Mobilization with movement, thoracic spine manipulation, and dry needling for the management of temporomandibular disorder:

Steigerwald/Maher TMD disability questionnaire was completed at the 2-month follow-up. Repeated measure ANOVAs were employed to determine the effects of the intervention on each outcome. Within-group effect sizes were calculated in order to assess clinical effectiveness. The ANOVA revealed significant decreases (all, p  <  0.01) VAS mean, VAS Worst, and VAS Best between baseline and final visit of 25.7 (95% CI; 17.7, 33.8); 33.2 (95% CI; 23.4, 43.0); 18.4 (12.1, 24.7); and 28.3 (95% CI; 18.8, 37.9); 36.1 (95% CI; 25.0, 47.3); 19.7 (95% CI; 12.8, 26.7) between baseline and the 2-month follow-up periods, respectively. Additionally, the ANOVA showed significant increases (all, p  <  0.01) in MMO and disability following the physical therapy management strategy between baseline and final visit with a mean of 11.4 (95% CI, 6.9, 15.9) and 10.2 (95% CI, 5.2, 15.2) between baseline and the 2-month follow-up. Within-group effect sizes were large (d  >  1.0) for all outcomes at both follow-up periods.

Individuals with TMD treated with a multimodal treatment exhibited significant and clinical improvements in pain intensity, disability, and MMO.

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Comments

Shane H - Physiotherapy

I am not surprised; when you look at the anatomy, and how many of the muscles that attached to the skull and subsequently the jaw. You can see a lot of connections. We see regularly how mobilizations of the Th/Sp can impact significantly on the shoulder, and a lot of evidence supports this. The reason’s are varied, but one is it can relax off the muscles attaching to the region, and also allow more movements (and subsequently less at the shoulder). It would be highly normal, if the same would occur at the TMD, but of course less investigated. Good to see some evidence.

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