Therapeutic Response of Ultrasound and Muscular Stretching in Temporomandibular Disorder Patients

Study Overview
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Brief Summary
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The combination of ultrasound and muscular stretching may have positive effects on pain relief and on the balance of the masticatory muscles activity.

Detailed Description
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This study aimed to evaluate the therapeutic response of ultrasound (US) and ultrasound associated with stretching of the masticatory muscles on the pressure pain threshold and the electrical activity of masseter and anterior temporal muscles in Temporomandibular Disorder (TMD) patients . The study included 18 women with TMD diagnosed by the instrument Research Diagnostic Criteria for Temporomandibular Disorders (RDC / TMD). The pressure pain threshold, evaluated through algometry, and the electrical activity of the masticatory muscles were evaluated, by means of surface electromyography, before and immediately after the therapeutic procedures. The volunteers underwent three different interventions: ultrasound, ultrasound associated with stretching and ultrasound placebo, with a 1-week of minimum interval between them.

Official Title
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Therapeutic Response of Ultrasound and Muscular Stretching in Temporomandibular Disorder Patients: Clinical Trial

Conditions
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Temporomandibular Joint Disorders

Intervention / Treatment
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* Other: Ultrasound
* Other: Ultrasound associated with stretching
* Other: Placebo


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: diagnosis of myogenic or mixed TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC / TMD) women aged 20 to 35 years. Exclusion Criteria: psychomotor impairment ; history of orthopedic trauma involving the temporomandibular region , orofacial surgery or poor training ; analgesics , anti-inflammatories , muscle relaxants , antidepressants ; presence of acute TMJ pain ( last 3 months) ; have perform physical therapy or speech therapy for the past 6 months; periods of the end of the menstrual cycle (7 days prior to menstruation ) and onset of menstruation ( first 2 days ) were excluded for conducting evaluations of volunteers who did not use oral contraception and those who used it to break.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 35 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Ultrasound<br>3 MHz (Mega Hertz) ultrasound in continuous mode with an intensity of 1.0 W / cm ² was applied for 3 minutes in the TMJ (Temporomandibular joint) and masseter muscles bilaterally | Other: Ultrasound associated with stretching<br>* 3 MHz ultrasound in continuous mode with an intensity of 1.0 W / cm ² was applied for 3 minutes in the TMJ and masseter muscles, bilaterally. Active stretching of the masseter muscles with mouth opening and closed lips<br>Other: Placebo<br>* Turned off ultrasound application on area of TMJ and masseter muscle, bilaterally.<br>|
| Experimental: Ultrasound associated with stretchting<br>3 MHz ultrasound in continuous mode with an intensity of 1.0 W / cm ² was applied for 3 minutes in the TMJ and masseter muscles bilaterally. Active stretching of the masseter muscles with mouth opening and closed lips | Other: Ultrasound<br>* 3 MHz ultrasound in continuous mode with an intensity of 1.0 W / cm ² was applied for 3 minutes in the TMJ and masseter muscles bilaterally<br>Other: Placebo<br>* Turned off ultrasound application on area of TMJ and masseter muscle, bilaterally.<br>|
| Experimental: Placebo<br>Turned off ultrasound application on area of TMJ and masseter muscle, bilaterally. | Other: Ultrasound<br>* 3 MHz ultrasound in continuous mode with an intensity of 1.0 W / cm ² was applied for 3 minutes in the TMJ and masseter muscles bilaterally<br>Other: Ultrasound associated with stretching<br>* 3 MHz ultrasound in continuous mode with an intensity of 1.0 W / cm ² was applied for 3 minutes in the TMJ and masseter muscles, bilaterally. Active stretching of the masseter muscles with mouth opening and closed lips<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pressure pain threshold | algometry | 10 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| surface electromyography | electromyographic activity was measure at rest, in maximal intercuspal position and maximal voluntary clench | 10 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Temporomandibular Joint Disorders,, Ultrasonics,, Electromyography,, Pain Measurement,, Muscle Stretching Exercise