Vpliv manualne terapije na zmanjšanje bolečine v čeljustnem sklepu - pregled literature : diplomsko delo

Pirnat, Jerneja (author), Hlebš, Sonja (mentor), Ipavec, Matej (co-mentor), Vauhnik, Renata (reviewer)

Uvod: Okvare čeljustnega sklepa zajemajo sklepne okvare, dislokacijo diska in mišične okvare žvečnih mišic in pripadajočih tkiv. Prevalenca okvar čeljustnega sklepa je med 5 % in 12 %. Najpogostejša simptoma okvar sta bolečina in omejeno gibanje v sklepu. Postopki manualne terapije, ki se pogosto uporabljajo pri zdravljenju okvar čeljustnega sklepa, so sklepna manipulacija in mobilizacija, mobilizacija mehkih tkiv ali terapija miofascialnih prožilnih točk. Namen: Namen diplomskega dela je analizirati objavljene znanstvene dokaze o učinkih manualne terapije na zmanjšanje bolečine in povečanje gibljivosti sklepa pri pacientih z okvarami čeljustnega sklepa. Metode dela: Iskanje literature je potekalo v podatkovnih bazah PubMed in PEDro z uporabo ključnih iskalnih kombinacij besednih zvez v angleškem jeziku: temporomandibular joint OR temporomandibular disorder AND manual therapy. Pri iskanju smo uporabili časovni okvir, in sicer od leta 2012 do 2022. Članki so bili ovrednoteni po PEDro lestvici. Rezultati: V pregled literature je bilo vključenih šest randomiziranih kontroliranih raziskav. V vseh raziskavah so bili manualni postopki izvajani na področju čeljustnega sklepa in pripadajočih mišic, vendar so se med seboj razlikovali. V štirih raziskavah so raziskovalci izvajali mobilizacijo mehkih tkiv, v dveh raziskavah so izvajali sklepno mobilizacijo, v eni sklepno manipulacijo in v dveh terapijo miofascialnih prožilnih točk. V štirih raziskavah so imeli uporabljeni manualni postopki pomembne učinke na zmanjšanje bolečine in povečanje obsega giba depresije spodnje čeljusti. Za ohranjanje rezultatov manualne terapije je pomembna edukacija pacienta. Razprava in zaključek: Pregled literature je pokazal, da so postopki manualne terapije ena od učinkovitih in ugodnih konservativnih možnosti za zmanjšanje bolečine in izboljšanje gibljivosti čeljustnega sklepa ter tako predstavljajo pomemben del multidisciplinarnega pristopa k zdravljenju okvar čeljustnega sklepa. Učinki manualnih postopkov se z izvajanjem vaj in edukacijo pacienta ohranijo tudi po koncu terapije. Za določitev učinkovitega protokola zdravljenja bi bilo potrebno nadaljnje izvajanje raziskav.

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, čeljustne okvare, čeljustni sklep, manualna terapija, manipulacija, mobilizacija
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [J. Pirnat]
• Year: 2023
• Number of pages: 30 str.
• PID: 20.500.12556/RUL-149094
• UDC: 615.8
• COBISS.SI-ID: 163183363
• Publication date in RUL: 03.09.2023

Secondary language

• Language: English
• Title: Effects of manual therapy on pain in temporomandibular joint - literature review : diploma work

Abstract

Introduction: Temporomandibular disorders include arthrogenic disorders, disc dislocation and myogenic disorders around the temporomandibular joint, masticatory muscles, and associated tissues. The prevalence of temporomandibular disorders is between 5% and 12%. Most common symptoms of disorders are pain and limited joint movement. Manual therapy techniques are often used for treatment of temporomandibular disorders, most commonly joint manipulation and mobilization, soft tissue mobilization or myofascial trigger point therapy. Purpose: The purpose of this literature review is to analyse published scientific evidence on the effects of manual therapy on pain and limited joint movement in patients with temporomandibular disorders. Methods: The literature search was conducted in the PubMed and PEDro databases using key search combinations of phrases in English: temporomandibular joint OR temporomandibular disorder AND manual therapy. We used the time frame from 2012 to 2022. Articles were evaluated according to the PEDro scale. Results: Six randomized control trials were included in the literature review. In all the studies, manual techniques were performed on the temporomandibular joint and associated muscles, but different techniques were used. Soft tissue mobilization was performed in four studies, joint mobilization in two studies, joint manipulation in one study, and myofascial trigger point therapy in two studies. In four studies, manual therapy had a significant effect on reducing pain and increasing the range of motion of jaw depression. Discussion and conclusion: This literature review showed that manual therapy is one of the effective and conservative options for reducing pain and improving joint mobility of temporomandibular joint, thus an important part of a multidisciplinary approach for treatment of temporomandibular disorders. Positive effects of manual therapy are maintained in combination with therapeutic exercises and education. Further research is needed to determine an effective treatment protocol.

• Keywords: diploma theses, physiotherapy, temporomandibular disorders, temporomandibular joint, manual therapy, manipulation, mobilization