Herpich Carolina Marciela, Leal-Junior Ernesto Cesar Pinto, Gomes Cid Andre Fidelis de Paula, Gloria Igor Phillip Dos Santos, Amaral Ana Paula, Amaral Maitê de Freitas de Rocha Souza, Politti Fabiano, Biasotto-Gonzalez Daniela Aparecida
a Postgraduate Program in Rehabilitation Sciences, Center for Support to Research on Movement Analysis , University Nove de Julho (UNINOVE) , São Paulo , Brazil.
b Department of Physical Therapy , University Nove de Julho (UNINOVE) , São Paulo , Brazil.
Disabil Rehabil. 2018 Sep;40(19):2318-2324. doi: 10.1080/09638288.2017.1336648. Epub 2017 Jun 11.
The aim of the present study was to evaluate the immediate and short-term effects of phototherapy on pain intensity, the pressure pain threshold (PPT), maximum vertical mandibular movement, and the electrical activity of the masseter and temporal muscles in women with temporomandibular disorder (TMD).
Sixty women were randomly allocated to four different groups and submitted to phototherapy with a combination of super-pulsed laser (905 nm), red (640 nm), and infrared (875 nm) light emitting diodes in the same equipment on the masseter (three points) and temporal (two points) muscles bilaterally in a single session. The following doses were used in each point of application: Group 1 - 2.62 J; Group 2 - 5.24 J; Group 3 - 7.86 J; placebo group. Pain intensity was determined using the visual analog scale. The PPT was analyzed using a digital algometer. Vertical mandibular movement was measured using digital calipers. Myoelectrical activity of the masseter and temporal muscles was measured using electromyography. Four evaluations were performed: pre-intervention, immediately after, 24 and 48 hours after phototherapy.
A significant reduction in pain intensity during the post-treatment evaluations in comparison to the pretreatment evaluation was observed in group 1 (Median difference = 2.60 [95% CI = 1.35-3.85]) and group 2 (Median difference = 2.2 [95% CI = 0.98-3.42]) especially after 48 hours and group 3 (Median difference = 2.50 [95% CI: 0.56-4.46]) especially after 24 hours, with a moderate effect size, but no effect was found regarding the other variables.
A single session of combined phototherapy was capable of reducing pain intensity in individuals patients with TMD. ClinicalTrials.gov (NCT02018770). Implications for Rehabilitation Phototherapy device combining two light sources (LED and laser), and different densities in the same device is a novelty in the rehabilitation market, and has proved to be a useful intervention for people with temporomandibular disorders. This mode of phototherapy is another option that assists in the rapid intervention in pain symptoms, promoting a considerable degree of comfort to the patient moments after its application.
本研究旨在评估光疗对颞下颌关节紊乱症（TMD）女性患者疼痛强度、压痛阈（PPT）、下颌最大垂直运动以及咬肌和颞肌电活动的即时和短期影响。
60名女性被随机分为四组，在同一设备上使用超脉冲激光（905nm）、红色（640nm）和红外（875nm）发光二极管组合对双侧咬肌（三个点）和颞肌（两个点）进行单次光疗。每个照射点使用以下剂量：第1组 - 2.62焦耳；第2组 - 5.24焦耳；第3组 - 7.86焦耳；安慰剂组。使用视觉模拟量表确定疼痛强度。使用数字式压力痛觉计分析PPT。使用数字卡尺测量下颌垂直运动。使用肌电图测量咬肌和颞肌的肌电活动。进行了四次评估：干预前、光疗后即刻、光疗后24小时和48小时。
与治疗前评估相比，第1组（中位数差异 = 2.60 [95%置信区间 = 1.35 - 3.85]）和第2组（中位数差异 = 2.2 [95%置信区间 = 0.98 - 3.42]）在治疗后评估期间疼痛强度显著降低，尤其是在48小时后；第3组（中位数差异 = 2.50 [95%置信区间：0.56 - 4.46]）尤其是在24小时后，效应量中等，但在其他变量方面未发现影响。
单次联合光疗能够降低TMD个体患者的疼痛强度。ClinicalTrials.gov（NCT02018770）。康复意义 结合两种光源（发光二极管和激光）且同一设备具有不同密度的光疗设备在康复市场中是一种新颖的产品，并且已被证明对颞下颌关节紊乱症患者是一种有用的干预措施。这种光疗模式是另一种有助于快速干预疼痛症状的选择，在应用后即刻为患者带来相当程度的舒适感。
