Central Sensitisation, Endurance Training, Myofascial Pain Syndrome, Temporomandibular Disorder
Conditions
Brief summary
Temporomandibular disorders are common in the general population, the myogenic subtype being the most frequent. Central sensitization seems to be present in this pathology, with a decreased pain pressure threshold observed in both local and remote areas. The best evidence-based treatment consists in combining education, manual therapy and therapeutic exercise in both temporomandibular and cervical regions. Aerobic exercise showed to be effective in subjects with chronic pain and central sensitization, by inducing an hypoalgesic effect. However, there isn't investigation about the effects of aerobic exercise in subjects with myogenic temporomandibular disorders and central sensitization. Thus, the aim of the pilot study is to determine if adding aerobic exercise to an effective physical therapy programme is more effective than physical therapy alone to improve pain pressure threshold in subjects with myogenic temporomandibular disorders and suspicion of central sensitization.
Interventions
OTHERPhysical therapy combined with aerobic exercise
30 minutes of physical therapy with education, manual therapy and therapeutic exercise at both temporomandibular and cervical regions, combined with a 30 minutes aerobic exercise programme on a bike.
OTHERPhysical Therapy
30 minutes of physical therapy with education, manual therapy and therapeutic exercise at both temporomandibular and cervical regions (same programme than the intervention group)
Sponsors
Universitat Internacional de Catalunya
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Diagnosis of a myogenic temporomandibular disorder (DC/TMD) by an odontologist. * A minimum score of 30 in the Central Sensitization Index * Positive FRT
Exclusion criteria
* History of trauma, TMJ or cervical fracture the past three months * History of TMJ or cervical surgery * Systemic, rheumatic, metabolic, neurologic, psychiatric, pulmonary diseases or neoplastic malignant * History of cardiovascular diseases which contraindicate aerobic exercise * Current orthodontic treatment, splints for bruxism * Drug addiction, alcoholism * Pregnancy * Use of analgesic medication less than 48 hours before each data collection * Physical therapy treatment during the past three months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change of baseline in Pain Pressure Threshold at 2 weeks, 1 month (final) and 3 months (post) | Baseline - 2 weeks - 1 month (final) - 3 months | Bilateral measure with digital algometer: TMJ, masseter, temporal, SCOM, achilles Tendon |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change of baseline in Central Sensitization at 2 weeks, 1 month (final) and 3 months (post) | Baseline - 2 weeks - 1 month (final) - 3 months post | Central Sensitization Index: 25 items, from 0 to 100 (0-29=subclinic; 30-39=mild; 40-59=moderate; 60-100=extrem) |
| Change of baseline in Jaw function at 1 month (final) and 3 months (post) | Baseline - 1 month (final) - 3 months post | Fonseca Anamnestic Index. 10 questions with a three-point scale: 0 = no, 5 = sometimes and 10 = yes; total score from 0 good function, to 100 worst. |
| Change of baseline in Jaw range of motion al 1 month (final) and 3 months (post) | Baseline - 1 month (final) - 3 months posts | Millimeter metalic rule to assess opening, lateral and protrusion jaw range of motion |
| Change of baseline in Cervical global ROM at 1 month (final) and 3 months (post) | Baseline - 1 month (final) - 3 months post | CROM for global cervical range (flexion, extension, rotations, inclinations) |
| Change of baseline in Pain intensity at 2 weeks, 1 month (final) and 3 months (post) | Baseline - 2 weeks - 1 month (final) - 3 months posts | Visual Analog Scale: 100mm (no pain to worst pain) |
| Change of baseline in Neck disability at 1 month (final) and 3 months (post) | Baseline - 1 month (final) - 3 months posts | Neck Disability Index: from 0 to 50 (0-4= no disability; 5-14=mild; 15-24=moderate; 25-34=severe; 35-50=complete) |
| Change of baseline in Anxiety and depression at 1 month (final) and 3 months (post) | Baseline - 1 month (final) - 3 months posts | Hospital Anxiety and Depression Scale: 2 subscales, one for anxiety and the other one for depression. Each scale score is from 0 (less) to 21 (worst) |
| Change of baseline in Sleep Quality at 1 month (final) and 3 months (post) | Baseline - 1 month (final) - 3 months posts | Pittsburgh Sleep Quality Index: maximum score of 21; 5 being the cut-off point. |
| Change of baseline in Perceived change at 1 month (final) and 3 months (post) | Baseline - 1 month (final) - 3 months posts | Global Rating of Change scale: 15 points, from -7 (worst) to 7 (best) |
| Change of baseline in Upper cervical ROM at 2 weeks, 1 month (final) and 3 months (post) | Baseline - 2 weeks - 1 month (final) - 3 months posts | Assessment of upper cervical ROM performing the Flexion Rotation Test with a CROM device |
Countries
Spain
Contacts
Primary ContactFlora Dantony
Outcome results
None listed