Učinki manualne terapije na težave v čeljustnem sklepu – pregled literature : diplomsko delo

Colja, Evelin (author), Hlebš, Sonja (mentor)

Uvod: Okvare čeljustnega sklepa so podskupina orofacialnih bolečin, ki lahko izvirajo iz žvečnih mišic, čeljustnega sklepa in z njimi povezanih struktur, kot sta glava in vrat. Prizadenejo od 5 do 12 % populacije. Pri konzervativni obravnavi se poleg drugih fizioterapevtskih postopkov izvajajo različne manualne tehnike na čeljustnem sklepu in povezanih strukturah. Namen: Predstaviti učinkovitost manualnih postopkov na vratni hrbtenici pri okvarah čeljustnega sklepa. Metode dela: Pregledane so bile podatkovne zbirke PEDro, PubMed, CINAHL in Springer Link z uporabo naslednjih ključnih besed in njihovih kombinacij v angleškem jeziku: (temporomandibular disorder [Title/Abstract]) OR (temporomandibular joint [Title/Abstract]) AND (cervical spine manipulation [Title/Abstract]) OR (manual therapy [Title/Abstract]). Rezultati: V pregled literature je bilo na podlagi vključitvenih kriterijev izbranih šest randomiziranih kontroliranih raziskav, poleg tega smo vključili tudi dve randomizirani kontrolirani raziskavi, v katerih so izvajali manipulacijo prsne hrbtenice. V šestih raziskavah so preučevali učinek mobilizacije ali manipulacije na obseg giba odpiranja ust v čeljustnem sklepu, v treh bolečino in v petih vrednost bolečinskih dražljajev na pritisk v čeljustnem sklepu. Poleg tega so ocenjevali še učinek na EMG aktivnost žvečnih mišic v dveh raziskavah, na simpatični živčni sistem v eni in na kvaliteto življenja v eni. Rezultati so pokazali, da tehnike mobilizacije in manipulacije na vratni hrbtenici statistično značilno (p = < 0,05) povečajo sklepno gibljivost čeljustnega sklepa, zmanjšajo bolečino in povečajo vrednosti bolečinskih dražljajev na pritisk. Vplivajo tudi na EMG aktivnost žvečnih mišic, na simpatični živčni sistem z zvišanjem prevodnosti kože, srčne frekvence in frekvence dihanja ter povišajo kakovost življenja. Razprava in zaključek: Pri uporabi manualnih tehnik na zgornji vratni hrbtenici oziroma na segmentu zgornje vratne hrbtenice s prisotno okvaro je prišlo do izboljšanja simptomov, medtem ko te niso bile učinkovite pri izvedbi na prsni hrbtenici. V nadaljnjih raziskavah bi bilo potrebno določiti najustreznejši postopek in raziskati tudi dolgoročne učinke manualnih intervencij na vratni hrbtenici na okvaro čeljustnega sklepa.

• Language: Slovenian
• Keywords: okvara čeljustnega sklepa, vratna hrbtenica, manipulacija, mobilizacija
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2019
• PID: 20.500.12556/RUL-111515
• COBISS.SI-ID: 5703019
• Publication date in RUL: 02.10.2019

Secondary language

• Language: English
• Title: Effects of manual therapy on temporomandibular disorders – literature review : diploma work

Abstract

Introduction: Temporomandibular disorders are a subgroup of orofacial pain affecting muscles of mastication, temporomandibular joint and associated structures like head and neck. They affect from 5 to 12 % of population. In addition to different physiotherapeutic treatments the conservative treatment includes manual therapy techniques on the temporomandibular joint and associated structures. Purpose: To review relevant literature and present the effectiveness of manual therapy on the cervical spine in people with temporomandibular disorders. Methods: Database search included PEDro, PubMed, CINAHL and Springer Link databases with the following key words and their combinations: (temporomandibular disorder [Title/Abstract]) OR (temporomandibular joint [Title/Abstract]) AND (cervical spine manipulation [Title/Abstract]) OR (manual therapy [Title/Abstract]). Results: Six randomized controlled trials were included in the review based on the set criteria. We also included two randomized controlled trials with the intervention directed to the thoracic spine. In six trials they evaluated the effects on the range of motion of mouth opening, in three trials the effect on pain and in five trials the effects on pressure pain threshold regarding temporomandibular joint. In addition, an evaluation of EMG activity of the masticatory muscles was conducted in two trials, the effects on sympathetic nervous system in one trial and the quality of life in one trial. The results show mobilization and manipulation techniques cause statistically significant (p = < 0,05) improvement in range of motion of mouth opening, in pain and pressure pain threshold. They also positively affect EMG activity of masticatory muscles, sympathetic nervous system causing higher skin conductance, higher heart rate and breathing frequency and improve quality of life. Discussion and conclusion: The use of manual techniques on the upper cervical spine or for the segmental dysfunction of the upper cervical spine showed an improvement of symptoms whereas, manual techniques applied to the thoracic spine resulted in no changes. Further research should determine the most suitable procedure and explore the long-term effectiveness of manual techniques on the cervical spine in people with temporomandibular disorders.

• Keywords: temporomandibular disorder, cervical spine, manipulation, mobilization