Clinical trial NCT04578626: Ultrasounds Evaluation of Asymptomatic Perimandibular Muscles Treated With Dry Needling
Official title: Morphological Changes in Asymptomatic Perimandibular Muscles After Dry Needling Assessed With Rehabilitative Ultrasound Imaging
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Asymptomatic State
Temporomandibular Joint
Masticatory Muscles
Keywords: ultrasonography
dry needling
physical therapy
Lead sponsor: Poliambulatorio Physio Power
Sponsor class: OTHER
Collaborators: name: Universidad Francisco de Vitoria
First posted: 2020-10-08
Enrollment: 17
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief summary: The articular disc of temporomandibular joint and three muscles of the cervico-facial region (temporal, masseter, sternocleidomastoid) are evaluated by means of sonographic images to observe and measure their dimensions' changes after a dry needling intervention. The participants are asymptomatic subjects and will be randomly divided in 2 groups: half of them are treated on the right side of the face, while the other half on the left side. Our hypothesis is that ultrasonography can reveal changes in the structures measured on the treated side.

Detailed description: The trial is designed as a before-and-after study conducted on asymptomatic subjects. The aim is to assess temporomandibular joint and three perimandibular muscles (temporal, masseter, sternocleidomastoid) by means of rehabilitative ultrasound imaging, carried out by a novice clinician. These evaluations are performed before and after a dry needling treatment directed to the tree studied muscles of one side of the face. The side to be treated is randomly assigned by using a computer-generated randomization process, the other side is used as control.

One month after the treatment sonographic images are taken by the novice clinician and by an expert one. The aim is to assess the reliability of ultrasonography comparing the results of their assessments.

Eligibility criteria: Inclusion Criteria:

* Age major then 18 years
* Must be asymptomatic in the face/head region at the time of the visit and in the previous 6 months.

Exclusion Criteria:

* Pregnancy
* medical history of systemic disease
* current pharmacological therapy
* history of recurrent headache and/or neck pain
* presence of orofacial pain or temporomandibular symptoms assessed with the DC/TMD (Diagnostic Criteria for TemporoMandibular Disorders)
* current use of a bite during sleep

Primary outcomes:
measure: mean of temporomandibular joint disc thickness
timeFrame: Baseline (before the treatment), immediately after the treatment, one month after the treatment
measure: mean of temporal muscle thickness
timeFrame: Baseline (before the treatment), immediately after the treatment, one month after the treatment
measure: mean of masseter muscle thickness
timeFrame: Baseline (before the treatment), immediately after the treatment, one month after the treatment
measure: mean of masseter muscle width
timeFrame: Baseline (before the treatment), immediately after the treatment, one month after the treatment
measure: mean of masseter muscle cross-sectional area
timeFrame: Baseline (before the treatment), immediately after the treatment, one month after the treatment
measure: mean of sternocleidomastoid muscle thickness
timeFrame: Baseline (before the treatment), immediately after the treatment, one month after the treatment
measure: mean of sternocleidomastoid muscle width
timeFrame: Baseline (before the treatment), immediately after the treatment, one month after the treatment
measure: mean of sternocleidomastoid muscle cross-sectional area
timeFrame: Baseline (before the treatment), immediately after the treatment, one month after the treatment
Secondary outcomes:
measure: mean of maximum mouth opening
timeFrame: Baseline (before the treatment), one month after the treatment
Other outcomes:
Locations:
city: Pozuelo De Alarcón
country: Spain
facility: Universidad Francisco de Vitoria
state: Madrid
Study officials:
affiliation: Poliambulatorio PhysioPower, Brescia, Italy
name: Alice Botticchio, PT, OMPT
role: PRINCIPAL_INVESTIGATOR
References:
citation: Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, List T, Svensson P, Gonzalez Y, Lobbezoo F, Michelotti A, Brooks SL, Ceusters W, Drangsholt M, Ettlin D, Gaul C, Goldberg LJ, Haythornthwaite JA, Hollender L, Jensen R, John MT, De Laat A, de Leeuw R, Maixner W, van der Meulen M, Murray GM, Nixdorf DR, Palla S, Petersson A, Pionchon P, Smith B, Visscher CM, Zakrzewska J, Dworkin SF; International RDC/TMD Consortium Network, International association for Dental Research; Orofacial Pain Special Interest Group, International Association for the Study of Pain. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Groupdagger. J Oral Facial Pain Headache. 2014 Winter;28(1):6-27. doi: 10.11607/jop.1151.
citation: de-Pedro-Herraez M, Mesa-Jimenez J, Fernandez-de-Las-Penas C, de-la-Hoz-Aizpurua JL. Myogenic temporomandibular disorders: Clinical systemic comorbidities in a female population sample. Med Oral Patol Oral Cir Bucal. 2016 Nov 1;21(6):e784-792. doi: 10.4317/medoral.21249.
citation: Ries LG, Alves MC, Berzin F. Asymmetric activation of temporalis, masseter, and sternocleidomastoid muscles in temporomandibular disorder patients. Cranio. 2008 Jan;26(1):59-64. doi: 10.1179/crn.2008.008.
citation: Dahlstrom L, Carlsson GE. Temporomandibular disorders and oral health-related quality of life. A systematic review. Acta Odontol Scand. 2010 Mar;68(2):80-5. doi: 10.3109/00016350903431118.
citation: Oliveira LK, Almeida Gde A, Lelis ER, Tavares M, Fernandes Neto AJ. Temporomandibular disorder and anxiety, quality of sleep, and quality of life in nursing professionals. Braz Oral Res. 2015;29:S1806-83242015000100265. doi: 10.1590/1807-3107BOR-2015.vol29.0070.
citation: Weiss RC, Oostrom-Ram T. Inhibitory effects of ribavirin alone or combined with human alpha interferon on feline infectious peritonitis virus replication in vitro. Vet Microbiol. 1989 Jul;20(3):255-65. doi: 10.1016/0378-1135(89)90049-7.
citation: Emshoff R, Bertram S, Strobl H. Ultrasonographic cross-sectional characteristics of muscles of the head and neck. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999 Jan;87(1):93-106. doi: 10.1016/s1079-2104(99)70302-1.
citation: Djordjevic O, Djordjevic A, Konstantinovic L. Interrater and intrarater reliability of transverse abdominal and lumbar multifidus muscle thickness in subjects with and without low back pain. J Orthop Sports Phys Ther. 2014 Dec;44(12):979-88. doi: 10.2519/jospt.2014.5141. Epub 2014 Nov 3.
citation: Strini PJ, Strini PJ, Barbosa Tde S, Gaviao MB. Assessment of thickness and function of masticatory and cervical muscles in adults with and without temporomandibular disorders. Arch Oral Biol. 2013 Sep;58(9):1100-8. doi: 10.1016/j.archoralbio.2013.04.006. Epub 2013 May 16.
citation: Pallegama RW, Ranasinghe AW, Weerasinghe VS, Sitheeque MA. Influence of masticatory muscle pain on electromyographic activities of cervical muscles in patients with myogenous temporomandibular disorders. J Oral Rehabil. 2004 May;31(5):423-9. doi: 10.1111/j.1365-2842.2004.01266.x.
citation: Fedorowicz Z, van Zuuren EJ, Schoones J. Botulinum toxin for masseter hypertrophy. Cochrane Database Syst Rev. 2013 Sep 9;2013(9):CD007510. doi: 10.1002/14651858.CD007510.pub3.
citation: Ariji Y, Sakuma S, Izumi M, Sasaki J, Kurita K, Ogi N, Nojiri M, Nakagawa M, Takenaka M, Katsuse S, Ariji E. Ultrasonographic features of the masseter muscle in female patients with temporomandibular disorder associated with myofascial pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004 Sep;98(3):337-41. doi: 10.1016/j.tripleo.2004.06.068.
citation: Gonzalez-Perez LM, Infante-Cossio P, Granados-Nunez M, Urresti-Lopez FJ, Lopez-Martos R, Ruiz-Canela-Mendez P. Deep dry needling of trigger points located in the lateral pterygoid muscle: Efficacy and safety of treatment for management of myofascial pain and temporomandibular dysfunction. Med Oral Patol Oral Cir Bucal. 2015 May 1;20(3):e326-33. doi: 10.4317/medoral.20384.
citation: Dunning J, Butts R, Mourad F, Young I, Flannagan S, Perreault T. Dry needling: a literature review with implications for clinical practice guidelines. Phys Ther Rev. 2014 Aug;19(4):252-265. doi: 10.1179/108331913X13844245102034.
citation: Diracoglu D, Vural M, Karan A, Aksoy C. Effectiveness of dry needling for the treatment of temporomandibular myofascial pain: a double-blind, randomized, placebo controlled study. J Back Musculoskelet Rehabil. 2012;25(4):285-90. doi: 10.3233/BMR-2012-0338.
citation: Turo D, Otto P, Hossain M, Gebreab T, Armstrong K, Rosenberger WF, Shao H, Shah JP, Gerber LH, Sikdar S. Novel Use of Ultrasound Elastography to Quantify Muscle Tissue Changes After Dry Needling of Myofascial Trigger Points in Patients With Chronic Myofascial Pain. J Ultrasound Med. 2015 Dec;34(12):2149-61. doi: 10.7863/ultra.14.08033. Epub 2015 Oct 21.
citation: Emshoff R, Bertram S, Rudisch A, Gassner R. The diagnostic value of ultrasonography to determine the temporomandibular joint disk position. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997 Dec;84(6):688-96. doi: 10.1016/s1079-2104(97)90374-7.
citation: Raadsheer MC, Van Eijden TM, Van Spronsen PH, Van Ginkel FC, Kiliaridis S, Prahl-Andersen B. A comparison of human masseter muscle thickness measured by ultrasonography and magnetic resonance imaging. Arch Oral Biol. 1994 Dec;39(12):1079-84. doi: 10.1016/0003-9969(94)90061-2.
citation: Cagnie B, Dewitte V, Barbe T, Timmermans F, Delrue N, Meeus M. Physiologic effects of dry needling. Curr Pain Headache Rep. 2013 Aug;17(8):348. doi: 10.1007/s11916-013-0348-5.
citation: Smith P, Mosscrop D, Davies S, Sloan P, Al-Ani Z. The efficacy of acupuncture in the treatment of temporomandibular joint myofascial pain: a randomised controlled trial. J Dent. 2007 Mar;35(3):259-67. doi: 10.1016/j.jdent.2006.09.004. Epub 2006 Nov 13.
citation: Hides J, Richardson C, Jull G, Davies S. Ultrasound imaging in rehabilitation. Aust J Physiother. 1995;41(3):187-93. doi: 10.1016/S0004-9514(14)60429-3.
citation: Hodges PW. Ultrasound imaging in rehabilitation: just a fad? J Orthop Sports Phys Ther. 2005 Jun;35(6):333-7. doi: 10.2519/jospt.2005.0106. No abstract available.
citation: Teyhen DS. Rehabilitative ultrasound imaging for assessment and treatment of musculoskeletal conditions. Man Ther. 2011 Feb;16(1):44-5. doi: 10.1016/j.math.2010.06.012. Epub 2010 Aug 1. No abstract available.
citation: Bubnov RV. The use of trigger point "dry" needling under ultrasound guidance for the treatment of myofascial pain (technological innovation and literature review). Lik Sprava. 2010 Jul-Sep;(5-6):56-64.