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Cited by 16Temporomandibular Joint DisordersMusculoskeletal pain and rehabilitationMyofascial pain diagnosis and treatment

Predictors of pain reduction following manual therapy in patients with temporomandibular disorders: a protocol for a prospective observational study

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Asquini, Giacomo, Bianchi, Andrea Edoardo, Heneghan, Nicola R, Rushton, Alison B, Borromeo, Giulia, Locatelli, Matteo, Falla, Deborah·2019·BMJ Open
DOI 10.1136/bmjopen-2019-032113PMC PMC6858120
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Abstract

Introduction: Temporomandibular disorders (TMDs) are principally characterised by pain in the craniomandibular area and probable limitations of jaw opening. Manual therapy, like other recommended conservative treatments included in clinical guidelines, is commonly used to treat patients with TMD to reduce pain and improve function. However, outcomes may be variable. The aim of this study is to identify predictors associated with pain reduction in patients with TMD following manual therapy by analysing a combination of patient-reported outcome measures and clinical tests. Such knowledge will support a more personalised management approach by facilitating clinical decision-making. Methods/analysis: An observational prospective design will recruit a cohort of 100 adults with a diagnosis of TMD (according to Axis I of the Diagnostic Criteria for TMD) at a Dental Hospital in Italy. Patients will be treated with four weekly sessions of manual therapy applied to craniomandibular structures. An array of predictors has been chosen based on previous research on prognostic factors for TMD and altered pain modulation in musculoskeletal disorders. Candidate predictors including demographic variables, general health variables, psychosocial features, TMD characteristics and clinical tests of the temporomandibular joint and masticatory muscles will be collected at baseline. Definition of good outcome is a clinically significant reduction of pain intensity over the last week (≥30% reduction Visual Analogue Scale) immediately following the four week intervention. Exploratory factor analysis will be applied to analyse factor loading of candidate predictors for good outcome at four weeks. Subsequently, a logistic multivariable regression model will be performed to calculate low and high risk of good outcome. Ethics and dissemination: Ethical approval has been obtained from the ‘Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico’ and University of Birmingham Ethics Committee. The results will be submitted for publication in a peer-reviewed journal and presented at conferences. Trial registration number: NCT03990662 ; Pre-results.

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Cited by

Sorted by citations

Authors
Asquini, G., Bianchi, A. E., Heneghan, N. R., Rushton, A. B., Borromeo, G., Locatelli, M., & Falla, D.
Affiliations
  • University of Birmingham (GB)
  • Department of Craniomandibular Disorders, Italian Stomatologic Institute, Milan, Italy
  • IRCCS Ospedale San Raffaele (IT)
Corresponding author
Falla, Deborah
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2019-11
Volume
9
Issue
11
Pages
e032113
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2019-032113
PMC
PMC6858120
OpenAlex
W2989256019
Cited by
16
References
7
Citations by year
2025: 3 · 2024: 5 · 2023: 1 · 2022: 3 · 2021: 2 · 2020: 1 · 2019: 1
FWCI
2.46
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • BMJ Open (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (acceptedVersion)
  • HighWire Press Open Archive (acceptedVersion)
  • University of Birmingham Research Portal (University of Birmingham) (acceptedVersion, cc-by-nc)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion, cc-by-nc)
Topics
  • Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Myofascial pain diagnosis and treatment
Keywords
temporomandibular disorders, manual therapy, analgesia, prognostic factors, temporomandibular joint, masticatory muscles, patient-reported outcome measures, pain modulation, personalized treatment, treatment outcome prediction
MeSH terms
Humans, Pain, Prognosis, Prospective Studies, Research Design, Temporomandibular Joint Disorders, Treatment Outcome, Musculoskeletal Manipulations, Pain Management, Observational Studies as Topic

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