Do myofascial trigger points in masseter muscles affect the symptoms of disc displacement with reduction? A cross-sectional study.

OBJECTIVE: The aim of this study was to demonstrate the effect of myofascial pain with referral from the trigger points in the masseter muscles on the clinical symptoms and functional limitations of the temporomandibular joint in participants with disc displacement with reduction. METHODS: This prospective, cross-sectional study recruited participants aged 18-45 years with disc displacement with reduction with/without myofascial pain with referral in the masseter muscles based on the inclusion criteria. Maximum mouth opening and the presence of probable awake bruxism were assessed. The "Graded Chronic Pain Scale version 2.0" and "Jaw Function Limitation Scale-8" were used to evaluate Diagnostic Criteria for Temporomandibular Disorders Axis II. Pain levels were measured using the Visual Analog Scale. RESULTS: A comparison between the disc displacement with reduction and disc displacement with reduction+myofascial pain with referral groups revealed statistically significant differences in Visual Analog Scale (p<0.001), the presence of awake bruxism (p=0.038), and Graded Chronic Pain Scale version 2.0 (p=0.010). However, no statistically significant difference was observed between the two groups concerning maximum mouth opening and Jaw Function Limitation Scale-8. CONCLUSION: Participants with both disc displacement with reduction and myofascial pain with referral in the masseter muscle exhibited higher pain intensity, a higher prevalence of awake bruxism, and increased pain-related disability compared to those with disc displacement with reduction alone.

Effectiveness of virtual reality therapy in chronic unilateral vestibular hypofunction: A randomized controlled study.

Objectives: The aim of the study was to investigate the superiority of rehabilitation with virtual reality (Nintendo Wii) over habituation exercises in chronic vestibular hypofunction. Patients and methods: Eighty-seven patients (44 males, 43 females; mean age: 45.8±12.2 years; range, 19 to 70 years) with chronic unilateral vestibular hypofunction were included in the prospective randomized controlled study conducted between October 2017 and June 2018. Patients were randomized into two groups: the treatment group (TG; n=45) and the control group (n=42). Each group received vestibular rehabilitation exercises. The TG exercised with visual stimulation (virtual reality) in addition to the standard exercises. The patients were evaluated before the treatment and at two and three months. The frequency of dizziness was questioned. Visual analog scale, timed up and go test, Berg balance test, Romberg test, and Dizziness Handicap Inventory questionnaire were used to assess the patients. Results: There was a statistically significant decrease in the severity of dizziness in both groups at two- and three-month controls (p<0.001). In the comparison between the groups, severity of dizziness, frequency of attacks, and daily frequency were significantly improved in the TG (p<0.001). Conclusion: Adding virtual reality therapy to habituation exercises is effective in reducing the frequency of attacks.

Investigation of Factors Associated with Dizziness, Tinnitus, and Ear Fullness in Patients with Temporomandibular Disorders

Aims: To determine differences between TMD subtypes in terms of clinical characteristics, dizziness, tinnitus, and ear fullness according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and to investigate the clinical conditions associated with dizziness, tinnitus, and ear fullness. Methods: Participants having TMDs aged 18 to 45 years were included in this study. They were classified and divided into three groups according to the DC/TMD Axis I criteria: group 1 = pain-related TMDs and headache; group 2 = intra-articular joint disorders; and group 3 = degenerative joint disease. Demographic data and dizziness, tinnitus, and ear fullness were assessed. Maximum mouth opening, opening/closing click, lateral click, fine/coarse crepitation, bruxism, and presence of pain were evaluated by physical examination. Results: A total of 129 participants were included: 68 (52.7%) in group 1, 40 (31%) in group 2, and 21 (16.3%) in group 3. In the comparison of all three diagnostic groups, there was a significant difference only in educational level (P = .013). The presence of dizziness, tinnitus, or ear fullness was not found to be significantly different among the three groups. When all participants were divided into two groups according to the presence of dizziness, low education levels (P = .007), being married (P = .040), presence of pain (P = .002), tinnitus (P = .008), ear fullness (P = .017), and presence of thin crepitation (P = .015) were related to having dizziness symptoms. In addition, patients with ear fullness (P = .042), dizziness (P = .008), and female sex (P = .008) reported more tinnitus. Conclusion: TMD subtype was not associated with dizziness, tinnitus, or ear fullness. Painful conditions were associated with dizziness in participants with TMDs.

Five Times Sit-to-Stand Test in people with non-specific chronic low back pain-a cross-sectional test-retest reliability study.

PURPOSE/AIM: The Five Times Sit-to-Stand Test (FTSST) is a method that evaluates lower extremity muscle strength and balance level. The aim of this study is to test the validity and reliability of the FTSST in patients with non-specific chronic low back pain (NSCLBP) whose lower extremity muscle strength and balance levels are adversely affected. METHODS: The first outcome measure of the study was the FTSST, which was conducted by two different researchers. Secondary outcome measures are Biodex Balance System (BBS), Quadriceps Muscle Strength Test, Oswestry Disability Index (ODI), and Visual Analogue Scale (VAS). Intraclass Correlation Coefficient (ICC) was used for the validity and reliability of the FTSST, which was made by two different researchers, and Pearson's Correlation Analysis was used to determine its relationship with other measurements. RESULTS: Inter-rater and test-retest reliability for the FTSST were excellent (Intraclass Correlation Coefficient = 0.99). A statistically significant correlation was found between all secondary outcome measures (BBS, quadriceps muscle strength, ODI, VAS) and FTSST (p < 0.05). CONCLUSION: In line with the findings of our study, we think that FTSST is a simple, easy, and reproducible method for evaluating lower extremity muscle strength, balance level, functional status, and pain in patients with NSCLBP.

Investigation of temporomandibular disorders in patients with fibromyalgia syndrome: A case-control study.

INTRODUCTION: The aim of this study is to compare the frequency of temporomandibular disorders and to examine the temporomandibular pain and functionality levels between healthy female participants and female patients diagnosed with fibromyalgia. MATERIALS AND METHODS: Our study included 300 participants. Patients were evaluated according to the Diagnostic Criteria for Temporomandibular Disorders: Assessment Instruments (DC/TMD). While evaluating the patients using DC/TMD, TMD Pain Screener and Symptom questionnaire were used within the scope of Axis I, and Graded Chronic Pain Scale, Jaw Functional Limitation Scale-8 (JFLS-8), Patient Health Questionnaire (PHQ-4) and Oral Behaviors Checklist were applied. RESULTS: Bruxism, tooth grinding and masseter hypertrophy were found to be significantly higher in fibromyalgia patients compared to healthy volunteers (p<0.001). The pain screener, JFLS-8, PHQ-4 and OBC scores and GCPS levels were found to be increased in the fibromyalgia group compared to healthy individuals (p<0.001). Considering the post-examination diagnoses of the participants, the diagnoses of myalgia (p=0.022) and disc displacement with reduction (p<0.001) were significantly higher than healthy individuals. CONCLUSIONS: Fibromyalgia is a common pathology, therefore, TMD symptoms, which are more difficult to diagnose and often missed, should be questioned in fibromyalgia patients and should be kept in mind in the management of fibromyalgia patients.

Do myofascial trigger points in masseter muscles affect the symptoms of disc displacement with reduction? A cross-sectional study

SUMMARY OBJECTIVE: The aim of this study was to demonstrate the effect of myofascial pain with referral from the trigger points in the masseter muscles on the clinical symptoms and functional limitations of the temporomandibular joint in participants with disc displacement with reduction. METHODS: This prospective, cross-sectional study recruited participants aged 18-45 years with disc displacement with reduction with/without myofascial pain with referral in the masseter muscles based on the inclusion criteria. Maximum mouth opening and the presence of probable awake bruxism were assessed. The "Graded Chronic Pain Scale version 2.0" and "Jaw Function Limitation Scale-8" were used to evaluate Diagnostic Criteria for Temporomandibular Disorders Axis II. Pain levels were measured using the Visual Analog Scale. RESULTS: A comparison between the disc displacement with reduction and disc displacement with reduction+myofascial pain with referral groups revealed statistically significant differences in Visual Analog Scale (p<0.001), the presence of awake bruxism (p=0.038), and Graded Chronic Pain Scale version 2.0 (p=0.010). However, no statistically significant difference was observed between the two groups concerning maximum mouth opening and Jaw Function Limitation Scale-8. CONCLUSION: Participants with both disc displacement with reduction and myofascial pain with referral in the masseter muscle exhibited higher pain intensity, a higher prevalence of awake bruxism, and increased pain-related disability compared to those with disc displacement with reduction alone.

Comparison of platelet-rich plasma and extracorporeal shock wave therapy in patients with chronic lateral epicondylitis: A prospective, randomized-controlled study.

OBJECTIVES: In this study, we aimed to investigate the effectiveness or comparative therapeutic superiority of exercise, extracorporeal shock wave therapy (ESWT), and platelet-rich plasma (PRP) on pain, grip strength and functional activities in chronic lateral epicondylitis (LE). PATIENTS AND METHODS: Between January 2016 and February 2017, a total of 74 patients (14 males, 60 females; mean age; 49.7±7.6 years, range, 26 to 60 years) with chronic LE were included in this prospective, randomized-controlled study. All patients received stretching and eccentric strengthening exercises for three months. The patients were divided into three groups. The first group (Exercises group, n=24) was given home exercises. The second group (ESWT+Exercises group, n=25) received one session of ESWT added once a week for three weeks. The third group (PRP+Exercises group, n=25) received one session of PRP in addition to the exercise program. All patients were evaluated for pain by Visual Analog Scale (VAS), for functionality by Disabilities of Arm, Shoulder and Hand (DASH) questionnaire and Patient-Rated Tennis Elbow Evaluation (PRTEE), handgrip strength by a dynamometer, and extensor tendon thickness by ultrasonography (USG) at baseline and at one, two, three, and six months. RESULTS: A significant improvement was found in the VAS, DASH, PRTEE, handgrip strength values at six months compared to between in all groups (p<0.001). Extensor tendon thickness as assessed by USG indicated no significant difference (p>0.05). Regarding the VAS activity levels, there was a significant difference in the PRP+Exercises group compared to the Exercises group at six months of follow-up (p<0.001). The decrease in the DASH scores during six-month follow-up was significantly higher in the PRP+Exercises group compared to the Exercises group (p=0.004). For the PRTEE scores at six months, the PRP+Exercises group showed a statistically significant improvement than both Exercises (p<0.001) and ESWT+Exercises (p=0.007) groups. CONCLUSION: In the treatment of chronic LE, PRP combined with exercise seems to be superior to exercise or ESWT in terms of pain and functionality in chronic LE patients.