Effects of a program consisting of strain/counterstrain technique, phonophoresis, heat therapy, and stretching in patients with temporomandibular joint dysfunction: A pilot study.
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
11 Aug 2023
11 Aug 2023
Historique:
medline:
14
8
2023
pubmed:
11
8
2023
entrez:
11
8
2023
Statut:
ppublish
Résumé
The present study was conceptualized as a pilot study to examine the effects of a 3-week program consisting of strain/counterstrain technique (SCST), phonophoresis, heat therapy, and stretching exercises on pain and functions in patients with temporomandibular dysfunction (TMD). Seven participants (mean age 25.85 years) diagnosed with TMD having pain in the temporomandibular joint (TMJ) area with decreased jaw opening were recruited for the study. Treatment interventions consisting of SCST, phonophoresis (ultrasound gel mixed with diclofenac gel), heat therapy, and stretching (mouth-opening) exercises were performed 3 days a week for 3 weeks. SCST was performed on the masseter, medial, and lateral pterygoid muscles. No control group was present in the study. Paired samples t test revealed a significant difference in numerical pain rating scale (NPRS) (decreased by 50%, P < .001) and jaw functional limitation scale (JFLS) (reduced by 59.58%, P < .001) scores after 3 weeks of intervention. A large effect size (Cohen d = -3.00 for NPRS and -3.16 for JFLS) was observed for both variables. No correlation (R = 0) was found between the baseline values of NPRS and JFLS. A 3-week program consisting of SCST, phonophoresis, heat therapy, and stretching exercises was effective in reducing the pain and improving the functions related to TMJ in patients suffering from TMD. However, a randomized controlled trial is needed to reach a definite conclusion.
Sections du résumé
BACKGROUND
BACKGROUND
The present study was conceptualized as a pilot study to examine the effects of a 3-week program consisting of strain/counterstrain technique (SCST), phonophoresis, heat therapy, and stretching exercises on pain and functions in patients with temporomandibular dysfunction (TMD).
METHODS
METHODS
Seven participants (mean age 25.85 years) diagnosed with TMD having pain in the temporomandibular joint (TMJ) area with decreased jaw opening were recruited for the study. Treatment interventions consisting of SCST, phonophoresis (ultrasound gel mixed with diclofenac gel), heat therapy, and stretching (mouth-opening) exercises were performed 3 days a week for 3 weeks. SCST was performed on the masseter, medial, and lateral pterygoid muscles. No control group was present in the study.
RESULTS
RESULTS
Paired samples t test revealed a significant difference in numerical pain rating scale (NPRS) (decreased by 50%, P < .001) and jaw functional limitation scale (JFLS) (reduced by 59.58%, P < .001) scores after 3 weeks of intervention. A large effect size (Cohen d = -3.00 for NPRS and -3.16 for JFLS) was observed for both variables. No correlation (R = 0) was found between the baseline values of NPRS and JFLS.
CONCLUSION
CONCLUSIONS
A 3-week program consisting of SCST, phonophoresis, heat therapy, and stretching exercises was effective in reducing the pain and improving the functions related to TMJ in patients suffering from TMD. However, a randomized controlled trial is needed to reach a definite conclusion.
Identifiants
pubmed: 37565891
doi: 10.1097/MD.0000000000034569
pii: 00005792-202308110-00050
pmc: PMC10419340
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e34569Informations de copyright
Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose.
Références
Herb K, Cho S, Stiles MA. Temporomandibular joint pain and dysfunction. Curr Pain Headache Rep. 2006;10:408–14.
Lomas J, Gurgenci T, Jackson C, et al. Temporomandibular dysfunction. Aust J Gen Pract. 2018;47:212–5.
Sharma S, Gupta DS, Pal U, et al. Etiological factors of temporomandibular joint disorders. Natl J Maxillofac Surg. 2011;2:116.
Reiter S, Goldsmith C, Emodi-Perlman A, et al. Masticatory muscle disorders diagnostic criteria: the American Academy of Orofacial Pain versus the research diagnostic criteria/temporomandibular disorders (RDC/TMD). J Oral Rehabil. 2012;39:941–7.
Scrivani SJ, Keith DA, Kaban LB. Temporomandibular disorders. N Engl J Med. 2008;359:2693–705.
Jones L. Strain and Counterstrain. Newark, Ohio: American Academy of Osteopathy. 1981.
Ibáñez-García J, Alburquerque-Sendín F, Rodríguez-Blanco C, et al. Changes in masseter muscle trigger points following strain-counterstrain or neuro-muscular technique. J Bodyw Mov Ther. 2009;13:2–10.
Somprasong S, Mekhora K, Vachalathiti R, et al. Effects of strain counter-strain and stretching techniques in active myofascial pain syndrome. J Phys Ther Sci. 2011;23:889–93.
Dardzinski J, Ostrov B, Hamann L. Myofascial pain unresponsive to standard treatment: successful use of a strain and counterstrain technique with physical therapy. J Clin Rheumatol. 2000;6:169–74.
Atienza Meseguer A, Fernandez de las Penas C, Navarro-Poza JL, et al. Immediate effects of the strain/counterstrain technique in local pain evoked by tender points in the upper trapezius muscle. Clin Chiropr. 2006;9:112–8.
Blanco CR, de las Peñas CF, Xumet JEH, et al. Changes in active mouth opening following a single treatment of latent myofascial trigger points in the masseter muscle involving post-isometric relaxation or strain/counterstrain. J Bodyw Mov Ther. 2006;10:197–205.
Lewis C, Flynn TW. The use of strain-counterstrain in the treatment of patients with low back pain. J Man Manip Ther. 2001;9:92–8.
Grieder A, Vinton PW, Cinotti WR, et al. An evaluation of ultrasonic therapy for temporomandibular joint dysfunction. Oral Surg Oral Med Oral Pathol. 1971;31:25–31.
Ucar M, Sarp U, Koca I, et al. Effectiveness of a home exercise program in combination with ultrasound therapy for temporomandibular joint disorders. J Phys Ther Sci. 2014;26:1847–9.
Elgohary HM, Eladl HM, Soliman AH, et al. Effects of ultrasound, laser and exercises on temporomandibular joint pain and trismus following head and neck cancer. Ann Rehabil Med. 2018;42:846–53.
Furlan RMMM, Giovanardi RS, Britto ATBdO, Britto DBdO. The use of superficial heat for treatment of temporomandibular disorders: an integrative review. Paper presented at: Codas 2015.
Moraes AR, Sanches ML, Ribeiro EC, et al. Therapeutic exercises for the control of temporomandibular disorders. Dental Press J Orthod. 2013;18:134–9.
Spadoni GF, Stratford PW, Solomon PE, et al. The evaluation of change in pain intensity: a comparison of the P4 and single-item numeric pain rating scales. J Orthop Sports Phys Ther. 2004;34:187–93.
Ohrbach R, Larsson P, List T. The jaw functional limitation scale: development, reliability, and validity of 8-item and 20-item versions. J Orofac Pain. 2008;22.
Mishra A, Sinha A, Mehrotra P, et al. A comparative study on efficacy of three different treatment modalities for temporomandibular joint pain and dysfunction. Oral Health Dent Manag. 2015;3:27–32.
Rai S, Kaur M, Goel S, et al. Prospective utility of therapeutic ultrasound in dentistry—Review with recent comprehensive update. Adv Biomed Res. 2012;1:47.
Gupta A, Bharti Arora D, Rishi P. Recovery from temporomandibular joint dysfunction: an overview of different physiotherapy approaches.
Eisensmith LP. Massage therapy decreases frequency and intensity of symptoms related to temporomandibular joint syndrome in one case study. J Bodyw Mov Ther. 2007;11:223–30.
Calixtre LB, Rezende MA, Kamonseki DH, et al. Effects of myofascial release applied to neck muscles and craniocervical flexor training in patients with chronic myofascial TMD: a single arm study. Int J Osteopath Med. 2021;41:4–10.
Benson HA, McElnay JC. Transmission of ultrasound energy through topical pharmaceutical products. Physiotherapy. 1988;74:587–9.
Shin S-M, Choi J-K. Effect of indomethacin phonophoresis on the relief of temporomandibular joint pain. Cranio. 1997;15:345–8.
Fernandez-Cuadros ME, Bocanegra LOC, Albaladejo-Florin MJ, et al. Effect of diclofenac gel phonophoresis on temporomandibular joint disorders: a prospective quasi-experimental study. Middle East J Rehabil Health Stud. 2020;7.
Vijayalakshmi K, Khan M, Rajguru P. Phonophoresis in temporomandibular joint disorders: a clinical trial. J Adv Clin Res Insights. 2015;2:259–64.
Yang J-H, Kim D-K, Yun M-Y, et al. Transdermal delivery system of triamcinolone acetonide from a gel using phonophoresis. Arch Pharm Res. 2006;29:412–7.
Newman JT, Nellermoe M, Carnett J. Hydrocortisone phonophoresis. A literature review. J Am Podiatr Med Assoc. 1992;82:432–5.
Freesmeyer WB, Fussnegger M, Ahlers M. Diagnostic and therapeutic-restorative procedures for masticatory dysfunctions. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2005;4.
Wieckiewicz M, Boening K, Wiland P, et al. Reported concepts for the treatment modalities and pain management of temporomandibular disorders. J Headache Pain. 2015;16:1–12.
Michelotti A, Steenks MH, Farella M, et al. The additional value of a home physical therapy regimen versus patient education only for the treatment of myofascial pain of the jaw muscles: short-term results of a randomized clinical trial. J Orofac Pain. 2004;18:114–25.
Fricton JR. Management of masticatory myofascial pain. Paper presented at: Semin Orthod. 1995;1:229–43.
Michelotti A, de Wijer A, Steenks M, et al. Home-exercise regimes for the management of non-specific temporomandibular disorders. J Oral Rehabil. 2005;32:779–85.
Oliveira L, Lopes T, Soares C, et al. Transcranial direct current stimulation and exercises for treatment of chronic temporomandibular disorders: a blind randomised-controlled trial. J Oral Rehabil. 2015;42:723–32.