Effects of Therapeutic and Aerobic Exercise Programs on Pain, Neuromuscular Activation, and Bite Force in Patients with Temporomandibular Disorders

Abstract

Pain in masticatory muscles is one of the most frequent symptoms in patients with temporomandibular disorders (TMD) and can lead to changes in the patterns of neuromuscular activity of masticatory muscles and decrease in bite force. This study assesses the effects of three eight-week exercise programs on pain intensity, neuromuscular activation, and bite force of masticatory muscles in patients with TMD. Forty-five patients were divided into three groups: a therapeutic exercise program (G1), a therapeutic and aerobic exercise program (G2), and an aerobic exercise program (G3). The masticatory muscles’ pain was evaluated using the numeric pain rating scale (NPRS), surface electromyographic (sEMG) activity of the masseter was recorded during maximum voluntary contraction and at rest, and bite force was evaluated using a dynamometer. These parameters were evaluated twice at baseline (A01/A02), at the end of the eight-week intervention period (A1), and 8–12 weeks after the end of the intervention (A2). After intervention, G2 showed the best results, with a significantly decrease in masticatory muscles’ pain and increase in bite force. These results suggest that interventions to reduce pain in patients with TMD should be multimodal.

Effect of daily treadmill running exercise on masseter muscle nociception associated with social defeat stress in mice

“…Due to the multidimensional etiology of TMD, multidisciplinary approaches, including exercise, are expected for managing chronic pain in deep craniofacial tissues [1][2][3][4]. Biopsychosocial approaches are important for managing painful TMD, which can be affected by physical activity and exercise [27][28][29]. Furthermore, in one study, the prevalence of TMD symptoms was higher among those who exercised less frequently than weekly [30].…”

Efficacy of Aerobic Exercise on Widespread Pain Sensitization in Patients with Temporomandibular Disorders: A Preliminary Randomized Controlled Study

“…The exclusion criteria were as follows: a history of trauma; fracture in the temporomandibular joint or cervical spine within the last 3 months; previous surgery on the temporomandibular joint or cervical spine; active systemic, rheumatic, metabolic, neurological, psychiatric, pulmonary, or malignant neoplastic disease [15][16][17]; history of cardiovascular disease contraindicating moderate-intensity AE; wearing orthodontic braces, bruxism splints; substance addiction, alcoholism; pregnancy; having taken analgesic or muscle relaxant medication within 48 h before each data collection; and having received PT treatment for this condition within the last 3 months [26][27][28].…”

“…To avoid altering the heart rate (HR) value when prescribing the AE, the room temperature was set at 21 • C with a maximum humidity of 50%, and participants were advised not to have a large meal before the session. The program was based on the studies by Molherino Alves et al [26][27][28], which complied with the recommendations from a systematic review [10] regarding the required intensities to expect pain-related effects. The seat height was adjusted for each participant, and the training was divided as follows: a.…”

Silencing of TRPV4-expressing sensory neurons attenuates temporomandibular disorders pain

“…[3][4][5] A wealth of evidence demonstrates that TMD patients have significantly lower bite strength compared with healthy controls, which can be regarded as functional masticatory pain in clinics. [6][7][8][9][10] Detailed understanding of the mechanisms underlying TMD pain is still absent.…”