Navarro-Rico Cayetano, Fricke-Comellas Hermann, Heredia-Rizo Alberto M, Díaz-Mancha Juan Antonio, Rosado-Portillo Adolfo, Fernández-Seguín Lourdes M
Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, 41009 Sevilla, Spain.
Instituto de Biomedicina de Sevilla-IBiS, Hospitales Universitarios Virgen del Rocío y Macarena/Consejo Superior de Investigaciones Científicas (CSIC)/Universidad de Sevilla, 41013 Sevilla, Spain.
Dent J (Basel). 2025 Jul 16;13(7):325. doi: 10.3390/dj13070325.
: Bruxism has been associated with dysregulation of the autonomic nervous system (ANS). Visceral manual therapy (VMT) has shown beneficial effects on the vagal tone and modulation of ANS activity. This study aimed to evaluate the immediate and short-term effects of VMT in individuals with clinically based bruxism. : A single-blind randomized controlled trial was conducted including 24 individuals with clinically based bruxism. Participants received two sessions of either VMT or a sham placebo technique. Outcome measures included heart rate variability (HRV), both normal-to-normal intervals (HRV-SDNN), and the root mean square of successive normal-to-normal intervals (HRV-RMSSD), as well as muscle tone and stiffness and pressure pain thresholds (PPTs). Measurements were made at T1 (baseline), T2 (post-first intervention), T3 (pre-second intervention), T4 (post-second intervention), and T5 (4-week follow-up). : A significant time*group interaction was observed for HRV-SDNN ( = 0.04, η = 0.12). No significant changes were found for muscle tone or stiffness. PPTs significantly increased at C4 after the second session ( = 0.049, η = 0.16) and at the left temporalis muscle after the first session ( = 0.01, η = 0.07). : The findings suggest that two sessions of VMT may lead to significant improvements in HRV-SDNN compared to the placebo, suggesting a modulatory effect on autonomic function. No consistent changes were observed for the viscoelastic properties of the masticatory muscles. Isolated improvements in pressure pain sensitivity were found at C4 and the left temporalis muscle. Further research with larger sample sizes and long-term follow-up is needed to determine the clinical relevance of VMT in the management of signs and symptoms in individuals with bruxism.
磨牙症与自主神经系统（ANS）功能失调有关。内脏手法治疗（VMT）已显示出对迷走神经张力和ANS活动调节具有有益作用。本研究旨在评估VMT对临床型磨牙症患者的即时和短期影响。：进行了一项单盲随机对照试验，纳入24名临床型磨牙症患者。参与者接受了两次VMT治疗或假安慰剂技术治疗。结果测量指标包括心率变异性（HRV），即正常到正常间期（HRV-SDNN）以及连续正常到正常间期的均方根（HRV-RMSSD），还有肌张力、肌肉僵硬度和压力疼痛阈值（PPTs）。在T1（基线）、T2（首次干预后）、T3（第二次干预前）、T4（第二次干预后）和T5（4周随访）进行测量。：观察到HRV-SDNN存在显著的时间*组交互作用（=0.04，η=0.12）。肌张力或僵硬度未发现显著变化。第二次治疗后C4处的PPTs显著增加（=0.049，η=0.16），第一次治疗后左侧颞肌处的PPTs也显著增加（=0.01，η=0.07）。：研究结果表明，与安慰剂相比，两次VMT治疗可能会使HRV-SDNN有显著改善，提示对自主神经功能有调节作用。咀嚼肌的粘弹性特性未观察到一致变化。在C4和左侧颞肌处发现压力疼痛敏感性有孤立性改善。需要进行更大样本量和长期随访的进一步研究，以确定VMT在磨牙症患者体征和症状管理中的临床相关性。
