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Effectiveness of Physical Teraphy in the Treatment of Myogenic Temporomandibular Disorders

25. maj 2022 opdateret af: Paolo Pillastrini

The aim of study is evaluate the effectiveness of physical therapy in of the treatment myogenic temporomandibular disorders.

They will enrolled 100 patient which will be divided into two groups. The primary objective is evaluate the effectiveness of physiotherapy on pain (measured with the Visual Analogic Scale - VAS scale).

The second objective is evaluate mandibular motion (by measuring the range of motion - ROM) and investigate the presence of psychosocial factors (using the Anxiety and Depression Scale - HADS questionnaire).

Studieoversigt

Status

Afsluttet

Detaljeret beskrivelse

Randomized controlled clinical trial with randomization according to a multi-phase design.

Phase 1 involves the enrollment of patients with DTMs based on diagnostic criteria.

Phase 2 includes the algogenic, kinetic and gnathological evaluation of the enrolled patients.

Phase 3 provides for the adoption of the criterion to one of the 2 treatment groups on the basis of the randomization list.

The 2 therapeutic protocols are:

  • gnathological therapy (splint) associated with education and physiotherapy (test group);
  • gnathological therapy (splint) associated with education (control group). During the first visit the patient will be enlisted by evaluating the inclusion and exclusion criteria and signed the informed consent, he / she will be assigned a unique identification code.

The code consists of a progressive number followed by the patient's initials (eg 01-F.R.).

Subsequently, the patients will be randomized blinded and assigned to one of the two study groups.

Randomization will be performed using random, computer-generated, centralized numbers placed in sealed opaque envelopes provided by the study coordinator.

Both types of treatment will be performed by a single operator respectively.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

62

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Emilia-Romagna
      • Bologna, Emilia-Romagna, Italien, 40138
        • University of Bologna

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ja

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • patients with myogenic temporomandibular disorders assessed with clinical examination as established by the DC / TMD1;
  • patients older than 18 years;
  • good knowledge of Italian language;
  • patients who have signed informed consent

Exclusion Criteria:

  • edentulism which makes it impossible to apply gnathological bite;
  • patients with psychiatric problems;
  • patients included in other experimental protocols;
  • patients already undergoing surgical and / or radial therapy of the cervical and facial areas;
  • other temporomandibular disorders without a myogenic component;
  • treatment of the cervical and TMJ district in the previous 3 months;
  • history of drug abuse.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Andet: splint therapy

Alginate impressions will be taken and the plaster models of the dental arches will be made.

The splint will be subsequently delivered to the patient with the relative indications of use.

The splint therapy consist in the use of neuromuscoral splint every the night for 6 months.

In the control group the patient will undergo gnathologic therapy for 6 months with neuromuscural splint every night for 3 months
Andre navne:
  • splint therapy
Andet: physical therapy with splint therapy

The treatment consists of a series of interventions: advice on self-treatment techniques to be performed at home and administering manual therapy techniques addressed to: temporomandibular district, cervical and cervico-thoracic junction.

Each session will be carried out individually and will last for 45 minutes. This duration will be divided as follows: 25 minutes dedicated to the temporomandibular district, 15 minutes to the cervical and cervico-thoracic junction, 5 minutes to teaching self-treatment techniques to be carried out at home and to verify the correct way of performing them.

The cycle will consist of 10 sessions distributed over 3 months.

In the test group the patient will undergo gnathologic therapy with neuromuscural splint every night for 3 months in association with physical therapy
Andre navne:
  • splint therapy with physical therapy

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Evaluate the effectiveness of physical therapy using the VAS scale which allows to measure the varation of pain
Tidsramme: Change from initial VAS at 3 and 6 months from the beginning of the treatment
The VAS measures the intensity of the pain that thethe patient perceived and it is represented by a 10 cm long scale with a score from 0 to 10. The VAS will be evaluated in 3 times: at rest; during the maximum buccal opening; during chewing
Change from initial VAS at 3 and 6 months from the beginning of the treatment

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
ROM (range of motion)
Tidsramme: The measurement of the ROM occurs at the recruitment then at 3 and 6 months from the beginning of the treatment

The ROM measures the joint function. It provides the analytical and millimetric measurement of functional movements with a precision gauge positioned between the incisal edges of the upper and lower anterior groups.

It should be noted: maximum buccal opening; deviation of the median line; left and right lateral movements; overjet and overbite.

It should also be noted the extent of final elasticity (or end-feel test and its nature (elastic, painful, hard)

The measurement of the ROM occurs at the recruitment then at 3 and 6 months from the beginning of the treatment

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

31. oktober 2018

Primær færdiggørelse (Faktiske)

31. januar 2022

Studieafslutning (Faktiske)

31. januar 2022

Datoer for studieregistrering

Først indsendt

24. oktober 2018

Først indsendt, der opfyldte QC-kriterier

30. oktober 2018

Først opslået (Faktiske)

31. oktober 2018

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

31. maj 2022

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

25. maj 2022

Sidst verificeret

1. maj 2022

Mere information

Begreber relateret til denne undersøgelse

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