Role of physiotherapy in M.P.D.S: Systematic review and meta-analysis

Monal Karkar; Pritee Rajkumar Pandey; Shelly Sharma; Amrita Das; Priyanjali Dutta; Mariea Francis

doi:10.53730/ijhs.v6nS2.7683

Authors

Monal Karkar
monalk81290@gmail.com
Assistant Professor, Dept of Oral and Maxillofacial Surgery, Pravara Medical Institute, Rural Dental College, Loni
Pritee Rajkumar Pandey MDS, OMFS, Consultant Oral and MaxilloFacial Surgeon, Mahalaxmi Hospital, Nerul, Navi Mumbai
Shelly Sharma M.D.S, Assistant Professor, Department of Oral and Maxillo Facial Surgery, Subharti Dental College & Hospital, Swami Vivekananda Subharti University, Meerut
Amrita Das Senior lecturer, Department of Periodontology and Implantology, Dr. HSRSM dental college, Hingoli. Maharashtra, India
Priyanjali Dutta MDS, Consultant Oral Pathologist and Microbiologist, Benguluru, Karnataka
Mariea Francis MDS, Consultant Oral and maxillofacial surgeon, Coimbatore, Tamil Nadu

Keywords:

physiotherapy, pain, temporomandibular disorders

Abstract

Aim: To analyze the methodologic quality, summarize the findings, and perform a meta-analysis of the results from randomized controlled trials that assessed the effects of physiotherapy management of Myofascial Pain Dysfunction syndrome (MPDS). Methodology: A literature review was performed using the electronic databases PubMed, Science Direct. Each article was independently assessed by two investigators using the Cochrane Risk of Bias tool. A meta-analysis was conducted to obtain summary estimates of the standardized mean differences (SMD) and the corresponding 95% confidence intervals (95% CI). Between-study heterogeneity was computed and publication bias was assessed. Results : Seven articles met the inclusion criteria and were used in the analysis, corresponding to nine estimates of SMD. The meta-analysis showed that for pain reduction, the summary SMD favored physiotherapy (SMD = −0.63; 95% CI: −0.95 to −0.31; number of studies = 8; I2 = 0.0%), while for active range of movement (ROM) the differences between the intervention and control groups were not statistically significant (SMD = 0.33; 95% CI: −0.07 to 0.72; number of studies = 9; I2 = 61.9%). Conclusion: Physiotherapy seems to lead to decreased pain and may improve active muscle movement.

Downloads

Download data is not yet available.

References

Gass, A. N.: The myofascial pain dysfunction syndrome. Part I. Aetiology and diagnosis. N. Z. Dent. J. 1974: 70: 192-198.

SCHULZ, L. W.: A curative treatment for subluxation of the temporomandibular joint or any joint. J. Am. Dent. Assoc. 1937: 24: 1947-1950.

HENNY, F. A.: Intra-articular injection of cortisone into the temporomandibular joint. J. Oral Surg. 1954: 12: 314-319.

LASKIN, D. M.: Etiology of the pain-dysfunction syndrome. J. Am. Dent. Assoc. 1969: 79: 147-153.

RAMFJORD, S. P. & ASH, M. M.: Occlusion. Saunders, Philadelphia, 1966.

LUPTON, D. E.: Psychological aspects of temporomandibular joint dysfunction. J. Am. Dent. Assoc. 1969: 87: 131-136.

GREENE, C. S. & LASKIN, D. M.: Meprobamate therapy for the myofascial paindysfunction (M.P.O.) syndrome. A doubleblind evaluation. In: WEISENBERG, M. (ed.): Pain, clinical and experimental perspective, Ch. 40. C. V. Mosby, St. Louis 1975.

TASANEN, A. & KONOW, L. V.: Closed condylotomy in the treatment of idiopathic and traumatic pain dysfunction syndrome of the temporomandibular joint. Int. J. Oral Surg. 1973: 2: 102-106.

Kogo H, Kurosawa K: Seeking the cause of myofascial pain syndrome by identifying which manual therapy is effective against muscle tenderness and stiffness. J Phys Ther Sci, 2010, 22: 173–176.

Lee JH, Yong MS, Kong BJ, et al.: The effect of stabilization exercises combined with taping therapy on pain and function of patients with myofascial pain syndrome. J Phys Ther Sci, 2012, 24: 1283–1287.

Fernández-de-Las-Peñas C, Simons D, Cuadrado ML, et al.: The role of myofascial trigger points in musculoskeletal pain syndromes of the head and neck. Curr Pain Headache Rep, 2007, 11: 365–372.

Moldofsky HK: Disordered sleep in fibromyalgia and related myofascial facial pain conditions. Dent Clin North Am, 2001, 45: 701–713.

Iqbal ZA, Rajan R, Khan SA, et al.: Effect of deep cervical flexor muscles training using pressure biofeedback on pain and disability of school teachers with neck pain. J Phys Ther Sci, 2013, 25: 657–661.

Srbely JZ, Dickey JP, Lowerison M, et al.: Stimulation of myofascial trigger points with ultrasound induces segmental antinociceptive effects: a randomized controlled study. Pain, 2008, 139: 260–266.

Lee JH, Han JT: The dose-dependent effect of an 830-nm, 450-mW lowlevel laser therapy on the myofascial trigger point of the upper trapezius muscle: a randomized, double-blinded, clinical trial. J Phys Ther Sci, 2011, 23: 933–935.

Budgell B, Polus B: The effects of thoracic manipulation on heart rate variability: a controlled crossover trial. J Manipulative Physiol Ther, 2006, 29: 603–610.

Terkelsen AJ, Mølgaard H, Hansen J, et al.: Acute pain increases heart rate: differential mechanisms during rest and mental stress. Auton Neurosci, 2005, 121: 101–109.

Kuo TB, Yang CC: Scatterplot analysis of EEG slow-wave magnitude and heart rate variability: an integrative exploration of cerebral cortical and autonomic functions. Sleep, 2004, 27: 648–656.

Partanen JV, Ojala TA, Arokoski JP: Myofascial syndrome and pain: a neurophysiological approach. Pathophysiology, 2010, 17: 19–28.

Wheeler AH: Myofascial pain disorders: theory to therapy. Drugs, 2004, 64: 45–62.

Kamanli A, Kaya A, Ardicoglu O, et al.: Comparison of lidocaine injection, botulinum toxin injection, and dry needling to trigger points in myofascial pain syndrome. Rheumatol Int, 2005, 25: 604–611.

Majlesi J, Unalan H: High-power pain threshold ultrasound technique in the treatment of active myofascial trigger points: a randomized, doubleblind, case-control study. Arch Phys Med Rehabil, 2004, 85: 833–836.

Hakgüder A, Birtane M, Gürcan S, et al.: Efficacy of low level laser therapy in myofascial pain syndrome: an algometric and thermographic evaluation. Lasers Surg Med, 2003, 33: 339–343.

Ho KY, Tan KH: Botulinum toxin A for myofascial trigger point injection: a qualitative systematic review. Eur J Pain, 2007, 11: 519–527.

Ardiç F, Sarhus M, Topuz O: Comparison of two different techniques of electrotherapy on myofascial pain. J Back Musculoskeletal Rehabil, 2002, 16: 11–16.

Ingawalé S, Goswami T. Temporomandibular joint: Disorders, treatments, and biomechanics. Ann Biomed Eng 2009;37: 976–996.

McNeely ML, Olivo SA, Magee DJ. A systematic review of the effectiveness of physical therapy interventions for temporomandibular disorders. Phys Ther 2006;86:710–725.

Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions, ed 5. http://handbook.cochrane.org.

Sterne JA, Gavaghan D, Egger M. Publication and related bias in meta-analysis: Power of statistical tests and prevalence in the literature. J Clin Epidemiol 2000;53:1119–1129.

Schmid A, Brunner F, Wright A, Bachmann LM. Paradigm shift in manual therapy? Evidence for a central nervous system component in the response to passive cervical joint mobilisation. Man Ther 2008;13:387–396.