According to the International Association for the Study of Pain (IASP), the term temporomandibular disorder (TMD) regards a subgroup of orofacial pain, the symptoms of which include pain or ...discomfort in the temporomandibular joint, ears, masticatory muscles and neck on one or both sides, as well as joint sounds, limited mandibular movements or mandibular deviation and difficulties chewing. Phototherapy, such as low-level laser therapy (LLLT) and light-emitting diode (LED) therapy, is one of the resources used to treatment muscle pain. Thus, there is a need to investigate therapeutic resources that combine different wavelengths as well as different light sources (LLLT and LED) in the same apparatus. The aim of the proposed study is to evaluate the effects of four different doses of phototherapy on pain, activity of the masticatory muscles (masseter and bilateral anterior temporal) and joint mobility in individuals with temporomandibular disorder. A further aim is to determine the cumulative effect 24 and 48 hours after a single session.
A placebo-controlled, double-blind, randomized, clinical trial will be carried out involving 72 women between 18 and 40 years of age with a diagnosis of myogenous TMD. The participants will then be randomly allocated to four groups totaling 18 individuals per group. Three groups will be submitted to a single session of phototherapy with different light sources, and one group will receive placebo therapy: Group A (2.62 Joules); Group B (5.24 Joules); Group C (7.86 Joules); and Group D (0 Joules). The following assessment tools will be administered on four separate occasions (baseline and immediately after, 24 h after and 48 h after phototherapy). Pain intensity will be assessed using the visual analog scale for pain, while pain thresholds will be determined using algometer, and electromyographic (EMG) analysis on the masseter and anterior temporal muscles.
The study will contribute to the practice of the evidence-based use of phototherapy in individuals with a myogenous TMD. Data will be published after the study is completed.
This study is registered with the Brazilian Registry of Clinical Trials, NCT02018770, date of registration: 7 December 2013.
The aim of the present study was to evaluate the effect of intraoral photobiomodulation involving super-pulsed laser (905 nm) combined with red (640 nm) and infrared (875 nm) light-emitting diodes on ...pain, mandibular range of motion, and functioning in women with myogenous temporomandibular disorder. A randomized, sham-controlled, double-blind clinical trial was conducted involving 30 women with myogenous temporomandibular disorder diagnosed using the Research Diagnostic Criteria for Temporomandibular Disorders. The participants were randomly allocated to two groups (active and sham photobiomodulation). The evaluations involved this use of the visual analog scale, digital calipers, and a functional scale. Photobiomodulation was administered intraorally in the region of the pterygoid muscles, bilaterally, in all participants for a total of six sessions. Evaluations were performed on five occasions: prior to the intervention, immediately after the first session, 24 h and 48 h after the first session, and after the six sessions. Significant differences between groups were found regarding pain (
p
≤ 0.01) and functioning (
p
≤ 0.04). However, no statistically significant difference was found regarding range of mandibular motion. The findings demonstrate that intraoral photobiomodulation involving super-pulsed laser (905 nm) combined with red (640 nm) and infrared (875 nm) light-emitting diodes diminishes pain and improves functioning but does not exert an influence on mandibular range of motion in women with temporomandibular disorder.
Trial registration: NCT02839967
Kinesio taping consists of the attachment of a thin elastic tape over specific muscles, the thickness of which is similar to that of the epidermis.
The aim of the present study was to compare the ...effect of Kinesio taping and placebo taping on muscle torque, muscle activity and jumping performance soccer players.
Thirty athletes were randomly allocated to two groups (Group A: Kinesio taping and Group B: placebo taping). The participants were instructed to perform the Hop test's and were submitted to an isokinetic evaluation of the knee extensors as well as an electromyographic evaluation of the retus femoris muscle of the dominant lower limb. Next, Kinesio taping was performed for the activation of the rectus femoris muscle in Group A and placebo taping was performed in Group B. The participants were reevaluated 30 minutes after taping and 24 hours after the first evaluation using the same tests. Intra-group and inter-group comparisons were made considering the three evaluation times.
No statistically significant differences were found between groups at any evaluation time regarding the Hop test's, root mean square of the electromyographic signal or peak torque of the knee extensors of the dominant lower limb (p>0.05).
Kinesio taping for the activation of the rectus femoris muscle has no effect on peak muscle torque, muscle activity or jumping performance among soccer players.
Background: Low back pain is one of the most common musculoskeletal problems among workers. Studies estimate that 90% of the adults will suffer at least one episode of low back pain in life that will ...lead to the temporary interruption of work. A type of exercise that has gained increasing popularity among individuals with low back pain in the last decade is the Pilates method. Objective: Determine the influence of the Pilates method on improvements in pain, kinesiophobia, central sensitization and function in patients with chronic nonspecific low back pain. Methods: Thirty-four male and female volunteers between 18 and 35 years of age with a complaint of nonspecific low back pain for at least three months will be divided into two groups: Pilates method and control group. An evaluation chart created by the authors will be used to collect data on personal information, history of diseases, alcohol use, smoking, pain intensity (visual analog scale) and medications used. The Tampa Scale for Kinesiophobia, Central Sensitization Questionnaire and Oswestry Disability Index will also be administered. Pilates exercises will be performed three time per week for four weeks and administered by a researcher with adequate training in the method. Reevaluations will be performed after the sixth treatment session in the Pilates group, two weeks after the initial evaluation in the control group, after the 12th session in the Pilates group and after four weeks in the control group. Another reevaluation will be performed three months after treatment. Results: The data will be submitted to statistical analysis and the level of significance will be set to 5%. Conclusion: Based on the results analyzed it will be possible to determine the influence of Pilates Method on improvements in pain, kinesiophobia, central sensitization and function in patients with chronic nonspecific low back pain.
To summarize and update the current knowledge on the effectiveness of hippotherapy on postural control in children with cerebral palsy.
Using a systematic review methodology, the electronic databases ...PubMed, Virtual Health Library, PEDro, Scielo, Embase, and Web of Science were searched for eligible articles from 2011 up to September 2021. Quality assessment of eligible studies was performed using the PEDro scale.
There were 239 identified studies. Eight clinical trials were selected. The total sample consisted of 264 individuals, with 134 allocated to the experimental group (hippotherapy) and 130 individuals to the control group (conventional therapy). Most studies had moderate to high methodological quality.
Hippotherapy can be an effective intervention to improve several aspects related to postural control, such as static balance (especially in the sitting posture), dynamic balance, and alignment (body posture) in children aged 3 to 16 years, particularly with spastic hemiplegia or diplegia.
This review summarizes studies that explore potential effects of hippotherapy on postural control in children with cerebral palsy.
Background: Photobiomodulation with low-level laser therapy (LLLT) has been widely used in clinical practice for diverse purposes, such as modulation of the inflammatory process, acceleration of the ...tissue repair process, pain relief and the enhancement of post-exercise recovery. Studies have demonstrated a beneficial interaction between photobiomodulation and the production of creatine kinase, with a reduction in the release of this marker of muscle damage when laser and/or LEDs is administered prior to high-intensity physical activity. Objective: The aim of the proposed study is to determine the influence of pre-exercise phototherapy on post-exercise muscle recovery. Methods: A randomized, cross-over, sham-controlled, double-blind, clinical trial is proposed. The participants will be healthy professional soccer players aged 15 to 20 years from the same team with a body mass index within the ideal range (20 to 25 kg/m2 ) and no history of lower limb musculoskeletal injuries or surgery or back surgery in the previous six months. The athletes will be allocated to two groups based on the previously calculated sample size and will be blinded to allocation. Creatine kinase will be measured and the subjective perception of fatigue will be determined for each participant. The volunteers will then be randomly allocated to Group A, which will receive active phototherapy, and Group B, which will receive sham phototherapy. The athletes will undergo reevaluations immediately after as well as 48 hours after a football match. The data will be submitted to statistical analysis and the level of significance will be set to 5%. This study is registered with Clinical Trials under protocol number: NCT03416998.
Justificativa e Objetivos: O método Pilates consiste em um programa de exercícios que integra o corpo e a mente através do condicionamento físico, visando ampliar a capacidade de movimentos e assim ...aumentar o controle, equilíbrio muscular, força e a consciência corporal, trabalhando o corpo como um todo, sendo muito procurado por pessoas que procuram prevenir ou reabilitar a dor lombar inespecífica crônica. Este estudo teve como objetivo avaliar a influência do método Pilates em pacientes com lombalgia inespecífica crônica. Conteúdo: Foi realizado uma revisão sistemática, com busca nas principais bases de dados relacionadas a área da saúde: PubMed, PEDro, Scielo, Embase, Biblioteca Virtual da Saúde (BVS) e Web of Science, no idioma de português e inglês, utilizando descritores que atendessem a pergunta da investigação. Os critérios de seleção com base na estratégia PICO foram: população - adultos 18-65 anos com lombalgia crônica inespecífica; intervenção - método Pilates; comparação – grupo controle; desfechos – melhora da dor. Após a busca, foram selecionados 15 artigos do tipo ensaio clinico, do período de 2006 a 2021. Conclusão: A presente revisão sistemática conclui que o método Pilates influencia positivamente na incapacidade funcional, flexibilidade, cinesiofobia e nível de saúde geral, estando diretamente ligados a melhora da dor em pacientes com lombalgia inespecífica crônica e consequentemente, melhorando a qualidade de vida dos mesmos a curto e médio prazo. Contudo, é necessário a realização de novos estudos para avaliar a influência do método Pilates em pacientes com lombalgia inespecífica crônica a longo prazo.
background and objectives: The Pilates method consists of an exercise program that integrates the body and mind through physical conditioning, aims to expand the capacity of movements and thus increase control, muscle balance, strength and body awareness, working the body as a whole, being highly sought after by people looking to prevent or rehabilitate chronic nonspecific low back pain. This study aims to evaluate the influence of the Pilates method in patients with chronic nonspecific low back pain. Contents: A systematic review was carried out, with a search in the main databases related to the health area: PubMed, PEDro, Scielo, Embase, Biblioteca Virtual da Saúde (BVS) e Web of Science, in Portuguese and English, using descriptors that meet the research question. Selection criteria based on strategy PICO: adults 18-65 years with non-specific chronic low back pain; intervention - Pilates method; comparison – control group; outcomes – improvement of pain. After the search, 15 articles of the clinical trial type from 2006 to 2021 Conclusion: The present systematic review concludes that the Pilates method positively influences functional disability, flexibility, kinesiophobia and general health level, being directly linked to pain improvement in patients with chronic nonspecific low back pain and, consequently, improving their quality of life at short and medium term. However, further studies it's needed to assess the influence of the Pilates method in patients with long-term chronic nonspecific low back pain.
Objectives: 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).
Methods: 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.
Outcomes: 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.
Conclusions: 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.
The aim of the present study was to perform a systematic review of the literature on the effects of low-level laser therapy in the treatment of TMD, and to analyze the use of different assessment ...tools. Subjects and Methods Searches were carried out of the BIREME, MEDLINE, PubMed and SciELO electronic databases by two independent researchers for papers published in English and Portuguese using the terms: “temporomandibular joint laser therapy” and “TMJ laser treatment”. Results Following the application of the eligibility criteria, 11 papers were selected for in-depth analysis. The papers analyzed exhibited considerable methodological differences, especially with regard to the number of sessions, anatomic site and duration of low-level laser therapy irradiation, as well as irradiation parameters, diagnostic criteria and assessment tools. Conclusion Further studies are needed, especially randomized clinical trials, to establish the exact dose and ideal parameters for low-level laser therapy and define the best assessment tools in this promising field of research that may benefit individuals with signs and symptoms of TMD.
The aim of the present study was to evaluate the effect of intraoral photobiomodulation involving super-pulsed laser (905 nm) combined with red (640 nm) and infrared (875 nm) light-emitting diodes on ...pain, mandibular range of motion, and functioning in women with myogenous temporomandibular disorder. A randomized, sham-controlled, double-blind clinical trial was conducted involving 30 women with myogenous temporomandibular disorder diagnosed using the Research Diagnostic Criteria for Temporomandibular Disorders. The participants were randomly allocated to two groups (active and sham photobiomodulation). The evaluations involved this use of the visual analog scale, digital calipers, and a functional scale. Photobiomodulation was administered intraorally in the region of the pterygoid muscles, bilaterally, in all participants for a total of six sessions. Evaluations were performed on five occasions: prior to the intervention, immediately after the first session, 24 h and 48 h after the first session, and after the six sessions. Significant differences between groups were found regarding pain (p ≤ 0.01) and functioning (p ≤ 0.04). However, no statistically significant difference was found regarding range of mandibular motion. The findings demonstrate that intraoral photobiomodulation involving super-pulsed laser (905 nm) combined with red (640 nm) and infrared (875 nm) light-emitting diodes diminishes pain and improves functioning but does not exert an influence on mandibular range of motion in women with temporomandibular disorder.Trial registration: NCT02839967
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