Fernández-Carnero Josué, La Touche Roy, Ortega-Santiago Ricardo, Galan-del-Rio Fernando, Pesquera Jorge, Ge Hong-You, Fernández-de-Las-Peñas César
Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Esthesilogy Laboratory of Universidad Rey Juan Carlos, Spain.
J Orofac Pain. 2010 Winter;24(1):106-12.
To investigate the effects of dry needling over active trigger points (TrPs) in the masseter muscle in patients with temporomandibular disorders (TMD).
Twelve females, aged 20 to 41 years old (mean = 25, standard deviation +/- 6 years) diagnosed with myofascial TMD were recruited. Each patient attended two treatment sessions on two separate days and received one intervention assigned in a random fashion, at each visit: deep dry needling (experimental) or sham dry needling (placebo) at the most painful point on the masseter muscle TrP. Pressure pain threshold (PPT) over the masseter muscle TrP and the mandibular condyle and pain-free active jaw opening were assessed pre- and 5 minutes postintervention by an examiner blinded to the treatment allocation of the subject. A two-way repeated-measures analysis of variance (ANOVA) with intervention as the between-subjects variable and time as the within-subjects variable was used to examine the effects of the intervention.
The ANOVA detected a significant interaction between intervention and time for PPT levels in the masseter muscle (F = 62.5; P < .001) and condyle (F = 50.4; P < .001), and pain-free active mouth opening (F = 34.9; P < .001). Subjects showed greater improvements in all the outcomes when receiving the deep dry needling compared to the sham dry needling (P < .001).
The application of dry needling into active TrPs in the masseter muscle induced significant increases in PPT levels and maximal jaw opening when compared to the sham dry needling in patients with myofascial TMD.
探讨干针疗法对颞下颌关节紊乱病(TMD)患者咬肌激痛点(TrP)的影响。
招募12名年龄在20至41岁之间(平均25岁,标准差±6岁)、诊断为肌筋膜性TMD的女性患者。每位患者在两个不同的日子参加两次治疗,每次就诊时随机接受一种干预:在咬肌TrP最痛点进行深部干针治疗(实验组)或假干针治疗(安慰剂组)。由对受试者治疗分配不知情的检查者在干预前和干预后5分钟评估咬肌TrP和下颌髁突处的压痛阈值(PPT)以及无痛主动张口度。采用以干预为组间变量、时间为组内变量的双向重复测量方差分析(ANOVA)来检验干预效果。
ANOVA检测到咬肌PPT水平(F = 62.5;P <.001)、髁突PPT水平(F = 50.4;P <.001)以及无痛主动张口度(F = 34.9;P <.001)在干预和时间之间存在显著交互作用。与假干针治疗相比,接受深部干针治疗的受试者在所有结果上均有更大改善(P <.001)。
与假干针治疗相比,对肌筋膜性TMD患者的咬肌激痛点进行干针治疗可使PPT水平显著升高,并使最大张口度增加。