Study Type: Systematic review
Level of Evidence: Level 3
Clinical Summary: The reviewers state their results as follows: Exercises and mobilizations, alone or in combination, may be effective in short term increasing total ROM in patients with TMD. Postural training is of unclear importance in treating TMD. Laser may be more effective at improving both pain and function than other electrotherapies for TMD. Programs involving relaxation, biofeedback, EMG training, and proprioceptive training may be more effective than placebo or occlusal splints in improving pain and function for patients with myofascial TMD in the short and long term. Combinations of exercises, manual therapy, postural correction, and relaxation may decrease pain and impairment short-term, but it is impossible to determine whether the combination is more effective than individual elements of the program as treatments.
Overall Quality: Moderate- Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Why: The lit search only included English studies, inclusion and exclusion criteria were broad. Most of the search, data abstraction, and rating of studies were done by one author. Many of the studies looked at different outcome measures, so meta-analysis was of limited value.
Apply This: Based on this review, treatments for the TMJ should focus on exercises, mobilization, and relaxation training with biofeedback or other training techniques. Laser therapies are likely more effective than other electrotherapies at improving pain and function. Postural correction is of uncertain value in the clinical picture, but may best be determined on a case-by-case basis.
Study Author(s): Marega S Medlicott, Susan R Harris
Publication Date: 7/1/2006
Published in: Physical Therapy
Tags: (region, condition/dx, tx, level of evidence, quality rating)TMJ, TMD, manual therapy, LLLT, exercises, proprioceptive training, Level 3, Moderate
Evidence-Informed Practitioner 