Global Postural Reeducation and Static Stretching Exercises in the Treatment of Myogenic Temporomandibular Disorders: A Randomized Study

Maluf, Sâmia A.; Moreno, Bruno G.D.; Crivello, Osvaldo; Cabral, Cristina M.N.; Bortolotti, Gislaine; Marques, Amélia P.

doi:10.1016/j.jmpt.2010.08.005

« Previous Next »Journal of Manipulative and Physiological Therapeutics
Volume 33, Issue 7 , Pages 500-507, September 2010

Global Postural Reeducation and Static Stretching Exercises in the Treatment of Myogenic Temporomandibular Disorders: A Randomized Study

Sâmia A. Maluf, PhD
- Physiotherapist, Movicet (Movement–Therapy and Research Centre), Campinas SP, Brazil
Bruno G.D. Moreno, MS
- Physiotherapist, Department of Physical Therapy, Adamantinenses School, Adamantina SP, Brazil
Osvaldo Crivello, PhD
- Dentist, School of Odontology, University of São Paulo, São Paulo SP, Brazil
Cristina M.N. Cabral, PhD
- Physiotherapist, Department of Physical Therapy, City of São Paulo University, São Paulo SP, Brazil
Gislaine Bortolotti, PhD
- Statistician, Uniararas, Araras SP, Brazil
Amélia P. Marques, PhD
- Physiotherapist, Department of Speech, Physical Therapy and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo SP, Brazil
- Submit requests for reprints to: Amélia P. Marques, PhD, Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine, University of São Paulo, Rua Cipotânea 51, Cidade Universitária, 05360-160, São Paulo SP, Brazil

Received 22 October 2009; received in revised form 22 May 2010; accepted 8 June 2010. published online 03 September 2010.

Abstract

Objective

The purpose of this study was to compare 2 different interventions, global postural reeducation (GPR) and static stretching exercises (SS), in the treatment of women with temporomandibular disorders (TMDs).

Methods

A total of 28 subjects with TMDs were randomized into 2 treatment groups: GPR, where therapy involved muscle global chain stretching, or SS, with conventional static stretching; but only 24 completed the study. Eight treatment sessions lasting 40 minutes each (weekly) were performed. Assessments were conducted at baseline, immediately after treatment end, and 2 months later. Measurements included pain intensity at the temporomandibular joint, headache, cervicalgia, teeth clenching, ear symptoms, restricted sleep, and difficulties for mastication, using a visual analogue scale. In addition, electromyographic activity and pain thresholds were measured at the masseter, anterior temporalis, sternocleidomastoid, and upper trapezius muscles. Two-way analysis of variance with Tukey post hoc test was used for between-group comparisons. Significance level was .05.

Results

Comparing the pain assessments using the visual analogue scale, no significant differences were seen with the exception of severity of headaches at treatment end (GPR, 3.92 ± 2.98 cm; SS, 1.64 ± 1.66 cm; P < .024). In addition, no significant differences were seen for pain thresholds and for electromyographic activity (P > .05).

Conclusions

For the subjects in this study, both GPR and SS were similarly effective for the treatment of TMDs with muscular component. They equally reduced pain intensity, increased pain thresholds, and decreased electromyographic activity.

Key Indexing Terms: Muscle Stretching Exercises, Temporomandibular Joint, Pain Measurement, Pain Threshold, Electromyography