Effects on Pain and Function of Orthopedic Manual Therapy in Patients With Painful Disc Displacement With Reduction

NCT ID: NCT05728905

Last Updated: 2023-02-15

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

COMPLETED

Clinical Phase

NA

Total Enrollment

75 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-21

Study Completion Date

2021-11-05

Brief Summary

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The objective of this study was to compare the short- and medium-term effects in pain and temporomandibular joint (TMJ) and function of implementing a manual therapy (MT) intervention treatment combined with a therapeutic exercise (TE) program, versus an isolated TE program and a non-intervention in patients with disc displacement with reduction (DDCR) with pain.

Detailed Description

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Study Design: The study adopted a single-blind, randomized, controlled clinical trial approach. Adults with disc displacement with reduction clinical diagnosis, pain and loss of function were eligible for inclusion.

Intervention: Patients in the study were randomized into three groups, 25 subjects to the manual therapy and therapeutic exercise group, 25 to the therapeutic exercise group and 25 to the no intervention group. Subjects were excluded if there was presence of surgical history, dentistry treatment and use of medication. The dependent variables were the presence of clicking, TMJ function, cervical disability, pain, and range of motion of the TMJ. Subjects in every group were assessed after four weeks of intervention and after eight weeks.

Conditions

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Temporomandibular Disorder Manual Therapy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A randomized single blind clinical trial
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
The assessing physiotherapist did not know to which group the patient belongs

Study Groups

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Therapeutic exercise

The patients assigned to this group performed a self-treatment program that included three coordination exercises, two post-isometric relaxation (contraction-relaxation) and one self-traction. All exercises were performed in front of a mirror. It was performed every 3 hours, 5 times a day, for 4 weeks. The patient was instructed and supervised by a physiotherapist until they were executed correctly. All participants were provided with a video where the procedure and dosage of each exercise was described in detail.

Group Type EXPERIMENTAL

Therapeutic exercise

Intervention Type OTHER

Intervention with therapeutic exercise: coordination, relaxation and disc recapture exercises.

Therapeutic exercise + orthopedic manual therapy

The patients assigned to this group performed the exercise program and also received a manual therapy treatment applied by a physiotherapist. Two sessions were held per week for 4 weeks (8 sessions). Treatment consisted of traction, mobilization, and friction massage of the muscles of mastication.

Group Type EXPERIMENTAL

Therapeutic exercise

Intervention Type OTHER

Intervention with therapeutic exercise: coordination, relaxation and disc recapture exercises.

Orthopedic manual therapy

Intervention Type OTHER

Intervention with orthopedic manual therapy: traction, ventral sliding and massage.

Control

The patients assigned to this group did not receive any type of intervention during the 4 weeks. They were asked not to change their habits or receive any other type of treatment.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Therapeutic exercise

Intervention with therapeutic exercise: coordination, relaxation and disc recapture exercises.

Intervention Type OTHER

Orthopedic manual therapy

Intervention with orthopedic manual therapy: traction, ventral sliding and massage.

Intervention Type OTHER

Other Intervention Names

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Exercise Physiotherapy

Eligibility Criteria

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Inclusion Criteria

* Disc displacement with reduction diagnosis according to the Research Diagnostic Criteria for Temporomandibular Disorders; in the last 30 days, any TMJ noise present during the exam or clicking detected with palpation during at least one of three repetitions of jaw opening, closing, protrusion, or laterotrusion movements.
* equal or greater than 30 mm on the VAS scale
* Age is greater than or equal to18 years.

Exclusion Criteria

* Participants were excluded if they had received interventions of TMJ surgery or TMJ steroid injections in the previous month, a rheumatoid diagnosis, neurological or psychiatric diseases, or pregnancy.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fisioterapia Manual Ortopedica

NETWORK

Sponsor Role lead

Responsible Party

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ARMANDO CAMPOS

Director

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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ARMANDO CAMPOS

Role: PRINCIPAL_INVESTIGATOR

FMO

Locations

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Clinic

Hermosillo, Sonora, Mexico

Site Status

Countries

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Mexico

References

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Au AR, Klineberg IJ. Isokinetic exercise management of temporomandibular joint clicking in young adults. J Prosthet Dent. 1993 Jul;70(1):33-9. doi: 10.1016/0022-3913(93)90034-l.

Reference Type BACKGROUND
PMID: 8366455 (View on PubMed)

Yoda T, Sakamoto I, Imai H, Honma Y, Shinjo Y, Takano A, Tsukahara H, Morita S, Miyamura J, Yoda Y, Sasaki Y, Tomizuka K, Takato T. A randomized controlled trial of therapeutic exercise for clicking due to disk anterior displacement with reduction in the temporomandibular joint. Cranio. 2003 Jan;21(1):10-6. doi: 10.1080/08869634.2003.11746226.

Reference Type BACKGROUND
PMID: 12555926 (View on PubMed)

Wanman A, Marklund S. Treatment outcome of supervised exercise, home exercise and bite splint therapy, respectively, in patients with symptomatic disc displacement with reduction: A randomised clinical trial. J Oral Rehabil. 2020 Feb;47(2):143-149. doi: 10.1111/joor.12888. Epub 2019 Sep 30.

Reference Type BACKGROUND
PMID: 31520538 (View on PubMed)

Armijo-Olivo S, Pitance L, Singh V, Neto F, Thie N, Michelotti A. Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis. Phys Ther. 2016 Jan;96(1):9-25. doi: 10.2522/ptj.20140548. Epub 2015 Aug 20.

Reference Type BACKGROUND
PMID: 26294683 (View on PubMed)

Craane B, Dijkstra PU, Stappaerts K, De Laat A. Randomized controlled trial on physical therapy for TMJ closed lock. J Dent Res. 2012 Apr;91(4):364-9. doi: 10.1177/0022034512438275. Epub 2012 Feb 8.

Reference Type BACKGROUND
PMID: 22318373 (View on PubMed)

Campos Lopez A, De-Miguel EE, Malo-Urries M, Acedo TC. Mouth opening, jaw disability, neck disability, pressure pain thresholds, and myofascial trigger points in patients with disc displacement with reduction: A descriptive and comparative study. Cranio. 2024 May;42(3):309-315. doi: 10.1080/08869634.2021.1956214. Epub 2021 Aug 12.

Reference Type BACKGROUND
PMID: 34382921 (View on PubMed)

Medlicott MS, Harris SR. A systematic review of the effectiveness of exercise, manual therapy, electrotherapy, relaxation training, and biofeedback in the management of temporomandibular disorder. Phys Ther. 2006 Jul;86(7):955-73.

Reference Type BACKGROUND
PMID: 16813476 (View on PubMed)

Tuncer AB, Ergun N, Tuncer AH, Karahan S. Effectiveness of manual therapy and home physical therapy in patients with temporomandibular disorders: A randomized controlled trial. J Bodyw Mov Ther. 2013 Jul;17(3):302-8. doi: 10.1016/j.jbmt.2012.10.006. Epub 2012 Nov 16.

Reference Type RESULT
PMID: 23768273 (View on PubMed)

Other Identifiers

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FMO Fisioterapia

Identifier Type: -

Identifier Source: org_study_id

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