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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
20
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.
30 minutes of physical therapy with education, manual therapy and therapeutic exercise at both temporomandibular and cervical regions (same programme than the intervention group)
Universitat Internacional de Catalunya
Sant Cugat del Vallès, Spain
RECRUITINGChange of baseline in Pain Pressure Threshold at 2 weeks, 1 month (final) and 3 months (post)
Bilateral measure with digital algometer: TMJ, masseter, temporal, SCOM, achilles Tendon
Time frame: Baseline - 2 weeks - 1 month (final) - 3 months
Change of baseline in Central Sensitization at 2 weeks, 1 month (final) and 3 months (post)
Central Sensitization Index: 25 items, from 0 to 100 (0-29=subclinic; 30-39=mild; 40-59=moderate; 60-100=extrem)
Time frame: Baseline - 2 weeks - 1 month (final) - 3 months post
Change of baseline in Pain intensity at 2 weeks, 1 month (final) and 3 months (post)
Visual Analog Scale: 100mm (no pain to worst pain)
Time frame: Baseline - 2 weeks - 1 month (final) - 3 months posts
Change of baseline in Jaw function at 1 month (final) and 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.
Time frame: Baseline - 1 month (final) - 3 months post
Change of baseline in Jaw range of motion al 1 month (final) and 3 months (post)
Millimeter metalic rule to assess opening, lateral and protrusion jaw range of motion
Time frame: Baseline - 1 month (final) - 3 months posts
Change of baseline in Cervical global ROM at 1 month (final) and 3 months (post)
CROM for global cervical range (flexion, extension, rotations, inclinations)
Time frame: Baseline - 1 month (final) - 3 months post
Change of baseline in Upper cervical ROM at 2 weeks, 1 month (final) and 3 months (post)
Assessment of upper cervical ROM performing the Flexion Rotation Test with a CROM device
Time frame: Baseline - 2 weeks - 1 month (final) - 3 months posts
Change of baseline in Neck disability at 1 month (final) and 3 months (post)
Neck Disability Index: from 0 to 50 (0-4= no disability; 5-14=mild; 15-24=moderate; 25-34=severe; 35-50=complete)
Time frame: Baseline - 1 month (final) - 3 months posts
Change of baseline in Anxiety and depression at 1 month (final) and 3 months (post)
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)
Time frame: Baseline - 1 month (final) - 3 months posts
Change of baseline in Sleep Quality at 1 month (final) and 3 months (post)
Pittsburgh Sleep Quality Index: maximum score of 21; 5 being the cut-off point.
Time frame: Baseline - 1 month (final) - 3 months posts
Change of baseline in Perceived change at 1 month (final) and 3 months (post)
Global Rating of Change scale: 15 points, from -7 (worst) to 7 (best)
Time frame: Baseline - 1 month (final) - 3 months posts
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