The Effectiveness of Kinesiotaping and Inactivation of Trigger Points in Chronic Myofascial Pain of TMD
Condition: Myofascial Pain; TMD
MeSH terms: Myofascial Pain Syndromes
Study type: Interventional

Summary: 
      In patients with a long-lasting TMD syndrome, especially of a muscular nature, palpation
      examination can locate the trigger points of pain (TrP) in the chewing muscles, i.e., the
      nodules in the shape of bumps the size of rice or pea grains. Kinesiotaping (KT) is
      considered as an intervention method that can be used to release latent myofascial trigger
      points. It is a method that involves applying specific tapes to the patient's skin surface in
      order to use the natural self-healing processes of the body. The aim of the study was to
      evaluate the effect of Kinesiotaping methods and inactivation of Trigger Points on
      nonpharmacological elimination of pain in patients with functional disorders of the
      masticatory motor system.
    

Detailed description: 
      BACKGROUND:

      Temporomandibular Dysfunction (TMD) is a disease characterized by a set of signs and symptoms
      that may include joint noise, pain in the mastication muscles, limitation of mandibular
      movements, facial pain, joint pain and / or dental wear. Pain appears as a very present and
      striking symptom, with a tendency to chronicity. This is a difficult treatment condition
      often associated with psychological factors such as anxiety. In patients with a longlasting
      TMD syndrome, especially those of a muscular nature, palpation can locate the trigger points
      of pain (TrP) in the chewing muscles, i.e. the nodules in the shape of bumps the size of
      grains of rice or peas. Of particular importance in the treatment of pain syndromes of
      temporomandibular joint disorders is physiotherapy and physical therapy. Some studies have
      shown improvement in subjects with chronic pain using different physiotherapy treatments, but
      this requires further investigation to determine the effectiveness of individual therapies in
      the fight against pain.

      PROBLEM:

      The multiple manifestation of symptoms causes a multitude of treatment methods and indicates
      that there is still no consensus in the understanding of the pathophysiology of the
      underlying TMD mechanisms. Treatment of pain syndrome in temporomandibular dysfunction due to
      heterogeneity of causes should have a multiprofile character. Despite the wide range of
      strategies used to treat patients with TMD, some patients have a temporary and / or
      unsatisfactory relief response. There are many physiotherapeutic methods to fight pain, among
      others: compressive mobilization, positional release, myofascial relaxation, active
      relaxation technique, postisometric relaxation technique. Of the commonly used methods, a
      deep tissue massage and stretching. Some of them are very unpleasant for patients, because in
      the first phase they intensify pain, eg active inactivation (therapy) of trigger points
      (TrP). Kinesiotaping is a painless method that does not intensify pain symptoms. Reports from
      various researchers are contradictory in this regard, hence the attempt to compare both
      methods in the aspect of non-pharmacological analgesic activity in patients with TMD.

      HYPOTHESIS:

      Researchers believe that in patients with severe pain symptoms, patients with TMD who are
      often accompanied by anxiety before symptom intensification, it is very important to use
      physiotherapeutic methods, which can eliminate or reduce pain in a non-pharmacological
      manner. In this type of patients, the psychological aspect is important in the form of
      immediate relief without aggravating the symptoms at least in the first phase, because it can
      cause patients psychological reluctance to the entire treatment process. Because of the
      mutual influence between pain and psychological factors, it is expected that the analgesic
      effect will have a positive effect influence on the level of anxiety before further often
      long-term therapeutic treatment.

      AIM:

      Evaluation and comparison of the analgesic efficacy of two physiotherapeutic methods:
      Kinsiotapinng (KT) and active inactivation of trigger points (TrP) in the pain levels in
      individuals with chronic pain due muscular TMD.
    

Intervention name(s): Kinesiotaping; inactivation of trigger points (TrP)
Intervention type(s): Diagnostic Test; Diagnostic Test
Intervention description(s): Dynamic adhesive taping is a method that involves the application of specific tapes to the surface of the patient's skin in order to use the natural self-healing processes of the body. It is often used as an element that sustains the therapeutic effect. Its action is based mainly on the action normalizing muscle tone, supporting the work of joints, improving the function of weakened muscles, increasing microcirculation at the site of application.; A procedure for releasing trigger points using physiotherapy using the ischemic compression method, which involves applying pressure to the active trigger point, until it is switched off, i.e. pain ceases.The location of the trigger point is done palpatively, with a pliers grip, covering the strained tissue on the inside and outside of the cheek with the thumb and index finger.
Other intervention name(s): Dynamic adhesive plaster, Dynamic adhesive tape; compressive mobilization
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Experimental: Kinesiotaping Participants receive an application of active tapes (KT) Original kinesiotaping active tapes Duration: 2 times Application maintenance 5 days with a break for the weekend Muscle application on the masseter muscle area, using a tape (5 cm wide) dissected into 2 parts called tails, which included the treatment site without their tension.
Experimental: active inactivation of trigger points (TrP) Duration: 10-20 minutes of surgery; 2 inactivation treatments Between the treatments 5 days break
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Kinesiotaping, Manual therapy; Physiotherapy