Blasco-Bonora Paloma María, Martín-Pintado-Zugasti Aitor
Private Practice, Physical Therapy, Valencia, Spain.
Department of Nursery and Physical Therapy, Faculty of Medicine, CEU-San Pablo University, Madrid, Spain.
Acupunct Med. 2017 Mar;35(1):69-74. doi: 10.1136/acupmed-2016-011102. Epub 2016 Oct 3.
To investigate the effects of deep dry needling (DN) of myofascial trigger points (MTrPs) of the masseter and temporalis on pain, pressure pain threshold (PPT), pain-free maximal jaw opening and temporomandibular disorder (TMD)-related disability in patients with sleep bruxism (SB) and myofascial TMD.
Seventeen subjects (11 women, 6 men) aged 39±13 years (range 23-66) diagnosed with SB and myofascial TMD were invited to participate in this prospective case series study. Each subject received a deep DN intervention in the masseter and temporalis MTrPs. Pain intensity, PPT, pain-free maximal jaw opening and TMD-related disability were assessed before treatment, immediately after treatment and at 1-week follow-up. Jaw disability was assessed using the jaw disability checklist (JDC) at baseline and 1 week post-treatment only.
One-way analyses of variance showed significant improvements in pain intensity, PPT and jaw opening (p<0.001). Post-hoc analysis revealed significant differences between baseline and post-intervention follow-up time points in pain (immediate: Cohen's d=1.72, p<0.001; 1 week: d=3.24, p<0.001), jaw opening (immediate: d=0.77, p<0.001; 1 week: d=1.02, p<0.001) and PPT in the masseter (immediate: d=1.02, p<0.001; 1 week: d=1.64, p<0.001) and temporalis (immediate: d=0.91, p=0.006; 1 week: d=1.8, p<0.001). A dependent t-test showed a significant improvement in jaw functioning, reflected by a large reduction in 1-week JDC scores relative to baseline (d=3.15, p<0.001).
Deep DN of active MTrPs in the masseter and temporalis in patients with myofascial TMD and SB was associated with immediate and 1-week improvements in pain, sensitivity, jaw opening and TMD-related disability.
NCT02587182; Results.
探讨对磨牙症(SB)和肌筋膜性颞下颌关节紊乱病(TMD)患者的咬肌和颞肌肌筋膜触发点(MTrP)进行深部干针疗法(DN)对疼痛、压痛阈(PPT)、无痛最大张口度和颞下颌关节紊乱病(TMD)相关功能障碍的影响。
邀请17名年龄39±13岁(范围23 - 66岁)、诊断为SB和肌筋膜性TMD的受试者(11名女性,6名男性)参与这项前瞻性病例系列研究。每位受试者均接受咬肌和颞肌MTrP的深部DN干预。在治疗前、治疗后即刻和1周随访时评估疼痛强度、PPT、无痛最大张口度和TMD相关功能障碍。仅在基线和治疗后1周使用下颌功能障碍检查表(JDC)评估下颌功能障碍。
单因素方差分析显示疼痛强度、PPT和张口度有显著改善(p<0.001)。事后分析显示,在疼痛方面(即刻:Cohen's d = 1.72,p<0.001;1周:d = 3.24,p<0.001)、张口度方面(即刻:d = 0.77,p<0.001;1周:d = 1.02,p<0.001)以及咬肌的PPT方面(即刻:d = 1.02,p<0.001;1周:d = 1.64,p<0.001)和颞肌的PPT方面(即刻:d = 0.91,p = 0.006;1周:d = 1.8,p<0.001),基线与干预后随访时间点之间存在显著差异。相关样本t检验显示下颌功能有显著改善,表现为1周JDC评分相对于基线大幅降低(d = 3.15,p<0.001)。
对肌筋膜性TMD和SB患者的咬肌和颞肌中的活跃MTrP进行深部DN,与疼痛、敏感性、张口度和TMD相关功能障碍在即刻和1周时的改善相关。
NCT02587182;结果