Temporomandibular disorders. Part 2: conservative management

Shaffer, Stephen M.; Brismée, Jean Michel; Sizer, Phillip S.; Courtney, Carol A.

doi:10.1179/2042618613y.0000000061

Cited by 60 publications

(76 citation statements)

References 75 publications

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“…29 Additionally, considerable evidence does exist in favor of utilizing physical therapy for the management of TMD. 30,31 Physical therapists, therefore, are positioned well compared to their contemporary healthcare counterparts to provide comprehensive, conservative, musculoskeletal management for patients with TMD. Despite these general trends, clinical practice demonstrates that most physical therapists do not provide services to patients with TMD.…”

Section: Introductionmentioning

confidence: 99%

The status of temporomandibular and cervical spine education in credentialed orthopedic manual physical therapy fellowship programs: a comparison of didactic and clinical education exposure

Shaffer

Brismée

Courtney

et al. 2014

Journal of Manual & Manipulative Therapy

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Objective: The purpose of this investigation was to establish a baseline of physical therapist education on temporomandibular disorders (TMD)-related topics during credentialed orthopedic manual physical therapy fellowship training and compare it to cervical spine disorders education. Method: An online survey was distributed electronically to each fellowship program credentialed by the American Physical Therapy Association (APTA) and recognized by the Academy of Orthopedic Manual Physical Therapists (AAOMPT). Data were analyzed to compare overall exposure to TMD educational content, including a direct comparison of TMD and cervical spine disorders education. Results: The response rate was 79%. Thirteen programs (87%) reported providing both didactic and clinical training on both TMD and cervical spine disorders. Didactic education for cervical spine disorders ranged from 16-20 hours to over 25 hours, whereas TMD hours ranged from 0 to 6-10 hours. Clinical education for cervical spine disorders ranged from 11-15 hours to over 25 hours, whereas TMD hours ranged from 0 to 6-10 hours. The number of hours of exposure during didactic training and the number of patients exposed to during clinical training were significantly different when comparing TMD to cervical spine disorders exposure (P,0.0001). Discussion: The data indicate a lack of uniformity between credentialed fellowship programs in orthopedic manual physical therapy with respect to the extent to which programs expose trainees to evaluation and management of TMD. There is consistency in that all programs provided more training on cervical spine disorders than TMD. Despite a high level of clinical specialization, fellows-in-training receive minimal TMD education.

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Section: Introductionmentioning

confidence: 99%

The status of temporomandibular and cervical spine education in credentialed orthopedic manual physical therapy fellowship programs: a comparison of didactic and clinical education exposure

Shaffer

Brismée

Courtney

et al. 2014

Journal of Manual & Manipulative Therapy

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“…[30] A variety of biofeedback techniques has been put into practice including: Muscle tension discrimination to increase the perception of contractions, training progressively lower levels of muscle tension to obtain maximal relaxation, deactivation training to promote rapid recovery from contraction, and home practice to ensure carrying out of the day to day activities. [32] …”

Section: Tmdmentioning

confidence: 99%

The management of temporomandibular disorder using occlusal splint therapy and bio-behavioral therapy

Nayak¹

2016

JCRI

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Temporomandibular disorder (TMD) is a collective term that includes a number of clinical complaints involving the muscles of mastication, the temporomandibular joint, and associated orofacial structures. Diagnosing orofacial pain can be quite difficult as patients may have multiple pain complaints and often present with a confusing constellation of signs and symptoms. Management of TMD is based on certain basic principles that include the formulation of an accurate diagnosis, gradual escalation of therapy, restraining from irreversible forms of treatment and the psychophysiological aspects of the disease. A multidisciplinary model that includes patient awareness and self-care, cognitive behavioral intervention, occlusal splint therapy (OST) is endorsed for the management of most patients. The current article reviews the management of TMD by the OST and bio-behavioral therapies. KeywordsBio-behavioral therapy, occlusal splint therapy, temporomandibular disorder, temporomandibular joint Correspondence Dr.

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“…Conservative interventions for subjects with TMD including exercises, joint mobilisation, splints and combinations of some of these techniques are often applied as primary choice for care . Low to moderate level of evidence shows positive effects for improving symptoms of muscular TMD when using posture correction exercises for patients with myofascial pain .…”

Section: Introductionmentioning

confidence: 99%

“…6 Conservative interventions for subjects with TMD including exercises, joint mobilisation, splints and combinations of some of these techniques are often applied as primary choice for care. 7,8 Low to moderate level of evidence shows positive effects for improving symptoms of muscular TMD when using posture correction exercises for patients with myofascial pain. 9 There was also a trend to favour exercise therapy (general jaw exercises alone or combined with neck exercises in myogenous TMD) for pain free maximum opening and pain intensity when compared with a control group, with a moderate pooled effect size.…”

Section: Introductionmentioning

confidence: 99%

Effects of 8 weeks of masticatory muscles focused endurance exercises on women with oro‐facial pain and temporomandibular disorders: A placebo randomised controlled trial

Barbosa

Tahara

Ferreira

et al. 2019

J of Oral Rehabilitation

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Background Exercises are used to treat temporomandibular disorders (TMD), but they are often assessed with other therapies. Local endurance exercises may alter the resistance to fatigue and pain. Objective To assess the effects of an 8‐week protocol of local endurance exercises of masticatory muscles on muscle excitation, force response, perceived pain and over muscle efficiency. Design Randomised controlled trial. Setting Ambulatory care. Subjects In a placebo randomised controlled trial, 46 women with TMD and oro‐facial pain were randomised into intervention group and placebo group. The intervention group received a protocol of biting endurance exercises, controlled by biofeedback. The placebo group received a placebo (simulated laser therapy). Main Outcome Measures The primary outcomes were collected at baseline, 4 weeks and 8 weeks. Pain was assessed through visual analogue scale (VAS) and pressure pain thresholds (PPT). Bite force was collected by a load cell synchronised with surface electromyography of masticatory muscles, bilaterally. Results Pain scores decreased for both groups, but the intervention group showed lower values at 8 weeks. No differences were noted between groups for PPT, but the results increased for both overtime. Time until fatigue and muscle efficiency were higher in the intervention group vs placebo group in both within‐ and between‐subject analysis. Force increased from 4 to 8 weeks in the PG, without differences between groups. Temporal muscle excitation was higher on 8 weeks compared with baseline for the intervention group, without differences between groups. Conclusion Eight‐week exercise protocol of muscle endurance alleviates the pain and improves the resistance to fatigue and muscle efficiency in TMD subjects.

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Temporomandibular disorders. Part 2: conservative management

Cited by 60 publications

References 75 publications

The status of temporomandibular and cervical spine education in credentialed orthopedic manual physical therapy fellowship programs: a comparison of didactic and clinical education exposure

The status of temporomandibular and cervical spine education in credentialed orthopedic manual physical therapy fellowship programs: a comparison of didactic and clinical education exposure

The management of temporomandibular disorder using occlusal splint therapy and bio-behavioral therapy

Effects of 8 weeks of masticatory muscles focused endurance exercises on women with oro‐facial pain and temporomandibular disorders: A placebo randomised controlled trial

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