Patients With Temporomandibular Disorders: Pilot Study|
- Changing in maximum mouth opening pain free [ Time Frame: Before and 5 days follow-up intervetion ] [ Designated as safety issue: Yes ]The clinical signs was based on Research Diagnostic Criteria protocol and it was measured maximum mouth opening pain free using a caliper ((Somet, 150mm, Inox, Czechoslovakia)
- Changing of Pain [ Time Frame: Before and 5 days follow-up intervetion ] [ Designated as safety issue: Yes ]To evaluate pain it was applied a scale from Research Diagnostic Criteria protocol, that consists of a line scored from 0 to 10, where 0 represents no pain and 10 the worst pain that the subject has experienced, allowing it to check the number that features their pain at the moment.
- Changing in Mandibular Function Impairment Questionnaire -MFIQ [ Time Frame: Before and 5 days follow-up intervetion ] [ Designated as safety issue: Yes ]To evaluated mandibular function was used the Mandibular Function Impairment Questionnaire
|Study Start Date:||July 2012|
|Study Completion Date:||December 2012|
|Primary Completion Date:||December 2012 (Final data collection date for primary outcome measure)|
No Intervention: Manual therapy
Upper cervical flexion mobilization, C5 central posterior-anterior mobilization, Pressure biofeedback device
Other: Manual therapy
The patient was supine with the cervical spine in a neutral position. The therapist brought about a contact of the occipital bone with the ﬁrst ﬁnger and medial aspect of the hand, and other hand over the frontal region of the patient's head. The mobilizing force was delivered by ﬂexing the upper cervical region using a combination of cephalic traction with the occipital hand and caudal pressure with the frontal hand. This technique was applied for 10 minutes
Other Name: Upper cervical flexion mobilizationOther: Manual therapy
The patient was prone with the cervical spine in a neutral position. The therapist placed the tips of his thumbs on the posterior surface of the C5 spinous process, while the other ﬁngers rested gently around the patients' neck. This technique was applied for 9 minutes
Other Name: C5 central posterior-anterior mobilizationDevice: Pressure biofeedback device
Device: Stabilizer - Chattanooga Group Inc., Chattanooga, Tennessee, USA The cranio-cervical flexor stabilization exercise was done 10 times holding 10 seconds the flexing position graded through feedback from a pressure biofeedback device
Other Name: Stabilizer
Temporomandibular disorder (TMD) is a general term that refers to disorders associated with the temporomandibular joint (TMJ) and the masticatory muscles. Among the main symptoms are pre-auricular pain (in the region of the TMJ) and/or pain in the masticatory muscles.
It's usual to observe that subjects with TMD also present cervical alteration. Beside this, cervical postural alterations produced by muscle tension can influence mandibular position.
The intervention protocol was based on manual therapy, stabilization exercises and stretching.
The technique are:.
- Upper cervical flexion mobilization;
- C5 central posterior-anterior mobilization;
- Stabilization exercise: Cranio-cervical flexor stabilization exercise
- Stretching of muscles: upper trapezius, scalenes, semispinalis capitis; splenius capitis, sternocleidomastoid
Please refer to this study by its ClinicalTrials.gov identifier: NCT01954511
|Study Director:||Ana Beatriz Oliveira, Phd||Clinical professor - UFSCar|
|Principal Investigator:||Letícia Bojikian Calixtre, Pt||UFSCar|
|Principal Investigator:||Francisco Alburquerque Sendín, Phd||University of Salamanca|
|Principal Investigator:||Melina Nevoeiro Haik, MSc||UFSCar|