The Application of Manual Techniques in Masticatory Muscles Relaxation as Adjunctive Therapy in the Treatment of Temporomandibular Joint Disorders
Open accessAbstract
Temporomandibular disorders (TMD) are primarily characterized by pain as well as disorders concerning the proper functioning of individual elements of the stomatognathic system (SS). The aim of the study was to compare the degree of relaxation of the anterior part of the temporal muscles and the masseter muscles, achieved through the use of post-isometric relaxation and myofascial release methods in patients requiring prosthetic treatment due to temporomandibular joint disorders with a dominant muscular component. Sixty patients who met the inclusion criteria were alternately assigned to one of the two study groups, either group I—patients received post-isometric relaxation treatment (PIR), or group II—patients received myofascial release treatment (MR). The series of ten treatments were performed in both groups. The comparative assessment was based on physiotherapeutic examination, a surface electromyography (sEMG) of the anterior temporal and masseter muscles and the intensity of spontaneous masticatory muscle pain, assessed using the Visual Analogue Scale (VAS). We observed a significant decrease in the electrical activity of examined muscles and a significant drop in the intensity of spontaneous pain in the masticatory muscles both in group I and II. There were no significant differences between groups. Both therapeutic methods may be used as successful forms of adjunctive therapy in the prosthetic treatment of TMD. The trial was registered with an international clinical trials register.
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Written from the paper’s full text.
TL;DR
In 60 patients with painful temporomandibular disorders and increased masticatory muscle tension, ten sessions of either post-isometric relaxation (PIR) or myofascial release (MR) significantly reduced sEMG activity of the anterior temporalis and masseter muscles and VAS spontaneous pain, with no significant between-group differences. Both methods may be useful adjuncts to prosthetic TMD treatment.
Key findings
- Both PIR and MR groups showed a significant decrease in electrical activity of the anterior temporal and masseter muscles on the right and left sides; Bonferroni post hoc tests found significant differences between measurement 1 and 2 and between measurement 1 and 3, but not between measurements 2 and 3.
- Both groups showed a significant drop in the intensity of spontaneous masticatory muscle pain, with significantly higher VAS values at measurement 1 than at measurements 2 and 3.
- There were no significant differences between groups in changes in electrical activity of the anterior temporal muscles or in changes in spontaneous pain intensity. A greater decrease in mean masseter electric potentials occurred in group II, but this was not statistically significant (right side p = 0.10; left side p = 0.11).
- Physiotherapeutic examination showed improvement in both groups: mandibular abduction path/range, lateral mandibular movements, palpation pain in masticatory muscles and temporomandibular joints, and pain during passive mandibular movements.
Methods
- Comparative study of 60 patients of both sexes, aged 19 to 40, referred to the Dental Prosthetic Clinic of the Institute of Dentistry, Jagiellonian University, Krakow, Poland, for prosthetic treatment of pain-related TMD with increased masticatory muscle tension. Patients were alternately assigned to group I (PIR; 30 patients: 22 women, 8 men; 28 ± 5.31 years) or group II (MR; 30 patients: 25 women, 5 men; 28 ± 5.10 years). Each patient received 10 treatment sessions over 10 consecutive days except Sundays.
- Inclusion required RDC/TMD Axis I Group Ia with local or myofascial pain and increased masticatory muscle tension, absence of temporomandibular disc displacement, spontaneous masticatory muscle pain for at least one month before treatment, good general health, full dental arches with natural teeth or fixed prostheses, and written consent. Assessments occurred before treatment (measurement 1), after the last of 10 relaxation treatments (measurement 2), and on the 4th day after therapy end (measurement 3); all examinations and treatment sessions occurred before occlusal splint therapy.
- Outcomes were physiotherapeutic examination using Manual Functional Analysis, surface electromyography (sEMG) of the anterior temporal and masseter muscles using a two-channel NeuroTrac MyoPlus 4 device with a 30-second mean measurement, and 10-point VAS for spontaneous masticatory muscle pain. Statistical analysis used Statistica 12.0 and IBM SPSS Statistics 26.0, with Shapiro–Wilk, Student’s t-test, Mann–Whitney U test, Chi-square, repeated-measures ANOVA with Bonferroni post hoc, Friedman and Wilcoxon tests, and α = 0.05 for two-sided tests. The trial was registered with clinicaltrials.gov (No NCT05091996).
Limitations
- The authors state that a main limitation was the small sample size and recommend a multicentre study with a larger sample; they also note difficulty ensuring that electrode application points were exactly the same despite anthropometric points and photographic documentation, and that direct comparison of sEMG values with other studies may be limited by different technical parameters of measuring devices, such as sensitivity or frequency of measurement.
- Evident from the text: no untreated, sham, or usual-care control group is described, so the study cannot isolate treatment effects from natural history or placebo effects; allocation was described as alternating rather than clearly randomized; and follow-up extended only to the 4th day after treatment end, so longer-term durability is not assessed.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
11 of 66 cited sources checked · 4 supported · 1 flagged · accuracy not yet measured
- Premisecitation
The use of manual therapy with simultaneous prosthetic treatment significantly accelerates restoration of proper functioning of the masticatory organ.
“The use of these interventions with simultaneous prosthetic treatment significantly accelerates the restoration of proper functioning of the masticatory organ [1,13,14].”
Quote in the paperSubstantial claim2 of 3 sources checked- cites [1] Okeson, J.P. (2013). Management of Temporomandibular Disorders and Occlusion, Elsevier/Mosby. [7th ed.].
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [13] Silva, 2012, The interrelationship between dentistry and physiotherapy in the treatment of temporomandibular disorders, J. Contemp. Dent. Pr. source
Materials and Methods describes patients treated with both occlusal splints and physiotherapy, including massage therapy. The Discussion reports pain relief after interdisciplinary treatment, but it does not show that manual therapy alongside prosthetic treatment significantly accelerated recovery or restored masticatory function; the measured outcome was pain. (LLM, conf=0.86)
Experimental — accuracy not yet measured - cites [14] 2016, Psychoeducation training on stress management strategies as an addition to the therapy of temporomandibular joint dysfunction—preliminary studies, Arch. Psychiatry Psychother. source
The Method (page unavailable) says prosthetic treatment was supplemented with physiotherapeutic procedures, but does not identify them as manual therapy. The Discussion says psychoeducation may improve functional disorders, while the Conclusions report improved emotional status; neither establishes that manual therapy significantly accelerates restoration of masticatory function. (LLM, conf=0.81)
Experimental — accuracy not yet measured
- Premisecitation
Conservative interventions such as physiotherapy and manual therapy directly affect the muscular system to reduce excessive tension and minimize pain in the temporomandibular joints and chewing muscles.
“These interventions directly affect the muscular system, in order to reduce its excessive tension, and thus minimize pain in the area of the temporomandibular joints, and in muscles involved in the chewing process [1,3,19,20,21,22,23,24,25,26].”
Quote in the paperSubstantial claim4 of 10 sources checked- cites [1] Okeson, J.P. (2013). Management of Temporomandibular Disorders and Occlusion, Elsevier/Mosby. [7th ed.].
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [3] Czerwińska-Niezabitowska, B., and Kulesa-Mrowiecka, M. (2016). Diagnostyka i Leczenie Dysfunkcji Czaszkowo-Żuchwowych w Ujęciu Holistycznym, Medycyna Praktyczna. (In Polish).
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [19] Asquini, 2019, Predictors of pain reduction following manual therapy in patients with temporomandibular disorders: A protocol for a prospective observational study, BMJ Open source
- cites [20] Bispo, 2019, Short-term effectiveness of conservative therapies in pain, quality of life, and sleep in patients with temporomandibular disorders: A randomized clinical trial, Cranio
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [21] Brochado, 2018, Comparative effectiveness of photobiomodulation and manual therapy alone or combined in TMD patients: A randomized clinical trial, Braz. Oral Res. source
- cites [22] Pessoa, 2018, Association of facial massage, dry needling, and laser therapy in Temporomandibular Disorder: Case report, Codas source
- cites [23] Cleland, 2019, Effects of Cervico-Mandibular Manual Therapy in Patients with Temporomandibular Pain Disorders and Associated Somatic Tinnitus: A Randomized Clinical Trial, Pain Med.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [24] Reynolds, 2020, Effectiveness of Cervical Spine High-Velocity, Low-Amplitude Thrust Added to Behavioral Education, Soft Tissue Mobilization, and Exercise in Individuals with Temporomandibular Disorder (TMD) with Myalgia: A Randomized Clinical Trial, J. Orthop. Sports Phys. Ther. source
- cites [25] Tuncer, 2013, Effectiveness of manual therapy and home physical therapy in patients with temporomandibular disorders: A randomized controlled trial, J. Bodyw. Mov. Ther. source
- cites [26] Wieckiewicz, 2015, Reported concepts for the treatment modalities and pain management of temporomandibular disorders, J. Headache Pain source
- Findingown data
PIR and MR reduced pain in the masticatory muscles during palpation in both groups.
“Reduction of the pain in the masticatory muscles during palpation in group I and group II.”
Quote in the paperSubstantial claim - Findingown data
There were no significant differences between PIR and MR groups in change in intensity of spontaneous pain in the masticatory muscles.
“There were no significant differences in the change in the intensity of spontaneous pain in the masticatory muscles assessed during the first examination and follow-up examinations between patients in group I and patients in group II (Table 7).”
Quote in the paperNot a substantial claim - Findingown data
PIR and MR reduced pain in joints, periarticular structures or muscles during passive mandibular movements in both groups.
“Reduction of pain in joints, periarticular structures or muscles during passive mandibular movements in group I and group II.”
Quote in the paperSubstantial claim
- Findingown data
PIR and MR improved the path and range of mandibular abduction movement in both groups.
“Improvement of the path and range of mandibular abduction movement both in group I and group II.”
Quote in the paperSubstantial claim - Findingown data
There were no significant differences between PIR and MR groups in changes in electrical activity of the masseter muscles (right p=0.10, left p=0.11).
“A greater decrease in the mean values of the electric potentials of the masseter muscles occurred in group II, but this relationship did not reach statistical significance, and were found to be, for the right side, p = 0.10, for the left side, p = 0.11 (Figure 8).”
Quote in the paperNot a substantial claim - Findingown data
There were no significant differences between PIR and MR groups in changes in electrical activity of the anterior temporal muscles.
“The comparison of changes in the electrical activity of the anterior part of the temporal muscles during the first and control examinations between the groups showed no statistically significant differences.”
Quote in the paperNot a substantial claim - Findingown data
After a series of both post-isometric muscle relaxation (PIR) and myofascial release (MR) treatments, there was a significant decrease in electrical activity of the anterior part of the temporal and masseter muscles.
“When analyzing the collected results, a significant decrease in the electrical activity of the anterior part of the temporal and masseter muscles was observed, as well as a significant decrease in the intensity of spontaneous pain in the masticatory muscles after a series of both PIR and MR treatments.”
Quote in the paperSubstantial claim - Findingown data
The use of both PIR and MR methods reduces increased tension of the anterior part of the temporal and masseter muscles in patients treated for temporomandibular disorder.
“The use of both post-isometric muscle relaxation and myofascial release methods reduces the increased tension of the anterior part of the temporal and masseter muscles in the group of patients treated due to a temporomandibular disorder.”
Quote in the paperSubstantial claim - Findingown data
The use of PIR and MR methods reduces the intensity of spontaneous pain in the masticatory muscles to a similar degree.
“The use of post-isometric muscle relaxation and myofascial release methods reduces the intensity of spontaneous pain in the masticatory muscles to a similar degree.”
Quote in the paperSubstantial claim - Findingown data
The use of PIR and MR methods reduces electrical activity of the masticatory muscles in the rest position of the mandible to a similar degree.
“The use of post-isometric muscle relaxation and myofascial release methods reduces the electrical activity of the masticatory muscles in the rest position of the mandible to a similar degree.”
Quote in the paperSubstantial claim - Findingown data
There were no significant differences in improvement of measured parameters between the PIR and MR study groups.
“There were also no significant differences in the improvement of the measured parameters between study groups.”
Quote in the paperSubstantial claim - Findingown data
After a series of both PIR and MR treatments, there was a significant decrease in intensity of spontaneous pain in the masticatory muscles.
“When analyzing the collected results, a significant decrease in the electrical activity of the anterior part of the temporal and masseter muscles was observed, as well as a significant decrease in the intensity of spontaneous pain in the masticatory muscles after a series of both PIR and MR treatments.”
Quote in the paperSubstantial claim - Premisenone given
Comparative studies on the effectiveness of PIR and MR applied in TMD patients have not been conducted so far.
“The comparative studies on the effectiveness of PIR and MR applied in TMD patients have not been conducted so far.”
Quote in the paperNot a substantial claim - Premisecitation
PIR is effective in increasing the range of mandibular motion in patients with trigger points and increased masseter tension.
“The reports indicate the effectiveness of PIR in increasing the range of mandibular motion in patients treated due to the presence of trigger points and an increased tension of the masseter muscles [16].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [16] Blanco, 2006, Changes in active mouth opening following a single treatment of latent myofascial trigger points in the masseter muscle involving post-isometric relaxation or strain/counterstrain, J. Bodyw. Mov. Ther. source
- Premisecitation
Current clinical guidelines for the treatment of temporomandibular disorders indicate the need for conservative therapy such as physiotherapy and manual therapy.
“Current clinical guidelines for the treatment of TMD clearly indicate the need for conservative therapy, such as physiotherapy and manual therapy [1,3,10].”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [1] Okeson, J.P. (2013). Management of Temporomandibular Disorders and Occlusion, Elsevier/Mosby. [7th ed.].
Not checked in the free run.
- cites [3] Czerwińska-Niezabitowska, B., and Kulesa-Mrowiecka, M. (2016). Diagnostyka i Leczenie Dysfunkcji Czaszkowo-Żuchwowych w Ujęciu Holistycznym, Medycyna Praktyczna. (In Polish).
Not checked in the free run.
- cites [10] Liu, 2013, Epidemiology, Diagnosis, and Treatment of Temporomandibular Disorders, Dent. Clin. North. Am. source
- Premisecitation
Ibanez-Garcia et al. demonstrated significantly greater improvement in pain-free mandibular range of motion after using the modified MR method than after using the PIR intervention described by Blanco et al.
“However, it should be noted that Ibanez-Garcia et al. [17] demonstrated a significantly greater improvement in the pain-free mandibular range of motion after using the modified MR method than using the PIR intervention described by Blanco et al. [16].”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [17] Girao, 2009, Changes in masseter muscle trigger points following strain-counterstrain or neuro-muscular technique, J. Bodyw. Mov. Ther. source
- cites [16] Blanco, 2006, Changes in active mouth opening following a single treatment of latent myofascial trigger points in the masseter muscle involving post-isometric relaxation or strain/counterstrain, J. Bodyw. Mov. Ther. source
- Premisecitation
Reports on trunk and limbs soft-tissue therapy indicate that PIR is accompanied by a decrease in muscle electrical activity.
“These reports indicate a significant effect of PIR on the minimization of pain and increasing the range of motion in the joints [16,27,32,33,34], accompanied by a decrease in muscle electrical activity [35].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [35] Ptaszkowski, 2014, Ocena efektów krótkoterminowych tech-niki energii mięśniowej—poizometrycznej relaksacji na aktywność bioelektryczną i elastyczność mięśnia prostego uda—pi-lotażowe badanie randomizowane, Acta Balneol.
Not checked in the free run.
- Premisecitation
Authors assessing MR procedures methodically consistent with this study indicate their effectiveness in improving musculoskeletal function.
“Authors assessing the outcomes of MR procedures, methodically consistent with the approach carried out in this study, indicate their effectiveness in increasing the pain-free range of motion [17], reducing pain [17,36,37], improving musculoskeletal function [36,37] and reducing muscle stiffness [38].”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [36] Ajimsha, 2012, Effectiveness of Myofascial Release in the Management of Lateral Epicondylitis in Computer Professionals, Arch. Phys. Med. Rehabil. source
- cites [37] Ajimsha, 2014, Effectiveness of myofascial release in the management of plantar heel pain: A randomized controlled trial, Foot source
- Premisecitation
In Ibanez-Garcia et al.'s study, there was a moderate effect on reducing the intensity of local pain induced by palpation.
“Nevertheless, both methods were found to be highly effective in reducing the pressure pain threshold (PPT) and increasing the maximum pain-free mandibular active range of motion, while a moderate effect on reducing the intensity of local pain induced by palpation was observed.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [17] Girao, 2009, Changes in masseter muscle trigger points following strain-counterstrain or neuro-muscular technique, J. Bodyw. Mov. Ther. source
- Interpretationcitation
The results of the cited studies by Blanco et al. and Ibanez-Garcia et al. are consistent with each other despite different measurement tools.
“Despite the fact that the measurement tools used in the cited studies differ from those used in our report, the results of these researches are consistent with each other [16,17].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [16] Blanco, 2006, Changes in active mouth opening following a single treatment of latent myofascial trigger points in the masseter muscle involving post-isometric relaxation or strain/counterstrain, J. Bodyw. Mov. Ther. source
- cites [17] Girao, 2009, Changes in masseter muscle trigger points following strain-counterstrain or neuro-muscular technique, J. Bodyw. Mov. Ther. source
- Premisecitation
In Blanco et al.'s study, there was no significant change in pain-free active mandibular range of motion in the group undergoing positional release.
“A significant increase in the pain-free active mandibular range of motion was observed in subjects who underwent a single PIR procedure, while there was no significant change in the examined parameter in the group of subjects undergoing the positional release method.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [16] Blanco, 2006, Changes in active mouth opening following a single treatment of latent myofascial trigger points in the masseter muscle involving post-isometric relaxation or strain/counterstrain, J. Bodyw. Mov. Ther. source
- Premisecitation
Reports have shown a direct relationship between the level of perceived pain and muscle electrical activity.
“In the reports that have shown a direct relationship between the level of perceived pain and muscle electrical activity [56,57], all of the aforementioned findings are consistent with the results of the present study.”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [56] Veiersted, 2009, Association between numbers of long periods with sustained low-level trapezius muscle activity and neck pain, Ergonomics source
- cites [57] Nordander, 2013, Exposure–response relationships in work-related musculoskeletal disorders in elbows and hands—A synthesis of group-level data on exposure and response obtained using uniform methods of data collection, Appl. Ergon. source
- Premisecitation
Authors assessing MR procedures methodically consistent with this study indicate their effectiveness in reducing muscle stiffness.
“Authors assessing the outcomes of MR procedures, methodically consistent with the approach carried out in this study, indicate their effectiveness in increasing the pain-free range of motion [17], reducing pain [17,36,37], improving musculoskeletal function [36,37] and reducing muscle stiffness [38].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [38] Ichikawa, 2015, Comparative analysis of ultrasound changes in the vastus lateralis muscle following myofascial release and thermotherapy: A pilot study, J. Bodyw. Mov. Ther. source
- Premisecitation
Authors assessing MR procedures methodically consistent with this study indicate their effectiveness in increasing pain-free range of motion.
“Authors assessing the outcomes of MR procedures, methodically consistent with the approach carried out in this study, indicate their effectiveness in increasing the pain-free range of motion [17], reducing pain [17,36,37], improving musculoskeletal function [36,37] and reducing muscle stiffness [38].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [17] Girao, 2009, Changes in masseter muscle trigger points following strain-counterstrain or neuro-muscular technique, J. Bodyw. Mov. Ther. source
- Study design and conductreasoning
A direct comparison of values of muscle electrical activity between this study and other researchers may not be possible due to different technical parameters of measuring devices.
“A direct comparison of the values of muscle electrical activity may not be possible due to the different technical parameters of measuring devices, such as the sensitivity or frequency of measurement.”
Quote in the paperNot a substantial claim - Premisecitation
In Blanco et al.'s study, a significant increase in pain-free active mandibular range of motion was observed in subjects who underwent a single PIR procedure.
“A significant increase in the pain-free active mandibular range of motion was observed in subjects who underwent a single PIR procedure, while there was no significant change in the examined parameter in the group of subjects undergoing the positional release method.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [16] Blanco, 2006, Changes in active mouth opening following a single treatment of latent myofascial trigger points in the masseter muscle involving post-isometric relaxation or strain/counterstrain, J. Bodyw. Mov. Ther. source
- Study design and conductnone given
One of the main limitations of the study is the small sample size.
“One of the main limitations of the study seems to be the small sample size.”
Quote in the paperNot a substantial claim - Interpretationreasoning
In the studies by Cuccia et al. and Raiadurai, it is not possible to selectively assess the impact of each discussed method on the clinical condition of treated patients.
“They reported an improvement of clinical outcomes—however, it is clearly not possible to selectively assess the impact of each of the discussed methods on the clinical condition of treated patients.”
Quote in the paperSubstantial claim - Premisecitation
Authors assessing MR procedures methodically consistent with this study indicate their effectiveness in reducing pain.
“Authors assessing the outcomes of MR procedures, methodically consistent with the approach carried out in this study, indicate their effectiveness in increasing the pain-free range of motion [17], reducing pain [17,36,37], improving musculoskeletal function [36,37] and reducing muscle stiffness [38].”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [17] Girao, 2009, Changes in masseter muscle trigger points following strain-counterstrain or neuro-muscular technique, J. Bodyw. Mov. Ther. source
- cites [36] Ajimsha, 2012, Effectiveness of Myofascial Release in the Management of Lateral Epicondylitis in Computer Professionals, Arch. Phys. Med. Rehabil. source
- cites [37] Ajimsha, 2014, Effectiveness of myofascial release in the management of plantar heel pain: A randomized controlled trial, Foot source
- Premisecitation
Blanco et al. conducted a study comparing the efficacy of PIR and positional release (strain/counterstrain) in the treatment of myofascial pain with latent myofascial trigger points in the masseter muscles.
“Blanco et al. [16] conducted a study comparing the efficacy of PIR and positional release (strain/counterstrain) in the treatment of myofascial pain, manifested by latent myofascial trigger points (MTrPs) and located in the masseter muscles.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [16] Blanco, 2006, Changes in active mouth opening following a single treatment of latent myofascial trigger points in the masseter muscle involving post-isometric relaxation or strain/counterstrain, J. Bodyw. Mov. Ther. source
- Interpretationown data
The results of this study indicate that both PIR and MR methods can be used as effective forms of supportive therapy in the prosthetic treatment of pain-related TMD accompanied by increased masticatory muscle tension.
“The results of this study indicate that both the PIR and MR methods can be used as effective forms of supportive therapy in the prosthetic treatment of pain-related TMD, accompanied by increased masticatory muscle tension.”
Quote in the paperSubstantial claim
- May combine two claims. 15
- Classified as probably not a substantial claim. 12
- The quote only partly states this claim. 3
May combine two claims.
PremisecitationPIR reduces muscle tension immediately after isometric contraction and minimizes pain sensations related to the muscular system.
“The PIR method, based mainly on neurophysiological inhibitory (relaxing) mechanisms, allows for reduced muscle tension immediately after their isometric contraction and minimizes pain sensations related to the muscular system [15,27].”
Quote in the paperSubstantial claim1 of 2 sources checked- cites [15] Chaitow, L. (2015). Techniki Energii Mięśniowej, Edra Urban & Partner. [3rd ed.].
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [27] Ballantyne, 2003, The effect of muscle energy technique on hamstring extensibility: The mechanism of altered flexibility, J. Osteopat. Med. source
The paper’s discussion of MET mechanisms (page unavailable) calls reflex relaxation after isometric contraction poorly supported and cites evidence disputing a neurological mechanism. Its Control Experimental section instead attributes the increased hamstring range of motion to greater tolerance of stretch: the same stretch caused less discomfort, but the study did not show reduced muscle tension or a general reduction in muscular pain. (LLM, conf=0.86)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measured
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationPIR and MR are highly effective in improving musculoskeletal function, increasing range of motion, alleviating pain, and decreasing muscle stiffness in trunk and limbs.
“The reports indicate that PIR and MR are highly effective in improving the functioning of the musculoskeletal system, increasing the range of motion in the joints, alleviating pain and decreasing muscle stiffness.”
Quote in the paperNot a substantial claim2 of 9 sources checked- cites [27] Ballantyne, 2003, The effect of muscle energy technique on hamstring extensibility: The mechanism of altered flexibility, J. Osteopat. Med. source
The Results (page unavailable) report increased knee range of motion after muscle energy technique in the hamstrings of asymptomatic subjects. The Conclusion (page unavailable) attributes this to greater stretch tolerance, not a biomechanical change. The paper does not establish that both PIR and MR are highly effective, or that they improve general musculoskeletal function, relieve pain, or decrease muscle stiffness in the trunk and limbs. (LLM, conf=0.89)
Experimental — accuracy not yet measured - cites [32] Smith, 2008, A comparison of two muscle energy techniques for increasing flexibility of the hamstring muscle group, J. Bodyw. Mov. Ther. source
- cites [33] Fryer, 2004, The influence of contraction duration in muscle energy technique applied to the atlanto-axial joint, J. Osteopat. Med. source
- cites [34] Lenehan, 2003, The effect of muscle energy technique on gross trunk range of motion, J. Osteopat. Med. source
The Conclusion reports that muscle energy technique (MET) increased restricted trunk rotation in asymptomatic subjects. The study does not establish that PIR and MR are highly effective across the trunk and limbs, or that they alleviate pain or decrease muscle stiffness; the Conclusion calls for future research using pain and disability measures. Page numbers are unavailable in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measured - cites [35] Ptaszkowski, 2014, Ocena efektów krótkoterminowych tech-niki energii mięśniowej—poizometrycznej relaksacji na aktywność bioelektryczną i elastyczność mięśnia prostego uda—pi-lotażowe badanie randomizowane, Acta Balneol.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [36] Ajimsha, 2012, Effectiveness of Myofascial Release in the Management of Lateral Epicondylitis in Computer Professionals, Arch. Phys. Med. Rehabil. source
- cites [37] Ajimsha, 2014, Effectiveness of myofascial release in the management of plantar heel pain: A randomized controlled trial, Foot source
- cites [38] Ichikawa, 2015, Comparative analysis of ultrasound changes in the vastus lateralis muscle following myofascial release and thermotherapy: A pilot study, J. Bodyw. Mov. Ther. source
- cites [39] 2011, Effects of myofascial release techniques on pain, physical function, and postural stability in patients with fibromyalgia: A randomized controlled trial, Clin. Rehabil. source
May combine two claims.
PremisecitationReports on trunk and limbs soft-tissue therapy indicate a significant effect of PIR on minimization of pain and increasing range of motion in joints.
“These reports indicate a significant effect of PIR on the minimization of pain and increasing the range of motion in the joints [16,27,32,33,34], accompanied by a decrease in muscle electrical activity [35].”
Quote in the paperSubstantial claim2 of 6 sources checked- cites [16] Blanco, 2006, Changes in active mouth opening following a single treatment of latent myofascial trigger points in the masseter muscle involving post-isometric relaxation or strain/counterstrain, J. Bodyw. Mov. Ther. source
- cites [27] Ballantyne, 2003, The effect of muscle energy technique on hamstring extensibility: The mechanism of altered flexibility, J. Osteopat. Med. source
The Abstract and Results report a significant increase in knee range of motion after muscle energy technique applied to the hamstrings. The participants were asymptomatic, however, and the paper does not report pain reduction or establish an effect across trunk and limb joints. (LLM, conf=0.88)
Experimental — accuracy not yet measured - cites [32] Smith, 2008, A comparison of two muscle energy techniques for increasing flexibility of the hamstring muscle group, J. Bodyw. Mov. Ther. source
- cites [33] Fryer, 2004, The influence of contraction duration in muscle energy technique applied to the atlanto-axial joint, J. Osteopat. Med. source
- cites [34] Lenehan, 2003, The effect of muscle energy technique on gross trunk range of motion, J. Osteopat. Med. source
The Abstract and Conclusion (page numbers unavailable) report a significant increase in restricted trunk rotation after muscle energy technique in asymptomatic volunteers. The paper did not test pain reduction or limb-joint motion, and it does not explicitly identify the intervention as PIR. The Conclusion calls for future research using pain indicators in symptomatic subjects. (LLM, conf=0.88)
Experimental — accuracy not yet measured - cites [35] Ptaszkowski, 2014, Ocena efektów krótkoterminowych tech-niki energii mięśniowej—poizometrycznej relaksacji na aktywność bioelektryczną i elastyczność mięśnia prostego uda—pi-lotażowe badanie randomizowane, Acta Balneol.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
The quote only partly states this claim.
Findingown dataPIR and MR reduced pain in the temporomandibular joints during palpation in both groups.
“Reduction of pain in the temporomandibular joints during palpation in group I and group II.”
Quote in the paperSubstantial claimThe quote only partly states this claim.
Findingown dataPIR and MR improved the range of lateral movements of the mandible in both groups.
“Improvement of the range of lateral movements of the mandible in group I and group II.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataPIR and MR both significantly decreased electrical activity of the anterior temporal and masseter muscles (right and left) from baseline to post-treatment and follow-up.
“We observed a significant decrease in the electrical activity of examined muscles and a significant drop in the intensity of spontaneous pain in the masticatory muscles both in group I and II.”
- Also stated in: § 3.2. The Results of Electromyographic Examination of the Masticatory Muscles Obtained in Group I and Group II · plain
“A significant decrease in electrical activity of both muscles was observed, on the right and left, in both groups.”
- Also stated in: § 3.2. The Results of Electromyographic Examination of the Masticatory Muscles Obtained in Group I and Group II · boosted
“In both groups, the Bonferroni post hoc tests demonstrated a statistically significant difference in the mean values of the studied parameter between the 1st and 2nd measurement, and between the 1st and 3rd measurement for both the anterior part of the temporal muscles and the masseter muscles, on the right and left sides.”
Quote in the paperSubstantial claim- Also stated in: § 3.2. The Results of Electromyographic Examination of the Masticatory Muscles Obtained in Group I and Group II · plain
May combine two claims.
Findingown dataPIR and MR both significantly reduced the intensity of spontaneous pain in the masticatory muscles from baseline to post-treatment and follow-up.
“We observed a significant decrease in the electrical activity of examined muscles and a significant drop in the intensity of spontaneous pain in the masticatory muscles both in group I and II.”
- Also stated in: § 3.3. The Results of the Evaluation of the Intensity of Pain in the Masticatory Muscles in Group I and Group II · plain
“In both group I and group II, significantly higher values of the intensity of spontaneous pain in the masticatory muscles were declared by the participants of the study for measurement 1, compared to measurement 2 and measurement 3 (Table 6).”
Quote in the paperSubstantial claim- Rests on an assumption: The 10-point VAS is a valid measure of spontaneous pain intensity in the masticatory muscles.
- Also stated in: § 3.3. The Results of the Evaluation of the Intensity of Pain in the Masticatory Muscles in Group I and Group II · plain
Classified as probably not a substantial claim.
Study design and conductcitationThe electrical activity of the anterior temporal and masseter muscles was assessed in accordance with the assumptions of surface electromyography (sEMG).
“The electrical activity of the anterior part of the temporal and masseter muscles was assessed in accordance with the assumptions of surface electromyography (sEMG) [42,43,44].”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [42] Sobota, 2012, Elektromiografia i jej zastosowanie w zaburzeniach aparatu żucia, Twój Prz. Stomatol.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [43] Berni, 2015, Accuracy of the surface electromyography RMS processing for the diagnosis of myogenous temporomandibular disorder, J. Electromyogr. Kinesiol. source
- cites [44] Peter, K. (2007). ABC EMG: Praktyczne Wprowadzenie do Elektromiografii Kinezjologicznej, Technomex. (In Polish).
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningsEMG electrode positions were standardized using anthropometric points and photographic documentation to ensure repeatability.
“In order to ensure the repeatability of the electrode positions, the relationships of selected anthropometric points were used and a photographic documentation of the sEMG test was created each time.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningThe sEMG test was conducted in the rest position of the mandible to standardize the starting position.
“The sEMG test was conducted in the rest position of the mandible in order to standardize the starting position for the measurement.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataBoth PIR and MR may be used as successful forms of adjunctive therapy in the prosthetic treatment of TMD.
“Both therapeutic methods may be used as successful forms of adjunctive therapy in the prosthetic treatment of TMD.”
Quote in the paperSubstantial claim- Rests on an assumption: The observed improvements in muscle activity and pain are attributable to the PIR and MR treatments rather than to natural course, placebo, or other factors.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationThe physiotherapeutic examination was performed in compliance with the guidelines of the Manual Functional Analysis (MFA) according to Bumann.
“The physiotherapeutic examination was performed in compliance with the guidelines of the Manual Functional Analysis (MFA) of the masticatory apparatus according to Bumann [3,41].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [3] Czerwińska-Niezabitowska, B., and Kulesa-Mrowiecka, M. (2016). Diagnostyka i Leczenie Dysfunkcji Czaszkowo-Żuchwowych w Ujęciu Holistycznym, Medycyna Praktyczna. (In Polish).
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [41] Bumann, A., and Lotzmann, U. (2002). TMJ Disorders and Orofacial Pain The Role of Dentistry in a Multidisciplinary Diagnostic Approach. Color Atlas of Dental Medicine, Thieme. source
Classified as probably not a substantial claim.
Study design and conductnone givenAll parts of the clinical examination were performed by the same experienced physiotherapist three times.
“All parts of the clinical examination were performed by the same experienced physiotherapist three times, firstly immediately before commencing treatment (measurement 1), secondly after the last of 10 relaxation treatments (measurement 2), and lastly on the 4th day after the end of therapy (measurement 3).”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationMR removes restrictions within the myofascial system, thus reducing pain and muscle tension.
“The MR method, based on the so-called phenomenon of relaxation, removes restrictions within the myofascial system, thus reducing pain and muscles tension [28,29,30,31].”
Quote in the paperSubstantial claim0 of 4 sources checked- cites [28] Chaitow, L., and Delany, J. (2008). Clinical Application of Neuromuscular Techniques, Volume 1: The Upper Body, Churchill Livingstone Elsevier. [2nd ed.].
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [29] Manheim, C.J. (2011). Rozluźnianie Mięśniowo-Powięziowe, WSEiT. (In Polish).
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [30] Myers, T., and James, E. (2012). Rozluźnianie Powięziowe Dla Równowagi Strukturalnej, WSEiT. (In Polish).
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [31] Cantu, R.I., and Grodin, A.J. (2001). Myofascial Manipulation: Theory and Clinical Application, Aspen Pub. [2nd ed.].
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
May combine two claims.
Study design and conductreasoningAll clinical examinations and treatment sessions occurred prior to occlusal splint therapy, so PIR and MR were evaluated without impact of the primary treatment.
“All clinical examinations and treatment sessions occurred prior to the introduction of occlusal splint therapy, which was used as a primary treatment of TMD. Thus, both PIR and MR methods (used as supportive therapies) were evaluated individually, with no impact of the primary treatment on the patients’ condition.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe trial was registered with clinicaltrials.gov (No NCT05091996).
“The trial was registered with clinicaltrials.gov (No NCT05091996 accessed on 25 October 2021).”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationMR is effective in reducing pain and improving the range of movement of the mandible in TMD.
“On the other hand, the results of studies assessing the clinical effects of MR in the treatment of such disorder show its effectiveness in reducing pain and improving the range of movement of the mandible [17].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [17] Girao, 2009, Changes in masseter muscle trigger points following strain-counterstrain or neuro-muscular technique, J. Bodyw. Mov. Ther. source
May combine two claims.
Study design and conductown dataBefore therapy, there was no difference between the PIR and MR groups in sex distribution, age, electromyographic tension of the anterior temporal and masseter muscles, and intensity of spontaneous pain in the masticatory muscles.
“Before the therapy there was found to be no difference between the groups in the distribution of sex, age, electromyographic tension of the anterior part of the temporal and masseter muscles, and the intensity of spontaneous pain in the masticatory muscles (Table 1).”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
InterpretationcitationAll of the aforementioned findings from the cited reports are consistent with the results of the present study.
“In the reports that have shown a direct relationship between the level of perceived pain and muscle electrical activity [56,57], all of the aforementioned findings are consistent with the results of the present study.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningAlthough efforts were made to ensure repeatability of electrode locations, it is difficult to say with certainty that the electrode application points were exactly the same.
“Although strenuous efforts were made and anthropometric points were used as well as photographic documentation of the sEMG study to ensure the repeatability of the electrode locations, it is difficult to say with certainty that the electrode application points were exactly the same.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationIbanez-Garcia et al. compared the therapeutic effects of the neuromuscular technique and the positional release method in patients with myofascial trigger points in the masseter muscles.
“Ibanez-Garcia et al. [17] attempted to compare the therapeutic effects of the neuromuscular technique and the positional release method among patients diagnosed with MTrPs located within the masseter muscles.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [17] Girao, 2009, Changes in masseter muscle trigger points following strain-counterstrain or neuro-muscular technique, J. Bodyw. Mov. Ther. source
May combine two claims.
Interpretationown dataBoth PIR and MR methods reduce pain and tension in the masticatory muscles.
“Both methods reduce pain and tension in the masticatory muscles.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationCuccia et al. and Raiadurai assessed the clinical effectiveness of treatment protocols consisting of several therapeutic techniques.
“Both authors assessed the clinical effectiveness of treatment protocols consisting of several therapeutic techniques.”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationcitationThe results of this research are confirmed by current scientific reports and indicate positive effects of using both PIR and MR methods in supportive treatment of TMD.
“Summarizing the above considerations, it should be noted that the results of this research are confirmed by current scientific reports and indicate the positive effects of using both PIR and MR methods in the supportive treatment of TMD.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationIn Ibanez-Garcia et al.'s study, both methods were highly effective in reducing the pressure pain threshold and increasing the maximum pain-free mandibular active range of motion.
“Nevertheless, both methods were found to be highly effective in reducing the pressure pain threshold (PPT) and increasing the maximum pain-free mandibular active range of motion, while a moderate effect on reducing the intensity of local pain induced by palpation was observed.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [17] Girao, 2009, Changes in masseter muscle trigger points following strain-counterstrain or neuro-muscular technique, J. Bodyw. Mov. Ther. source
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationCuccia et al. and Raiadurai investigated the use of PIR and MR methods in TMD patients.
“Additionally, Cuccia et al. [45] and Raiadurai [46] investigated the use of PIR [45,46] and MR methods [45] in TMD patients.”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [45] Cuccia, 2010, Osteopathic manual therapy versus conventional conservative therapy in the treatment of temporomandibular disorders: A randomized controlled trial, J. Bodyw. Mov. Ther. source
- cites [46] Rajadurai, 2010, The Effect of Muscle Energy Technique on Temporomandibular Joint Dysfunction: A Randomized Clinical Trial, Asian J. Sci. Res. source
May combine two claims. The quote only partly states this claim.
InterpretationcitationThe finding of greater improvement after MR than PIR is reflected in the results of this study and indicates possible greater efficiency of myofascial relaxation in improving functioning of the masticatory system.
“This finding, reflected also in the results of this study indicates the possible greater efficiency of myofascial relaxation in improving the functioning of the masticatory system.”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationcitationThe cited publications demonstrated beneficial effects of both PIR and MR methods in reducing pain sensations and improving masticatory organ function, similar to the present study.
“Similar to the present study, the cited publications demonstrated the beneficial effects of both PIR and MR methods in reducing pain sensations and improving masticatory organ function.”
Quote in the paperSubstantial claim
The paper relies on this without support.
The 10-point VAS is a valid measure of spontaneous pain intensity in the masticatory muscles.
“The intensity of spontaneous pain in the masticatory muscles was assessed based on a 10-point VAS.”
The paper relies on this without support.
The observed improvements in muscle activity and pain are attributable to the PIR and MR treatments rather than to natural course, placebo, or other factors.
“Both therapeutic methods may be used as successful forms of adjunctive therapy in the prosthetic treatment of TMD.”
The paper relies on this without support.
Comparative studies evaluating the effects of post-isometric muscle relaxation and myofascial release in patients treated for pain-related temporomandibular disorder with increased muscle tension have not been carried out as of yet.
“To the authors’ knowledge, comparative studies evaluating the effects of the post-isometric muscle relaxation and myofascial release in patients treated for pain-related TMD, accompanied by increased muscle tension, have not been carried out as of yet.”
The paper relies on this without support.
There are few scientific reports in the available literature assessing each of these methods separately in the context of the masticatory muscles.
“There are few scientific reports in the available literature assessing each of these methods separately in the context of the masticatory muscles.”
The paper relies on this without support.
There are limited data on assessing manual therapy interventions with the use of surface electromyography in this field of medicine.
“It is also noticeable that there are limited data on assessing manual therapy interventions with the use of sEMG in this field of medicine.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Statistical analysis attributed to two different software packages
MinorThe methods say the statistical analysis used Statistica 12.0, but later say all statistical analyses were performed using IBM SPSS Statistics 26. The text does not explain whether the analyses were duplicated or divided between the programs.
“A statistical analysis was performed using Statistica 12.0 (Statsoft, Tulsa, OK, USA).”
“All statistical analyses were performed using IBM Corp. released in 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY, USA: IBM Corp.”
Cites
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Liu, F., & Steinkeler, A. (2013) · Dental Clinics of North America · doi:10.1016/j.cden.2013.04.006 · Cited by 461 · cited 2× · see citing works
“Discussion Current clinical guidelines for the treatment of TMD clearly indicate the need for conservative therapy, such as physiotherapy and manual therapy [1,3,10].”
BackgroundReported concepts for the treatment modalities and pain management of temporomandibular disorders
Wieckiewicz, M., Boening, K., Wiland, P., Shiau, Y.-Y., & Paradowska-Stolarz, A. (2015) · The Journal of Headache and Pain · doi:10.1186/s10194-015-0586-5 · Cited by 359 · see citing works
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Bradbury-Squires, D. J., Noftall, J. C., Sullivan, K. M., Behm, D. G., Power, K. E., & Button, D. C. (2014) · Journal of Athletic Training · doi:10.4085/1062-6050-49.5.03 · Cited by 166 · see citing works
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“The PIR method, based mainly on neurophysiological inhibitory (relaxing) mechanisms, allows for reduced muscle tension immediately after their isometric contraction and minimizes pain sensations related to the muscular system [15,27].”
MethodCastro-Sánchez, A. M., Matarán-Peñarrocha, G. A., Arroyo-Morales, M., Saavedra-Hernández, M., Fernández-Sola, C., & Moreno-Lorenzo, C. (2011) · Clinical Rehabilitation · doi:10.1177/0269215511399476 · Cited by 107 · see citing works
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“In the reports that have shown a direct relationship between the level of perceived pain and muscle electrical activity [56,57], all of the aforementioned findings are consistent with the results of the present study.”
ResultPihut, M., Ferendiuk, E., Szewczyk, M., Kasprzyk, K., & Wieckiewicz, M. A. (2016) · The Journal of Headache and Pain · doi:10.1186/s10194-016-0621-1 · Cited by 94 · cited 1× · see citing works
“pharmacotherapy [1,11,12], as well as rehabilitation and education as forms of supportive treatment [1–3,13–18].”
BackgroundSelf-citationButts, R., Dunning, J. R., Pavkovich, R., Mettille, J., & Mourad, F. (2017) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2017.05.021 · Cited by 94 · see citing works
Ajimsha, M. S., Binsu, D., & Chithra, S. (2014) · The Foot · doi:10.1016/j.foot.2014.03.005 · Cited by 93 · cited 1× · see citing works
“Authors assessing the outcomes of MR procedures, methodically consistent with the approach carried out in this study, indicate their effectiveness in increasing the pain-free range of motion [17], reducing pain [17,36,37], improving musculoskeletal function [36,37] and reducing muscle stiffness [38].”
MethodCuccia, A. M., Caradonna, C., Annunziata, V., & Caradonna, D. (2010) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2009.08.002 · Cited by 91 · cited 1× · see citing works
“[45] and Raiadurai [46] investigated the use of PIR [45,46] and MR methods [45] in TMD patients.”
MethodStanek, J. M., Sullivan, T., & Davis, S. (2018) · Journal of Athletic Training · doi:10.4085/1062-6050-386-16 · Cited by 91 · see citing works
Temporomandibular Myofacial Pain Treated with Botulinum Toxin Injection
Mor, N., Tang, C., & Blitzer, A. (2015) · Toxins · doi:10.3390/toxins7082791 · Cited by 82 · cited 1× · see citing works
“pharmacotherapy [1,11,12], as well as rehabilitation and education as forms of supportive treatment [1–3,13–18].”
BackgroundAjimsha, M. S., Chithra, S., & Thulasyammal, R. P. (2012) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2011.10.012 · Cited by 82 · cited 1× · see citing works
“Authors assessing the outcomes of MR procedures, methodically consistent with the approach carried out in this study, indicate their effectiveness in increasing the pain-free range of motion [17], reducing pain [17,36,37], improving musculoskeletal function [36,37] and reducing muscle stiffness [38].”
MethodDelgado‐de‐la‐Serna, P., Plaza‐Manzano, G., Cleland, J., Fernández‐de‐las‐Peñas, C., Martín‐Casas, P., & Díaz‐Arribas, M. J. (2019) · Pain Medicine · doi:10.1093/pm/pnz278 · Cited by 80 · see citing works
Changes in masseter muscle trigger points following strain-counterstrain or neuro-muscular technique
Ibáñez-García, J., Alburquerque-Sendín, F., Rodríguez-Blanco, C., Girao, D., Atienza-Meseguer, A., Planella-Abella, S., & Fernández-de-las Peñas, C. (2009) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2008.03.001 · Cited by 78 · see citing works
Calixtre, L. B., Grüninger, B. L. D. S., Haik, M. N., Alburquerque‐Sendín, F., & Oliveira, A. B. (2016) · Journal of Applied Oral Science · doi:10.1590/1678-775720150240 · Cited by 75 · see citing works
Clinical Relevance of Foam Rolling on Hip Extension Angle in a Functional Lunge Position
Bushell, J. E., Dawson, S. M., & Webster, M. M. (2015) · The Journal of Strength and Conditioning Research · doi:10.1519/jsc.0000000000000888 · Cited by 73 · see citing works
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Effects of Myofascial Release on Pressure Pain Thresholds in Patients With Neck Pain
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“(1) General dental examination, based on the Diagnostic Criteria of Temporomandibular Disorders (RDC/TMD) [40]; (2) Physiotherapeutic examination of the masticatory organ; (3) Electromyographic examination (sEMG) of the anterior part of the temporal and masseter muscles; (4) Assessment of the intensity of muscle pain…”
MethodInfluentialBROCHADO, F. T., JESUS, L. H. D., CARRARD, V. C., FREDDO, A. L., CHAVES, K. D., & MARTINS, M. D. (2018) · Brazilian Oral Research · doi:10.1590/1807-3107bor-2018.vol32.0050 · Cited by 68 · see citing works
The influence of contraction duration in muscle energy technique applied to the atlanto-axial joint
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Blanco, C. R., de las Peñas, C. F., Xumet, J. E. H., Algaba, C. P., Rabadán, M. F., & de la Quintana, M. C. L. (2006) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2005.07.002 · Cited by 62 · cited 3× · see citing works
“The reports indicate the effectiveness of PIR in increasing the range of mandibular motion in patients treated due to the presence of trigger points and an increased tension of the masseter muscles [16].”
BackgroundResultInfluentialde Resende, C. M. B. M., Medeiros, F. G. L. D. O., Rêgo, C. R. D. F., Bispo, A. D. S. L., Barbosa, G. A. S., & de Almeida, É. O. (2019) · CRANIO® · doi:10.1080/08869634.2019.1627068 · Cited by 60 · see citing works
Berni, K. C. D. S., Dibai-Filho, A. V., Pires, P. F., & Rodrigues-Bigaton, D. (2015) · Journal of Electromyography and Kinesiology · doi:10.1016/j.jelekin.2015.05.004 · Cited by 59 · see citing works
The effect of muscle energy technique on gross trunk range of motion
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Østensvik, T., Veiersted, K. B., & Nilsen, P. (2009) · Ergonomics · doi:10.1080/00140130903199889 · Cited by 52 · cited 1× · see citing works
“In the reports that have shown a direct relationship between the level of perceived pain and muscle electrical activity [56,57], all of the aforementioned findings are consistent with the results of the present study.”
Resultvon Piekartz, H., Pudelko, A., Danzeisen, M., Hall, T. M., & Ballenberger, N. (2016) · Manual Therapy · doi:10.1016/j.math.2016.09.001 · Cited by 50 · see citing works
The Effects of Active Release Technique on Hamstring Flexibility: A Pilot Study
George, J. W., Tunstall, A. C., Tepe, R. E., et al. (2006) · Journal of Manipulative and Physiological Therapeutics · doi:10.1016/j.jmpt.2006.01.008 · Cited by 47 · see citing works
Ichikawa, K., Takei, H., Usa, H., Mitomo, S., & Ogawa, D. (2015) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2014.11.018 · Cited by 45 · cited 1× · see citing works
“Authors assessing the outcomes of MR procedures, methodically consistent with the approach carried out in this study, indicate their effectiveness in increasing the pain-free range of motion [17], reducing pain [17,36,37], improving musculoskeletal function [36,37] and reducing muscle stiffness [38].”
MethodReynolds, B., Puentedura, E. J., Kolber, M. J., & Cleland, J. A. (2020) · Journal of Orthopaedic & Sports Physical Therapy · doi:10.2519/jospt.2020.9175 · Cited by 43 · see citing works
TMJ Disorders and Orofacial Pain. The role of dentistry in a multidisciplinary diagnostic approach
Mahan, P. E. (2003) · Dentomaxillofacial Radiology · doi:10.1259/dmfr/13389903 · Cited by 38 · see citing works
de Toledo, E. G., Silva, D. P., de Toledo, J. A., & Salgado, I. O. (2012) · The Journal of Contemporary Dental Practice · doi:10.5005/jp-journals-10024-1190 · Cited by 36 · see citing works
Pessoa, D. R., Costa, D. R., Prianti, B. D. M., Costa, D. R., Delpasso, C. A., Arisawa, E. Â. L. S., & Nicolau, R. A. (2018) · CoDAS · doi:10.1590/2317-1782/20182017265 · Cited by 36 · see citing works
The Acute Effects of Foam Rolling on Fatigue-Related Impairments of Muscular Performance
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Kojidi, M. M., Okhovatian, F., Rahimi, A., Baghban, A. A., & Azimi, H. (2016) · Journal of Chiropractic Medicine · doi:10.1016/j.jcm.2016.08.010 · Cited by 25 · see citing works
Rajadurai, V. (2010) · Asian Journal of Scientific Research · doi:10.3923/ajsr.2011.71.77 · Cited by 22 · cited 1× · see citing works
“[45] and Raiadurai [46] investigated the use of PIR [45,46] and MR methods [45] in TMD patients.”
MethodMozhdeh, M., Caroccia, F., Moscagiuri, F., et al. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17238760 · Cited by 19 · cited 1× · see citing works
“This high prevalence is related to its multidimensional etiology [1–5], diagnostic and therapeutic difficulties [6], and the lack of knowledge even among dentist on TMD management [7].”
BackgroundKnowledge and management of temporomandibular joint disorders by general dentists in Spain
López-Frías, F. J., Gil-Flores, J., Bonilla-Represa, V., Ábalos-Labruzzi, C., & Martínez, M. H. (2019) · Journal of Clinical and Experimental Dentistry · doi:10.4317/jced.55634 · Cited by 17 · see citing works
Asquini, G., Bianchi, A. E., Heneghan, N. R., Rushton, A. B., Borromeo, G., Locatelli, M., & Falla, D. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-032113 · Cited by 16 · see citing works
D’Attilio, M., Migliore, F. M., Moscagiuri, F., & Caroccia, F. (2021) · Applied Sciences · doi:10.3390/app11188303 · Cited by 6 · cited 1× · see citing works
“Therefore, currently recommended approaches in TMD therapy include primarily prosthetic and orthodontic treatment [1,8,10],”
BackgroundBiegańska, J. (2016) · Archives of Psychiatry and Psychotherapy · doi:10.12740/app/62182 · Cited by 3 · cited 1× · see citing works
“The use of these interventions with simultaneous prosthetic treatment significantly accelerates the restoration of proper functioning of the masticatory organ [1,13,14].”
Clinical Application of Neuromuscular Techniques, Volume 2
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[Motor system physiotherapy of the masticatory organ].
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Garstka, A. A., Kozowska, L., Kijak, K., Brzózka, M., Gronwald, H., Skomro, P., & Lietz–Kijak, D. (2023) · Pain Research and Management · doi:10.1155/2023/1002235 · Cited by 94 · see citing works
Temporomandibular Joint Dysfunctions: A Systematic Review of Treatment Approaches
González-Sánchez, B., Monterey, P. G., Ramírez-Durán, M. D. V., Garrido-Ardila, E. M., Rodríguez-Mansilla, J., & Jiménez-Palomares, M. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12124156 · Cited by 78 · see citing works
“Study Objective DiagnosedDisorder [8] Sample/Age Intervention Duration Assessment Tool Results Urbański et al., 2021 [27] To compare the degree of relaxation of the anterior part of the temporal muscles and the masseter muscles achieved through the use of post-isometric relaxation and myofascial…”
BackgroundMethodInfluentialDiagnosis and Treatment of Myogenous Temporomandibular Disorders: A Clinical Update
Chan, N. H. Y., Ip, C.-K., Li, D.-O., & Leung, Y. (2022) · Diagnostics · doi:10.3390/diagnostics12122914 · Cited by 54 · see citing works
“Although the aforementioned procedures have been more extensively documented in treating muscles of the trunk and limbs, these relaxation techniques have been reported to improve musculoskeletal functions even in the masticatory system, possibly by relief of muscle tension [76].”
BackgroundBrighenti, N., Battaglino, A., Sinatti, P., Porras, V. A., Romero, E. A. S., Pedersini, P., & Villafañe, J. H. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20042777 · Cited by 45 · see citing works
“[25] evaluated the efficacy of two different physiotherapy techniques in 70 patients affected by TMD with a dominant muscle component who were divided into two groups: patients in group I underwent postisometric relaxation treatment, and patients in group II were treated with myofascial release treatment.”
MethodZieliński, G., & Gawda, P. (2024) · Journal of Personalized Medicine · doi:10.3390/jpm14060655 · Cited by 20 · see citing works
Novel Diagnostic and Therapeutic Approaches to Temporomandibular Dysfunction: A Narrative Review
Moxley, B., Stevens, W., Sneed, J., et al. (2023) · Life · doi:10.3390/life13091808 · Cited by 16 · see citing works
“This study by Urba´nski et al. enrolled patients who are currently undergoing prosthetic treatment to relieve TMD with a dominant muscular component [28].”
MethodLubecka, K., Chęcińska, K., Bliźniak, F., et al. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm13010106 · Cited by 15 · see citing works
“In the course of physical examination, it is possible to distinguish muscle pain from joint pain, which guides further diagnosis and treatment [5–7].”
BackgroundGębska, M., Dalewski, B., Pałka, Ł., & Kołodziej, Ł. (2023) · Injury · doi:10.1016/j.injury.2023.110906 · Cited by 14 · see citing works
Multimodal Approaches in the Management of Temporomandibular Disorders: A Narrative Review
Dąbkowska, I., Sobiech, L., Czępińśka, A., Bęben, A., Turżańska, K., & Gawda, P. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14124326 · Cited by 16 · see citing works
Militi, A., Bonanno, M., & Calabrò, R. S. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12103528 · Cited by 13 · see citing works
“Breathing and relaxing exercises in which therapists guide the diaphragmatic inspiration, through hands on the rectus abdominis, are useful to promote muscle release and psychological wellness [71,72].”
BackgroundGębska, M., Dalewski, B., Pałka, Ł., Kiczmer, P., & Kołodziej, Ł. (2023) · BMC Oral Health · doi:10.1186/s12903-023-03601-y · Cited by 12 · see citing works
“In the study by Urbanski et al. [44], this time was, as in our study, 10 days (excluding Sundays); however, in our study the days excluded from therapy were both Saturday and Sunday.”
ResultTariq, M., Fatima, K., Khan, S. F. A., Mahmood, W., Mahmood, T., Khurshaid, S., Khalid, M., Khoosa, M., & Babur, M. (2024) · BMC Sports Science Medicine and Rehabilitation · doi:10.1186/s13102-024-00865-x · Cited by 10 · see citing works
Ferreira, C. C. Q., Lima, K. R., Dias‐Peixoto, M. F., Orlando, D. R., Castelo, P. M., Pereira, L. J., & Andrade, E. F. (2024) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2024.05.015 · Cited by 11 · see citing works
Al-hadad, S. A., Ahmed, M. M. S., Zhao, Y., Wang, L., Hu, W., Li, C., Chen, X., & Alhammadi, M. S. (2024) · BMC Oral Health · doi:10.1186/s12903-024-04260-3 · Cited by 9 · see citing works
“Alternatively, there are non-invasive treatments such as manual therapy, psychotherapy, physiotherapy, short-term pharmacotherapy and occlusal splints [8–11].”
MethodDorosz, T., Mańko, A., & Ginszt, M. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13030920 · Cited by 12 · see citing works
“In the papers of Ginszt et al. [17], Ku´c et al. [15], and Urba´nski et al. [16], therapeutic techniques were applied by a specialized professional.”
BackgroundMethodInfluentialJaved, S., Bashir, M. S., Mehmood, A., et al. (2024) · BMC Oral Health · doi:10.1186/s12903-024-04440-1 · Cited by 8 · see citing works
“The PIR technique, which focuses primarily on neurophysiological inhibitory relaxation mechanisms (e.g. autogenic inhibition), allows for the immediate reduction of muscle tension following isometric contraction and the reduction of pain perception related to the muscular system [16].”
MethodInfluentialElectroacupuncture on Hemifacial Spasm and Temporomandibular Joint Pain Co-Morbidity: A Case Report
Huang, J., Liang, Z.-M., Zou, Q.-W., Zhan, J., Li, W., Li, S., Li, K., Fu, W., & Liu, J. (2022) · Frontiers in Neurology · doi:10.3389/fneur.2022.931412 · Cited by 8 · see citing works
“For TMJ pain, the intensity of pain was assessed by VAS, which included scores from 0 (no pain at all) to 10 (strongest pain) (30).”
MethodTemporomandibular Disorders and Physiotherapy
Almeida, L. E. (2023) · The Journal of Contemporary Dental Practice · doi:10.5005/jp-journals-10024-3575 · Cited by 7 · see citing works
Al-hadad, S. A., Chen, P., Zhao, Y., Li, C., Zhang, C., Alshoaibi, L. H., Musa, M., Saif, B. S., Izeldin, S., Al-Qurmoti, S., et al. (2025) · International Dental Journal · doi:10.1016/j.identj.2025.100845 · Cited by 7 · see citing works
Topaloğlu, E. Ş., Budak, M., Atılgan, E., & Kurt, H. (2025) · Medicine · doi:10.1097/md.0000000000044086 · Cited by 5 · see citing works
“Recent years have witnessed a growing body of research supporting the efficacy of MFR therapy in alleviating pain associated with TMD. [28,45] Prior research under-scores the importance of personalized jaw exercise programs for individuals with TMD, emphasizing the role of both written and verbal…”
Cordero, A., Jaramillo, A. P., Bautista, N. M. O., et al. (2025) · Cureus · doi:10.7759/cureus.92093 · Cited by 4 · see citing works
“Urbański et al. corroborated these findings, demonstrating equivalent reductions in pain and electromyographic activity with PIR and myofascial release techniques, supporting their use as adjunctive therapies in multidisciplinary management plans [3].”
InfluentialZhang, S., Jiang, Y., Gao, D., Zhou, Z., & Zhang, Q. (2025) · Journal of Back and Musculoskeletal Rehabilitation · doi:10.1177/10538127241309240 · Cited by 4 · see citing works
Boian, A. M. (2025) · Kharkiv Dental Journal · doi:10.26565/3083-5607-2025-4-03 · Cited by 3 · see citing works
Junior, P., Siéssere, S., de Mello, E., Rodrigues, S. R. M., REGALO, I. H., Gonçalves, L., Arnoni, V. W., Palinkas, M., & Regalo, S. C. H. (2023) · Journal of Clinical and Experimental Dentistry · doi:10.4317/jced.60312 · Cited by 3 · see citing works
“The success of IMR and DN in reducing pain in the temporal and masseter muscles in patients with TMD has been reported in other studies (26).”
Xia, T. D., Luo, R., & Wang, M. (2023) · Journal of Stomatology Oral and Maxillofacial Surgery · doi:10.1016/j.jormas.2023.101511 · Cited by 3 · see citing works
Zieliński, G., Suwała, M., Szkutnik, J., Ginszt, M., & Gawda, P. (2024) · CRANIO® · doi:10.1080/08869634.2024.2402577 · Cited by 4 · see citing works
“In the first group of 30 patients, a post-isometric masseter relaxation technique was used, which involved stretching a muscle previously performing isometric contraction [24].”
InfluentialYarygina, E. N., Shkarin, V. V., Makedonova, Y. А., et al. (2024) · Кубанский научный медицинский вестник · doi:10.25207/1608-6228-2024-31-6-56-71 · Cited by 3 · see citing works
Festa, F., Lopedote, N., Rotelli, C., Caulo, M., & Macrì, M. (2023) · Applied Sciences · doi:10.3390/app13137934 · Cited by 3 · see citing works
Ying, J., Gao, J., Gao, L., et al. (2025) · International Journal of General Medicine · doi:10.2147/ijgm.s539079 · Cited by 2 · see citing works
“44,45 A recent review demonstrated that all manual therapies, either alone or in association with other conservative interventions, can effectively reduce pain and increase degree of mouth opening.”
Skorupa-Strojna, A., & Kulesa-Mrowiecka, M. (2026) · Scandinavian Journal of Pain · doi:10.1515/sjpain-2025-0073 · Cited by 2 · see citing works
Szajkowski, S., Pasek, J., Dwornik, M., & Cieślar, G. (2023) · Minerva Dental and Oral Science · doi:10.23736/s2724-6329.23.04855-6 · Cited by 3 · see citing works
Yarygina, E. N., Shkarin, V. V., Makedonova, Y. А., et al. (2024) · Pediatric dentistry and dental prophylaxis · doi:10.33925/1683-3031-2024-762 · Cited by 2 · see citing works
Delkhoush, C. T., Mirmohammadkhani, M., & Qomi, F. N. (2024) · Journal of Oral Rehabilitation · doi:10.1111/joor.13859 · Cited by 2 · see citing works
Physical Therapy in Patients with Temporomandibular Joint Disorders
Liu, J., Zhang, F., Yue, C., & Liu, J. (2025) · Advanced Medical Research · doi:10.62836/amr.v4i1.370 · Cited by 2 · see citing works
Gradation of the severity of myofascial pain syndrome of the masticatory muscles
Yarygina, E. N., Shkarin, V. V., Makedonova, Y. А., et al. (2024) · Medical alphabet · doi:10.33667/2078-5631-2024-18-100-105 · Cited by 2 · see citing works
Gębska, M., Dalewski, B., Pałka, Ł., & Kołodziej, Ł. (2022) · Research Square · doi:10.21203/rs.3.rs-2179730/v1 · Cited by 2 · see citing works
Immediate and short-term effect of manual therapy on masseter muscle: an ultrasonography study
Açıkgöz, G., Uzun, E., Yıldız, G., et al. (2025) · Oral Radiology · doi:10.1007/s11282-025-00827-0 · Cited by 1 · see citing works
“It has been observed that manual therapy reduces pain, improves musculoskeletal system functions, and increases mandibular range of motion [9, 10, 13, 17, 26].”
InfluentialPelai, E. B., de Castro‐Carletti, E. M., Tavares, L. F., Michelotti, A., Pitance, L., Rodrigues-Bigaton, D., Mescollotto, F. F., Dennett, L., & Armijo-Olivo, S. L. (2025) · Disability and Rehabilitation · doi:10.1080/09638288.2025.2539469 · Cited by 1 · see citing works
“The pooled data from four studies [52,64,68,120] showed an SMD of 0.53 (95% CI [–0.71, 1.78], p = 0.40; Supplementary Material S9 (Figure 9.1 comparison 9.1.1)), with a small effect size and very weak evidence against the null hypothesis.”
InfluentialNovoseltsev, S., Reshetnikov, A., Nefedova, A., Rylskiy, A. V., & Abakumova, M. (2025) · Manual Therapy · doi:10.54504/1684-6753-2025-1-4-57-67 · Cited by 1 · see citing works
Ortiz, H. A. D. L. B., Lange, C. C., & Liebano, R. E. (2026) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph23060697 · Cited by 1 · see citing works
“…of LLLT-AT, these results underscore the role of manual therapy as a foundational intervention for the musculoskeletal components of myogenic TMDs [55,58], while suggesting that the adjunctive effects of LLLT-AT may preferentially emerge in non-mechanical domains, such as psycho-emotional…”
Ferrillo, M., Calafiore, D., ROSA, A. D., et al. (2026) · Journal of Oral Rehabilitation · doi:10.1111/joor.70271 · Cited by 1 · see citing works
“Similar outcomes were underlined in a previous study where MFR techniques were assessed for their efficacy in TMD disorders [51, 52].”
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dos Santos, A. C. D. J., de Oliveira, A. D. S., Gutierrez, C. M., et al. (2023) · doi:10.56238/seveniiimulti2023-142
Effect of telerehabilitation on patients with orofacial pain during the COVID-19 pandemic
dos Santos, A. C. D. J., de Oliveira, A. D. S., Gutierrez, C. M., et al. (2023) · doi:10.56238/seveniiimulti2023-268
ACUPUNTURA X TERAPIA MANUAL NAS DISFUNÇÕES TEMPOROMANDIBULARES: UMA REVISÃO INTEGRATIVA
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A eficácia das técnicas manuais fisioterapêuticas nas disfunções temporomandibulares
Bacha, C. D. J., Livramento, R. A., Moura, K. M. D. F., et al. (2023) · Brazilian Journal of Health Review · doi:10.34119/bjhrv6n6-530
Electromyography of Masticatory Muscles: Insights into Function and Clinical Applications
Temelci, A. (2024) · World Journal of Dentistry · doi:10.5005/jp-journals-10015-2317
张, 强. (2024) · Traditional Chinese Medicine · doi:10.12677/tcm.2024.135167
SHORT-STAY INPATIENT - EMPHASIS ON SPINE SURGERY AND PAIN MANAGE-MENT CLINIC
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“[6,8] Bruxism by grinding and clenching teeth, often during sleep, causes constant overstrain of the masseter muscles.”
InfluentialShkarin, V. V., Yarygina, E. N., Makedonova, Y. А., et al. (2025) · Medical alphabet · doi:10.33667/2078-5631-2025-1-71-76
The effectiveness of physical therapy for temporomandibular disorder: A systematic review
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Semiología del dolor orofacial: claves para el diagnóstico diferencial. Revisión de la literatura
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“…during daily activities, is an important parameter to evaluate in individuals with myofascial TMD. Significant improvements were observed in both groups, consistent with previous studies demonstrating the effectiveness of various physiotherapy interventions in individuals with TMD [10, 43].”
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Manual therapy for temporomandibular myofascial pain: a phenotype-guided narrative review
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“Craniomandibular manual therapy studies suggest short-term pain and maximum mouth-opening benefits, especially when combined with exercise and education [11,12,25-28] .”
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“For the masticatory muscles, Urbański et al. (2021) measured surface electromyographic activity of the temporal muscles falling from 251.5 µV to 186.6 µV and of the masseter from 239.4 µV to 187.4 µV following manual technique, alongside a fall in pain intensity from 5.0 to 2.0 on a visual analogue…”
InfluentialGębska, M., Dalewski, B., Pałka, Ł., & Kołodziej, Ł. (2023) · Head & Face Medicine · doi:10.1186/s13005-023-00385-y · Cited by 33 · see citing works
“The differences between the study results may be due to the use of a different methodology for conducting the soft tissue therapy procedure in the above study [40].”
- Authors
- Urbański, P., Trybulec, B., & Pihut, M.
- Affiliations
- Jagiellonian University (PL)
- Corresponding author
- Urbański, Piotr
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2021-12-08
- Volume
- 18
- Issue
- 24
- Pages
- 12970
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC8700844
- OpenAlex
- W4200390732
- Semantic Scholar
- d48dfe7ea4d632432c05295b5af64f3e5dc4984c
- Cited by
- 73
- References
- 48
- Citations by year
- 2026: 10 · 2025: 20 · 2024: 19 · 2023: 20 · 2022: 4
- FWCI
- 10.66
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Jagiellonian University Repository (Jagiellonian University) (submittedVersion, cc-by-nc-nd)
- PubMed Central (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Myofascial pain diagnosis and treatment
- Physical Sciences › Engineering › Biomedical Engineering › Muscle activation and electromyography studies
- Keywords
- temporomandibular disorders, post-isometric relaxation, myofascial release, masseter muscle, anterior temporalis muscle, surface electromyography, masticatory muscle pain, prosthetic treatment, adjunctive therapy, manual therapy
- MeSH terms
- Myofascial Release Therapy, Electromyography, Humans, Masseter Muscle, Masticatory Muscles, Temporal Muscle, Temporomandibular Joint Disorders
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