Kaltenborn Mobilization Versus Active Release Technique on Temporomandibular Joint Dysfunction for Radiation - Induced Trismus in Patients With Head and Neck Cancer
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 115
- 试验地点
- 1
- 主要终点
- Pain pressure threshold
研究概览
简要总结
Temporomandibular disorder (TMD) is a term describing musculoskeletal conditions of the face, jaw and temporal regions. TMD is frequently associated with pain and/or dysfunction such as impaired jaw function, pain in the temporomandibular joint (TMJ), muscles and/or related structures, and associated headaches. The etiology of TMD is multifactorial and complex.
It is known that one cause of TMD symptom development is treatment for head and neck cancer (HNC). The main treatment modalities for HNC include radiotherapy (RT) with or without chemotherapy and surgical intervention, as either a single therapy or a combination therapy. In the head and neck region, the anatomical structures are necessary for essential functions such as speech, swallowing, breathing, smell, and taste. The treatment of head and neck tumors may frequently impair some of these functions, which may result in pain, oral dysfunction, and impaired health-related quality of life.
详细描述
KMT evaluates the motions on the articular surfaces and applies them to treatment according to MacConaill's classification of synovial joints to restore the reduced accessory glides and achieve painless physiological movements. KMT involves the application of a passive sustained joint play that can be graded from I to III based on the type and amount of force applied. Grade-I, "loosening" refers to small-amplitude joint distraction that produces an appreciable increase in joint separation without any stress on the capsule that equalizes the cohesive forces, muscle tension and atmospheric pressure acting on the joint. Grade-II, "tightening" refers to the distraction or glide movements applied to tighten the tissues around the joint, also known as "taking up the slack". Grade-III, "stretching" refers to the distraction or glide movement applied to stretch the joint capsule and surrounding per articular structures, thus, increasing joint ROM.
Another option to consider is offered here at Pain and Performance Solutions. We have seen great results from treating TMJ disorders using Active Release Technique®. This deep tissue therapy technique is primarily used to break up adhesions and scar tissue on the surrounding muscle and ligaments. However, this technique has been proven a very effective method for treating TMD.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 20 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •An experienced oral and maxillofacial surgeon will diagnose patients with temporomandibular joint disorders (myofascial pain, trismus and limitation of ROM) after head and neck cancer, patients.
- •Patients with 20 to 60 years old.
- •6 months after ending radiotherapy.
排除标准
- •Patients with implants.
- •Current metastasis.
- •Continuing radiotherapy.
- •Pregnant females.
- •Sensitivity to phototherapy.
- •Bell's palsy.
- •Subjects with disk displacement, arthralgia or osteoarthritis at TMJ.
- •Subjects who received analgesics or antidepressants.
研究组 & 干预措施
control
No intervention
Kaltenborn mobilization
A certified therapist administered TMJ KM in the following way. The therapist stood behind the seated patient, placing their palms on both sides of the patient's head, with the thumbs over the zygomatic arches, to stabilize the head.
干预措施: Kaltenborn mobilization (Other)
active release technique
This deep tissue therapy technique is primarily used to break up adhesions and scar tissue on the surrounding muscle and ligaments. However, this technique has been proven to be a very effective method for treating TMD
干预措施: active release technique (Other)
结局指标
主要结局
Pain pressure threshold
时间窗: at baseline and at 8 weeks
The pain pressure threshold over the temporalis and masseter muscles will be assessed using an algometry with a 1 cm2 probe tip.lower thresholds indicating increased tenderness and sensitivity
Maximal interincisal opening
时间窗: at baseline and at 8 weeks
The stainless steel vernier caliper, which has two arms-one fixed and one movable-connected by a calibrated scale, showed exceptional reliability for measuring mouth opening.Millimeters were used to measure the separation between the incisal edges of the upper and lower incisor teeth
次要结局
- Functional disability(at baseline and at 8 weeks)
- Quality of life (Oral health Impact Profile(at baseline and at 8 weeks)
研究者
Ahmed Mohamed Ahmed Abd El hady El Fahl,ph.d
Assisstant professor
MTI University