Is low back pain a risk/prognostic factor for the development and/or progression of temporomandibular disorders? A systematic review with meta-analysis.

OBJECTIVES: To evaluate the association between low back pain (LBP) and painful temporomandibular disorders (TMDs). METHODS: Systematic review of observational studies. Searches were conducted using OVID MEDLINE, CINHAL, Web of Science and PUBMED databases up to 21 October 2022. Qualitative and quantitative analyses were performed. Risk of bias (RoB) was assessed using the Quality in Prognosis Studies tool (QUIPS). RESULTS: Eight studies were included in the present review with meta-analysis. The first onset of TMDs was more likely in patients with previous chronic LBP (hazard ratio (HR) 1.53 [95% confidence interval (CI): 1.28; 1.83, p < .00001]). In addition, patients with chronic LBP had 3.25 times the odds (OR) [95% CI: 1.94; 5.43, p < .00001] of having chronic TMDs than those who did not have chronic LBP. In addition, the higher the exposure to chronic LBP, the higher the risk of developing a first onset of TMDs. CONCLUSIONS: Chronic LBP can be considered a risk/contributing factor for painful TMDs. Although there is a high certainty in the evidence linking chronic LBP with the risk of a first onset of TMDs, there are insufficient studies to draw definitive conclusions. Furthermore, while an association between chronic LBP and chronic TMDs and a dose-effect was observed between these two conditions, a limited number of studies and evidence exist to support these findings. Future studies are needed to increase the body of evidence.

Myogenic temporomandibular disorders: Clinical systemic comorbidities in a female population sample.

BACKGROUND: Myogenic temporomandibular disorders (MTMD) frequently coexist with other clinical conditions in the same individual. In the last decades, several authors have analyzed these comorbidities looking for the origin of this overlapping. Objetives: The aim of this study was to perform a comparative anaylisis between a group of patients with MTMD and a control group of dental patients without dysfunctional pathology to assess whether there are significant differences in the presence of systemic medical comorbidities between the two groups. MATERIAL AND METHODS: Restrospective epidemiological analysis, based on medical questionnaires in a group of 31 patients, women, aged from 24 to 58 (average 39.96 years), diagnosed with MTMD (Masticatory Myofascial Pain), with a control group with the same number of individuals, gender and age range to evaluate if there is a significant statistical difference in the presence of medical comorbidities in this group of patients with MTMD and if they are in a higher risk of suffering different pathological conditions. RESULTS: It was found that the group affected by MTMD presented many more associated medical conditions than the control group: health changes during the last year, medical evaluations and treatments, presence of pain, sinus disease, tinnitus, headache, joint pain, ocular disorders, fatigue, dizziness, genitourinary disorders and xerostomia among others; and they were also in a higher risk to suffer other pathological entities as headaches and articular pain. CONCLUSIONS: These results reinforce our hypothesis that MTMD belong to a group of medical conditions triggered by a loss of equilibrium of the individual's Psycho-Neuro-Endocrine-Immune (PNEI) Axis that produces alterations in the response against external stimuli in some genetically predisposed individuals. It is, therefore, necessary to change the way of diagnosing and managing these individual's medical conditions, being mandatory to look from a more multidisciplinary perspective than the one we are currently offering.

Eficacia de la terapia manual en el tratamiento de la cefalea tensional. Una revisión sistemática desde el año 2000 hasta el 2013 / Efficacy of manual therapy in the treatment of tension-type headache. A systematic review from 2000-2013

Objetivos: Estudiar la eficacia de la terapia manual en el tratamiento de la cefalea tensional (CT) valorando los estudios controlados aleatorizados (ECA) publicados desde el año 2000 hasta abril del 2013. Métodos: Se realizó la búsqueda en las bases de datos MEDLINE, EBSCO, CINAHL, SCOPUS, PEDRO y OVID. Se incluyeron ECA que analizasen a pacientes con CT tratados con terapia manual y que recogiesen como variable de resultado la intensidad, frecuencia, duración del dolor de cabeza. La calidad metodológica fue valorada por 2 revisores independientes mediante la escala Jadad. Los datos de los ECA fueron extraídos por 2 revisores. Resultados: Se seleccionaron 14 ECA. Doce de ellos se consideraron de calidad aceptable (Jadad ≥ 3) y 2 de baja (Jadad = 2). Los estudios mostraron resultados positivos obteniendo disminución de la intensidad y/o frecuencia de cefaleas, reducción del consumo de medicamentos y mejora de la calidad de vida en pacientes con CT. Conclusiones: Debido a la heterogeneidad en diseños, instrumentos de medida y tratamientos de los estudios, no es posible obtener conclusiones definitivas sobre la eficacia de la terapia manual en pacientes con CT aunque se aprecien efectos beneficiosos. No obstante, el análisis de los estudios indica que, al recibir tratamiento con terapia manual, los pacientes con CT evolucionaron de forma más favorable respecto a aquellos que recibieron tratamiento habitual o un tratamiento placebo. Se requiere un mayor número de estudios con mayor calidad metodológica, así como mayor homogeneidad de los tratamientos y de los métodos de valoración de los resultados, para determinar la eficacia de la terapia manual en la CT

Objectives: To study the efficacy of manual therapy in the treatment of tension-type headache (TTH) by assessing the quality of randomized control trials (RCTs) published from the year 2000 to April 2013. Methods: A search was performed in the following databases: MEDLINE, EBSCO, CINAHL, SCOPUS, PEDRO and OVID. An analysis was made of RCT including patients with TTH receiving any manual therapy, and assessing outcome measures including the intensity, and frequency or duration of the headache. Two independent referees reviewed the methodological quality of RCTs using the Jadad scale. Data from the studies were extracted by two different reviewers. Results: A total of fourteen RCTs were selected. Twelve studies showed acceptable quality (Jadad scale ≥3), and the remaining 2 had low quality (Jadad = 2). The studies showed positive results, including reduction in headache intensity and/or frequency, reduction of medication consumption, and improvement in quality of life. Conclusions: The effectiveness of manual therapy for TTH cannot be completely assessed due to the heterogeneity in study design, outcome measures, and different treatments. Nevertheless, the results suggest patients with TTH receiving manual therapies showed better progress than those receiving conventional treatment or placebo. Further studies of high quality using manual therapy protocols, and also including standardized outcome measures, are now needed to clarify the efficacy of manual therapy in the management of TTH

Efficacy of manual therapy in the treatment of tension-type headache. A systematic review from 2000-2013. / Eficacia de la terapia manual en el tratamiento de la cefalea tensional. Una revisión sistemática desde el año 2000 hasta el 2013.

OBJECTIVES: To study the efficacy of manual therapy in the treatment of tension-type headache (TTH) by assessing the quality of randomized control trials (RCTs) published from the year 2000 to April 2013. METHODS: A search was performed in the following databases: MEDLINE, EBSCO, CINAHL, SCOPUS, PEDRO and OVID. An analysis was made of RCT including patients with TTH receiving any manual therapy, and assessing outcome measures including the intensity, and frequency or duration of the headache. Two independent referees reviewed the methodological quality of RCTs using the Jadad scale. Data from the studies were extracted by two different reviewers. RESULTS: A total of fourteen RCTs were selected. Twelve studies showed acceptable quality (Jadad scale ≥3), and the remaining 2 had low quality (Jadad=2). The studies showed positive results, including reduction in headache intensity and/or frequency, reduction of medication consumption, and improvement in quality of life. CONCLUSIONS: The effectiveness of manual therapy for TTH cannot be completely assessed due to the heterogeneity in study design, outcome measures, and different treatments. Nevertheless, the results suggest patients with TTH receiving manual therapies showed better progress than those receiving conventional treatment or placebo. Further studies of high quality using manual therapy protocols, and also including standardized outcome measures, are now needed to clarify the efficacy of manual therapy in the management of TTH.

Cadena cinética abierta... cadena cinética cerrada... una discusión abierta / Open kinetic chain... close kinetic chain... a dicussion opened

El uso de ejercicios en fisioterapia que involucran diferentes elementos articulares, partes de cadenas cinéticas, mantiene abierto el debate sobre el uso de los mismos en cadena cinética abierta(CCA) o cadena cinética cerrada (CCC).Diferentes estudios analizados en esta revisión demuestran que no existen diferencias sustanciales en orden a recomendar o proscribir el uso de uno u otro método, si bien son numerosas las consideraciones de tipo empírico, que lo hacen (AU)

Exercises used in physiotherapy involve different joints, as part of kinetic chains, maintaining a discussion about use and application of exercises in Closed Kinetic Chain (CCC) or well Open Kinetic Chain (CCA). Different studies included in this review, shows no differences in order to recommend or not use of each one exercise mode, if (AU)