PHYSICAL TECHNIQUES FOR THE TREATMENT OF THE TEMPOROMANDIBULAR DISORDERS. A REVIEW OF CLINICAL TRIALS.
Keywords:
temporomandibular joint disorders, Physical therapy, manual therapy, massage, acupuncture, exer-cise.Abstract
Purpose: the objective of this revision is to value the effectiveness of the different physical techniques for the treatment of the temporomandibular joint disorders. Material and method. Design: Bibliographical review of clinical rials. Databases: MEDLINE, Cochrane, PEDro, Doyma. Selection: Randomized controlled trials, clinical trials and un-controlled studies, with maximum age of 10 years, that make comparisons before-after the application of physical techniques in the temporomandibular joint disorders, comparisons between physical techniques versus placebo or other therapeutic or comparisons between different physical techniques. Search strategy: depending on the characteristics of the database searched randomized clinical trials or clinical trials with the words temporomandibular joint disorders in combination with the words physical therapy, manual therapy, massage, acupuncture, exercise or posture. Results. Articles included in this review: 14; 7 works testing the effectiveness of the exercise: 4 combine active and passive mobilizations with postural corrections and relaxation techniques, 1 work combines relaxation techniques, cryotherapy, transcutaneous electrical nerve stimulation (TENS), ultrasound and mobilizations while in 2 works compared mobilizations splint download with no treatment. One study assesses the effectiveness of the exercise and manual techniques. Three works testing the effectiveness of acupuncture. The other 3, 1 assesses the effectiveness of postural training and self-management instructions by comparing with instructions only and the 2 remaining tes-ting the effectiveness of stretching alongside other combinations of techniques. Conclusion: evidence in favor exist for the use of acupuncture, exercises and manual techniques, interventions on the position and the combination of massage and stretching together with other performances as the heat use, cold, relaxation techniques, electrotherapy or the use of unloading rules.
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