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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention Group | Experimental | Myogenous temporomandibular subjects Physical 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. |
|
| Control group | Active Comparator | Myogenous temporomandibular subjects Physical 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) |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Physical therapy combined with aerobic exercise | Other | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Change 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 | Baseline - 2 weeks - 1 month (final) - 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| 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) | 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) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Flora Dantony | Contact | +34601533951 | fdantony@uic.es |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Universitat Internacional de Catalunya | Recruiting | Sant Cugat del Vallès | Spain |
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| Physical Therapy | Other | 30 minutes of physical therapy with education, manual therapy and therapeutic exercise at both temporomandibular and cervical regions (same programme than the intervention group) |
|
Visual Analog Scale: 100mm (no pain to worst pain) |
| 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. | 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 | 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) | 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 | 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) | 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) | 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. | 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) | Baseline - 1 month (final) - 3 months posts |
| ID | Term |
|---|---|
| D013705 | Temporomandibular Joint Disorders |
| D009209 | Myofascial Pain Syndromes |
| ID | Term |
|---|---|
| D017271 | Craniomandibular Disorders |
| D008336 | Mandibular Diseases |
| D007571 | Jaw Diseases |
| D009140 | Musculoskeletal Diseases |
| D007592 | Joint Diseases |
| D009135 | Muscular Diseases |
| D009057 | Stomatognathic Diseases |
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| ID | Term |
|---|---|
| D015444 | Exercise |
| D026741 | Physical Therapy Modalities |
| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
| D013812 | Therapeutics |
| D012046 | Rehabilitation |
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