Efectos inmediatos de la técnica de energía muscular mandibular en pacientes con patología articular mandibular

Abstract

Objectives: evaluating the immediate effect of the mandibular muscle energy technique over the pain pressure threshold (PPT) in the muscular trigger points (TP) on a bilateral basis in upper trapezius, masseters, external pterygoid, and digastric muscle, and at the same time measuring the opening and lateral left and right movements (lateral excursion) of the jaw. Material and method: experimental, longitudinal and prospective, controlled, double blind study where we have performed a randomized clinical trial on subjects suffering from bruxism and temporomandibular joint dysfunction between the ages of 18 and 65, a total of 61 subjects from both sexes. It was intended to see the immediate results of the muscle energy technique on 31 patients in an experimental group (EG) comparing them with other 30 patients in a control group (CG) who were applied another manual technique (suboccipital inhibition placebo technique) without clinical objective. It is intended to put into practice the health benefits deriving from one of physical therapy’s manual techniques over incapacity and disability caused by this pathology. Pain was assessed with VAS scale pre and post intervention, PPT in TP with digital dynamometer on a bilateral basis on external pterygoid, masseters, digastric, and upper trapezius muscles with 2 pre and post immediate intervention measurements. A digital vernier caliper was also used to assess the mandibular range of motion in active mandibular opening and left and right lateral excursions pre and post immediate intervention, as well as fear to movement through the kinesiophobia test pre-intervention and 7 days after trough phone call. Results: Intergroup comparison showed clinically relevant changes in favor of EG in PPT in every bilaterally analyzed mandibular muscle (external pterygoid, masseter, digastric and upper trapezius) when it comes to the differences between pre and post intervention measures. Regarding post intervention sexes collation all results were significant except for lateral mobility or left excursion. Intergroup comparison also showed relevant changes in favor of EG in opening movements and left and right mandibular excursions. Post intervention mandibular kinesiopobia in CG and EG and by sexes obtained significant changes. Regarding pain assessment through VAS post intervention, intergroup comparison did not show relevant changes. Conclusions: Mandibular muscle energy technique produced immediate statistically significant changes on a bilateral basis over the PPT in the TP of the external pterygoid, masseter, digastric and upper trapezius muscles. Also, a statistically revealing improvement in mandibular movement regarding mandibular opening and left and right excursions, and mandibular movement fear in the kinesiophobia test after performing the technique.