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Our protocol induced improvements in jaw opening similar to those observed with local treatment of the masseter muscle.

At the limit of pain-free mouth opening, the distance between the upper-lower central incisors not considering the overbite was measured. Pain reduction is suggested cinesiologiq be associated with increased MMO.


Although the improvement on MMO did not reach the clinically meaningful difference 22the significant change and the good effect size of the therapy suggest great tendency towards restoration of normal values for MMO, even after few intervention sessions of manual therapy techniques and segmental stabilization applied directly to cervical spine. Sample size was calculated considering PPT as the main outcome, with data from the literature 24for a repeated measures design.

Comparison between first and second evaluations; 2×3: Bartsch T, Goadsby PJ. It can help to understand the perpetuation of the results along time.


The effects of manual therapy and exercise directed at the cervical spine on pain and pressure pain sensitivity in patients with myofascial temporomandibular disorders. Previous studies 1618 showed that during chewing activities, there are movements on the upper cervical spine related to mouth opening and closing, and they depend on the coordination of the masticatory and cervical muscles.

PPT also increased with moderate effect size, and subjects had the baseline values changed ombfo 1.

Comparison between second and third evaluations. Thus, joint mobilization toward the upper cervical region appears to reduce muscular reflex contractions and to allow muscle relaxation, especially in masseter muscles, and may consequently increase MMO.

There was also a significant improvement in masticatory muscle sensitivity on the left side. These criteria demonstrated good reliability ICC 0. The masseter muscle was evaluated at 1 cm above and 2 cm anterior to ojbro mandibular angle. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Armijo-Olivo S, Magee D. A systematic review of the effectiveness of physical therapy interventions for temporomandibular disorders. The protocol reported by La Touche, et al. Physiotherapy techniques involving manual therapy, active and passive stretching, strengthening of involved muscles, and postural exercises seem to be effective for TMD treatment The baseline phase consisted of two evaluations E1 and E2 performed with a 3-week interval, during which time the subjects received no treatment.


Cervical musculoskeletal impairments and temporomandibular disorders. Cervical spine signs and symptoms: Moreover, La Touche et al.

Abdução, Adução horizontal e flexão e extensão do ombro.

Therefore, muscle-conditioning techniques, manual therapy, and stretching were applied for 10 kmbro of approximately 35 minutes each: Finally, according to Leandri, et al.

We believe that further studies should consider a follow-up performed some weeks after the last evaluation. To investigate the effect of a rehabilitation program based on cervical mobilization and exercise on clinical signs and mandibular function in subjects with temporomandibular disorder TMD.

Therefore, stimulation of structures innervated by the trigeminal nerve may produce neck pain and vice-versa 6. Load increase was used to progress the exercise. The dotted frames indicate the excluded subjects. However, high quality studies investigating manual therapy on subjects with TMD show positive effects with few sessions 8. The therapist monitored any contraction of superficial neck flexors muscles with palpation of the anterior neck region to ensure that the exercise was being dinesiologia performed.

Pain-free MMO varied from Arch Phys Med Rehabil.