![]() Considerations Motion may be limited because of a problem within the joint, swelling of tissue around the joint, stiffness of the ligaments and muscles, or pain. Further studies should consider using standardised evaluations and better study designs to strengthen clinical relevance.Īrticular range of motion craniomandibular disorders facial pain musculoskeletal manipulations physical therapy modalities temporomandibular joint disorders. Limited range of motion is a term meaning that a joint or body part cannot move through its normal range of motion. In conclusion, there is widely varying evidence that MT improves pain, MMO and PPT in subjects with TMD signs and symptoms, depending on the technique. The methodological heterogeneity across trials protocols frequently contributed to decrease quality of evidence. There is moderate-to-high evidence that MT techniques protocols are effective. Upper cervical spine thrust manipulation or mobilisation techniques are more effective than control (low to high evidence), while thoracic manipulations are not. Myofascial release and massage techniques applied on the masticatory muscles are more effective than control (low to moderate evidence) but as effective as toxin botulinum injections (moderate evidence). Eight trials were included, seven of high methodological quality. Treatment effect size was calculated for pain, MMO and pressure pain threshold (PPT). People with pain in the muscles, ligaments, bones, or joints (see Introduction to the Biology of the Musculoskeletal System ) tend to consciously and unconsciously limit motion. Two authors independently extracted data, PEDro scale was used to assess risk of bias, and GRADE (Grading of Recommendations Assessment, Development and Evaluation) was applied to synthetise overall quality of the body of evidence. Movement may also be limited when motion causes pain. ![]() MEDLINE(®), Cochrane, Web of Science, SciELO and EMBASE(™) electronic databases were consulted, searching for randomised controlled trials applying MT for TMD compared to other intervention, no intervention or placebo. The aim of this systematic review is to synthetise evidence regarding the isolated effect of MT in improving maximum mouth opening (MMO) and pain in subjects with signs and symptoms of TMD. There is a lack of knowledge about the effectiveness of manual therapy (MT) on subjects with temporomandibular disorders (TMD). ![]()
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