Hedwig A van der Meer1, Leticia B Calixtre2, Raoul H H Engelbert3, Corine M Visscher4, Maria Wg Nijhuis-van der Sanden5, Caroline M Speksnijder6. 1. Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Department of Orofacial Pain and Dysfunction, Amsterdam, the Netherlands; University Medical Center Utrecht, Utrecht University, Department of Oral-Maxillofacial Surgery and Special Dental Care, Utrecht, the Netherlands; Amsterdam University of Applied Sciences, Education of Physiotherapy, Faculty of Health, Amsterdam, the Netherlands; Radboud University Medical Center, Research Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands; University of Amsterdam, Amsterdam University Medical Centers (AUMC), Department of Rehabilitation, Amsterdam, Meibergdreef 9, Amsterdam Movement Sciences, the Netherlands. Electronic address: h.a.van.der.meer@hva.nl. 2. Federal University of São Carlos (UFSCar), Physiotherapy Department, São Carlos, Brazil. 3. Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Department of Orofacial Pain and Dysfunction, Amsterdam, the Netherlands; Amsterdam University of Applied Sciences, Education of Physiotherapy, Faculty of Health, Amsterdam, the Netherlands. 4. University of Amsterdam, Amsterdam University Medical Centers (AUMC), Department of Rehabilitation, Amsterdam, Meibergdreef 9, Amsterdam Movement Sciences, the Netherlands. 5. University Medical Center Utrecht, Utrecht University, Department of Oral-Maxillofacial Surgery and Special Dental Care, Utrecht, the Netherlands. 6. Radboud University Medical Center, Research Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands.
Abstract
BACKGROUND: Physical therapy is regarded an effective treatment for temporomandibular disorders (TMD). Patients with TMD often report concomitant headache. There is, however, no overview of the effect of physical therapy for TMD on concomitant headache complaints. OBJECTIVES: The aim of this study is to systematically evaluate the literature on the effectiveness of physical therapy on concomitant headache pain intensity in patients with TMD. DATA SOURCES: PubMed, Cochrane and PEDro were searched. STUDY ELIGIBILITY CRITERIA: Randomized or controlled clinical trials studying physical therapy interventions were included. PARTICIPANTS: Patients with TMD and headache. APPRAISAL: The Cochrane risk of bias tool was used to assess risk of bias. SYNTHESIS METHODS: Individual and pooled between-group effect sizes were calculated according to the standardized mean difference (SMD) and the quality of the evidence was rated using the GRADE approach. RESULTS: and manual therapy on both orofacial region and cervical spine. There is a very low level of certainty that TMD-treatment is effective on headache pain intensity, downgraded by high risk of bias, inconsistency and imprecision. LIMITATIONS: The methodological quality of most included articles was poor, and the interventions included were very different. CONCLUSIONS: Physical therapy interventions presented small effect on reducing headache pain intensity on subjects with TMD, with low level of certainty. More studies of higher methodological quality are needed so better conclusions could be taken.
BACKGROUND: Physical therapy is regarded an effective treatment for temporomandibular disorders (TMD). Patients with TMD often report concomitant headache. There is, however, no overview of the effect of physical therapy for TMD on concomitant headache complaints. OBJECTIVES: The aim of this study is to systematically evaluate the literature on the effectiveness of physical therapy on concomitant headache pain intensity in patients with TMD. DATA SOURCES: PubMed, Cochrane and PEDro were searched. STUDY ELIGIBILITY CRITERIA: Randomized or controlled clinical trials studying physical therapy interventions were included. PARTICIPANTS: Patients with TMD and headache. APPRAISAL: The Cochrane risk of bias tool was used to assess risk of bias. SYNTHESIS METHODS: Individual and pooled between-group effect sizes were calculated according to the standardized mean difference (SMD) and the quality of the evidence was rated using the GRADE approach. RESULTS: and manual therapy on both orofacial region and cervical spine. There is a very low level of certainty that TMD-treatment is effective on headache pain intensity, downgraded by high risk of bias, inconsistency and imprecision. LIMITATIONS: The methodological quality of most included articles was poor, and the interventions included were very different. CONCLUSIONS: Physical therapy interventions presented small effect on reducing headache pain intensity on subjects with TMD, with low level of certainty. More studies of higher methodological quality are needed so better conclusions could be taken.