Toledo Physiotherapy Research Group (GIFTO). Departament of Nursing, Physiotherapy and Ocupational Therapy, Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain.
Toledo Physiotherapy Research Group (GIFTO). Departament of Nursing, Physiotherapy and Ocupational Therapy, Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain.
J Pain. 2023 Jun;24(6):946-956. doi: 10.1016/j.jpain.2023.01.016. Epub 2023 Feb 18.
Temporomandibular disorders comprise a set of conditions that include alterations of the temporomandibular joint and masticatory muscles. Although different modalities of electric currents are widely used for treating temporomandibular disorders, previous reviews have suggested these are ineffective. This systematic review and meta-analysis aimed to determine the effectiveness of different electrical stimulation modalities in patients with temporomandibular disorders for reducing musculoskeletal pain, increasing the range of movement, and improving muscle activity. An electronic search was conducted of randomized controlled trials published until March of 2022 that compared the application of an electrical stimulation therapy versus a sham or control group. The main outcome measure was pain intensity. Seven studies were included in the qualitative analysis and in the quantitative analysis (n = 184 subjects). The overall effect of electrical stimulation on pain reduction was statistically superior to sham/control (MD = -1.12 cm; CI 95%: -1.5 to -0.8), showing moderate heterogeneity of results (I = 57%, P = .04). The overall effect on range of movement of the joint (MD = 0.97 mm; CI 95%: -0.3 to 2.2) and muscle activity (SMD = -2.9; CI 95%: -8.1 to 2.3) were not significant. Transcutaneous electrical nerve stimulation (TENS) and high-voltage current stimulation reduces pain intensity clinically in people with temporomandibular disorders with a moderate quality of evidence. On the other hand, there is no evidence of the effect of different electrical stimulation modalities on range of movement and muscle activity in people with temporomandibular disorders with a moderate and low quality of evidence respectively. PERSPECTIVE: TENS and high voltage currents are valid options for the control of pain intensity in patients suffering from temporomandibular disorder. Data suggest clinically relevant changes compared to sham. Healthcare professionals should take this into account as it is inexpensive therapy, has no adverse effects and can be self-administered by patients.
颞下颌关节紊乱症包括一组病症，包括颞下颌关节和咀嚼肌的改变。尽管不同类型的电流广泛用于治疗颞下颌关节紊乱症，但之前的综述表明这些方法无效。本系统评价和荟萃分析旨在确定不同电刺激模式在治疗颞下颌关节紊乱症患者中的有效性，以减轻肌肉骨骼疼痛、增加运动范围和改善肌肉活动。对截至 2022 年 3 月发表的比较电刺激治疗与假治疗或对照组的随机对照试验进行了电子检索。主要结局指标为疼痛强度。有 7 项研究被纳入定性分析和定量分析（n=184 名受试者）。电刺激对疼痛减轻的总体效果明显优于假治疗/对照组（MD=-1.12cm；CI95%：-1.5 至-0.8），结果存在中等程度的异质性（I=57%，P=0.04）。对关节运动范围的总体影响（MD=0.97mm；CI95%：-0.3 至 2.2）和肌肉活动（SMD=-2.9；CI95%：-8.1 至 2.3）均无显著差异。经皮神经电刺激（TENS）和高压电流刺激可降低颞下颌关节紊乱症患者的疼痛强度，具有中等质量的证据。另一方面，对于颞下颌关节紊乱症患者，不同电刺激模式对运动范围和肌肉活动的影响，分别具有中等和低质量的证据，没有效果。观点：TENS 和高压电流是治疗颞下颌关节紊乱症患者疼痛强度的有效选择。与假治疗相比，数据表明有临床相关的变化。医疗保健专业人员应考虑到这一点，因为它是一种廉价的治疗方法，没有不良反应，并且可以由患者自行进行。
