Evaluation of Biofeedback Therapy Efficiency in Masticatory Muscles Pain Management

NCT ID: NCT03421028

Last Updated: 2021-07-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-01-01

Study Completion Date

2024-12-31

Brief Summary

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This study evaluates beneficial effects of biofeedback therapy in reducing pain and increased tension of muscles occurring in patients with temporomandibular disorders (TMD). During the study Electromyography Biofeedback (EMG-Biofeedback)- assisted training lowering muscle tension will be used. The patients will undergo 4 or 8 meetings of EMG-Biofeedback - assisted training Than the patients will be reevaluated after 6 and 12 weeks.

Detailed Description

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1. The Aim:

The aim of the study is to evaluate beneficial effects of biofeedback therapy in reducing pain, increased tension of masticatory muscles occurring in patients with myogenous TMD and if the therapy influences psychological and sleep parameters. Also to verify if the effect of the therapy persists in time.
2. Patients:

1. Experimental group 1 - patients diagnosed with myalgia subjected to 4 EMG-Biofeedback trainings. The group will include approximately 20 adults.
2. Experimental group 2 - patients diagnosed with myalgia subjected to 8 EMG-Biofeedback trainings. The group will include approximately 20 adults.
3. Control group - patients diagnosed with myalgia subjected to physiotherapy (manual therapy), stabilization splint usage and counseling (20 adults).
3. Methods:

Adult patients diagnosed with masticatory muscles myalgia will be included in this study. All participants will be evaluated in accordance to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Intensity of pain in the masticatory muscles will be defined using the Numerical Rating Scale (NRS). The pressure pain threshold (PPT) will be assessed with an dolorimeter and noticed on DC/TMD pain drawing diagram. Each of the qualified patients will also undergo the electromyography of temporal and masseter muscles. All participants will fill in questionnaires (Graded Chronic Pain Scale (GCPS), Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire-9 (PHQ-9), Beck Anxiety Inventory (BAI) and Perceived Stress Scale-10 (PSS-10) and Somatic Symptom Scale-8 (SSS-8).

Patients qualified to the experimental groups will be divided in to 2 subgroups composed of 20 participants each.

Experimental group 1 will undergo a cycle of 4 meetings (1 per week) of 20 minute EMG-Biofeedback- assisted training decreasing the masseter and temporalis muscle tension. 10 minutes of training for each group of muscle.

Experimental group 2 will undergo a cycle of 8 meetings (1 per week) of 20 minute EMG-Biofeedback- assisted training decreasing the masseter and temporalis muscle tension. 10 minutes of training for each group of muscle.

Postcycle examination:

After completing the cycle, patients from the study group and control group will be reevaluated. All participants will be evaluated in accordance to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Intensity of pain in the masticatory muscles will be defined using the Numerical Rating Scale (NRS). The pressure pain threshold (PPT) will be assessed with an dolorimeter and noticed on DC/TMD pain drawing diagram. Each of the qualified patients will also undergo the electromyography of temporal and masseter muscles. All participants will fill in questionnaires (Graded Chronic Pain Scale (GCPS), Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire-9 (PHQ-9), Beck Anxiety Inventory (BAI) and Perceived Stress Scale-10 (PSS-10) and Somatic Symptom Scale-8 (SSS-8).

The postcycle examination will take place after last planned training and during follow-ups - 6 and 12 weeks after completion of EMG-Biofeedback therapy.

Conditions

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Muscle Pain Feedback, Psychological Craniomandibular Disorders Temporomandibular Disorder Sleep

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Control group

Patients with masticatory muscle pain treated with occlusal splint, physiotherapy and counseling

Group Type ACTIVE_COMPARATOR

Classic treatment for myogenous TMD

Intervention Type OTHER

Combination of physiotherapy (manual therapy), stabilization occlusal splint usage and counseling

Experimental group 1

Patients diagnosed with masticatory muscle pain treated with 4 meetings of EMG-biofeedback assisted training

Group Type EXPERIMENTAL

Electromyography Biofeedback

Intervention Type DEVICE

EMG-Biofeedback- assisted training is a method in which electrodes situated on the surface of the skin detect small voltage changes which arise from the working muscles (in this case masseter and temporalis muscles). The voltage is transformed into a visual or sound time-variable signal which gives the patient feedback as he willingly tries to change the muscle tension (in this case to lower the excessive masseter tension)

Experimental group 2

Patients diagnosed with masticatory muscle pain treated with 8 meetings of EMG-biofeedback

Group Type EXPERIMENTAL

Electromyography Biofeedback

Intervention Type DEVICE

EMG-Biofeedback- assisted training is a method in which electrodes situated on the surface of the skin detect small voltage changes which arise from the working muscles (in this case masseter and temporalis muscles). The voltage is transformed into a visual or sound time-variable signal which gives the patient feedback as he willingly tries to change the muscle tension (in this case to lower the excessive masseter tension)

Interventions

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Electromyography Biofeedback

EMG-Biofeedback- assisted training is a method in which electrodes situated on the surface of the skin detect small voltage changes which arise from the working muscles (in this case masseter and temporalis muscles). The voltage is transformed into a visual or sound time-variable signal which gives the patient feedback as he willingly tries to change the muscle tension (in this case to lower the excessive masseter tension)

Intervention Type DEVICE

Classic treatment for myogenous TMD

Combination of physiotherapy (manual therapy), stabilization occlusal splint usage and counseling

Intervention Type OTHER

Other Intervention Names

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EMG-Biofeedback

Eligibility Criteria

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Inclusion Criteria

* diagnosis of myalgia in accordance to Diagnostic Criteria for Temporomandibular Disorders
* full dentition or single tooth loss
* age between 18 and 70

Exclusion Criteria

* age under 18
* age over 70
* terminal general diseases
* severe mental disorders
* severe neurological disorders
* intake of drugs affecting muscle function
* edentulism or destruction of dentition
* alcoholism
* drug addiction
* history of severe trauma in the head and neck region
* severe pathology of temporomandibular joints
* congenital or acquired craniofacial deformity
* patients suffering from neuropathic pain
* patients with craniofacial inflammation
* patients undergoing orthodontic treatment
* pregnancy
* significant postural defect
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Wroclaw Medical University

OTHER

Sponsor Role lead

Responsible Party

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Wojciech Florjański

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mieszko Więckiewicz, D.M.D.Ph.D.

Role: STUDY_CHAIR

Wroclaw Medical University

Locations

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Wroclaw Medical University

Wroclaw, Dolny Śląsk, Poland

Site Status

Countries

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Poland

Central Contacts

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Wojciech Florjański, D.M.D.P.H.D.

Role: CONTACT

+48783602042

Mieszko Więckiewicz, D.M.D.Ph.D.

Role: CONTACT

Other Identifiers

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WMU2/2017

Identifier Type: -

Identifier Source: org_study_id

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