Wagner Rodrigues Martins1, Juscelino Castro Blasczyk2, Micaele Aparecida Furlan de Oliveira3, Karina Ferreira Lagôa Gonçalves4, Ana Clara Bonini-Rocha5, Pierre-Michel Dugailly6, Ricardo Jacó de Oliveira7. 1. University of Brasilia, College of Physical Therapy, Brasilia, DF, Brazil. Electronic address: wrmartins@me.com. 2. Brazilian Institute of Osteopathic, Rio de Janeiro, RJ, Brazil. Electronic address: juscelinocastro@gmail.com. 3. Sena Aires College, College of Physical Therapy, Valparaíso, GO, Brazil. Electronic address: micaele-furlan@hotmail.com. 4. Brazilian Institute of Osteopathic, Rio de Janeiro, RJ, Brazil. Electronic address: karinalagoa@gmail.com. 5. University of Brasilia, College of Physical Therapy, Brasilia, DF, Brazil. Electronic address: anaclara@unb.br. 6. 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. Electronic address: Pierre-Michel.Dugailly@ulb.ac.be. 7. University of Brasilia, College of Physical Education, Brasilia, DF, Brazil. Electronic address: rjaco@unb.br.
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.
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 disorderpatients. 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.