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Frontiers in Neurology 2023Strength-based exercise is widely used to treat tension-type headache, but the evidence of its benefit is unclear. This study aims to analyze the efficacy of a...
BACKGROUND
Strength-based exercise is widely used to treat tension-type headache, but the evidence of its benefit is unclear. This study aims to analyze the efficacy of a strength-based exercise program in patients with chronic tension-type headaches.
METHODS
A randomized controlled trial with a 12-week strength-based exercise program, with chronic tension-type headache. The headache characteristics (which were the primary outcomes: frequency, duration, and intensity), cervical muscle thickness at rest or contraction of multifidus and longus-colli muscle, cervical range of motion, pain pressure threshold of temporalis, upper trapezius, masseter, tibialis muscle and median nerve, and cervical craniocervical flexion test were assessed at baseline and 12-weeks of follow-up in the intervention group ( = 20) and the control group ( = 20) was performed on 40 patients (85% women, aged 37.0 ± 13.3 years).
RESULTS
Between baseline and week-12 of follow-up the intervention group showed statistically significant differences compared to control group in the following primary outcomes: duration and intensity of headaches. In addition, the intervention group improved the thickness of deep cervical muscles, reduced the peripheral sensitization, and improved the strength of deep cervical flexors.
CONCLUSION
A 12-week strength training of neck and shoulder region induced changes in pain intensity and duration, and physical-related factors in patients with TTH. Future interventions are needed to investigate if normalization of pain characteristics and physical factors can lead to an increase of headache-related impact.
PubMed: 37789886
DOI: 10.3389/fneur.2023.1256303 -
Archives of Craniofacial Surgery Feb 2024The facial nerve stimulates the muscles of facial expression and the parasympathetic nerves of the face. Consequently, facial nerve paralysis can lead to facial...
The facial nerve stimulates the muscles of facial expression and the parasympathetic nerves of the face. Consequently, facial nerve paralysis can lead to facial asymmetry, deformation, and functional impairment. Facial nerve palsy is most commonly idiopathic, as with Bell palsy, but it can also result from a tumor or trauma. In this article, we discuss traumatic facial nerve injury. To identify the cause of the injury, it is important to first determine its location. The location and extent of the damage inform the treatment method, with options including primary repair, nerve graft, cross-face nerve graft, nerve crossover, and muscle transfer. Intracranial proximal facial nerve injuries present a challenge to surgical approaches due to the complexity of the temporal bone. Surgical intervention in these cases requires a collaborative approach between neurosurgery and otolaryngology, and nerve repair or grafting is difficult. This article describes the treatment of peripheral facial nerve injury. Primary repair generally offers the best prognosis. If primary repair is not feasible within 6 months of injury, nerve grafting should be attempted, and if more than 12 months have elapsed, functional muscle transfer should be performed. If the affected nerve cannot be utilized at that time, the contralateral facial nerve, ipsilateral masseter nerve, or hypoglossal nerve can serve as the donor nerve. Other accompanying symptoms, such as lagophthalmos or midface ptosis, must also be considered for the successful treatment of facial nerve injury.
PubMed: 38461822
DOI: 10.7181/acfs.2023.00528 -
Head & Face Medicine Sep 2023The limited number of randomized controlled trials (RCTs) comparing the efficacy of soft tissue manual therapy and self-therapy interventions prompted the authors to... (Randomized Controlled Trial)
Randomized Controlled Trial
UNLABELLED
The limited number of randomized controlled trials (RCTs) comparing the efficacy of soft tissue manual therapy and self-therapy interventions prompted the authors to focus on the analgesic and myorelaxant use of massage, post-isometric muscle relaxation (PIR) and therapeutic exercise in TMD patients.
OBJECTIVES
To evaluate the effectiveness of soft tissue therapy and therapeutic exercises in female patients with pain, increased masseter muscle tension and limited mandibular mobility.
MATERIAL AND METHODS
The study was conducted on a group of 82 women (G1) with the Ib disorder diagnosed in DC/TMD (Ib-myofascial pain with restricted mobility). The control group (G2) consisted of 104 women without diagnosed TMDs (normal reference values for TMJ ROM and masseter muscle sEMG bioelectric activity). Diagnostic procedures were performed in both groups (sEMG of the masseter muscles at baseline and during exercise, measurement of TMJ mobility, assessment of pain intensity-NRS scale). The G1 group was randomly divided into 3 therapeutic groups in which the therapy was carried out for 10 days: therapeutic exercises (TE), manual therapy - massage and therapeutic exercises (MTM_TE), manual therapy - PIR and therapeutic exercises (MTPIR_TE). Each time after therapy, the intensity of pain and TMJ mobility were assessed. Sealed, opaque envelopes were used for randomization. After 5 and 10 days of therapy, bilateral sEMG signals of the masseter muscles were acquired.
RESULTS
Massage, PIR and self-therapy led to a decrease in sEMG at rest as well as in exercise. After day 6 of therapy, the groups obtained a significant difference (p = 0.0001). Each of the proposed forms of therapy showed a minimal clinically significant difference (MID) in the sEMG parameter at the endpoint, with the most considerable difference in the MTM_TE group. The forms of MT used were effective in reducing the patients' pain intensity; however, a significant difference between therapies occurred after 4 treatments (p = 0.0001). Analyzing the MID between methods, it was observed that self-therapy had an analgesic effect only after 8 treatments, while PIR after 3 and massage after 1 treatment. After day 7, the mean pain score in the MTM_TE group was 0.889 and in the TMPIR_TE group was 3.44 on the NRS scale. In terms of MMO, a significant difference was obtained between monotherapy and each form of TM, i.e. massage (p = 0.0001) and PIR (p = 0.0001). Analyzing mandibular lateral movements, the authors got a significant difference in the proposed MT forms, of which massage treatments exceeded the effectiveness of PIR.
CONCLUSIONS
Soft tissue manual therapy and therapeutic exercise are simple and safe interventions that can potentially benefit patients with myogenic TMDs, with massage showing better analgesic effects than PIR.
Topics: Female; Humans; Mandible; Pain; Temporomandibular Joint; Therapy, Soft Tissue
PubMed: 37684652
DOI: 10.1186/s13005-023-00385-y -
Journal of Clinical Medicine Jul 2023Botulinum toxin (BTA) is a bacterial-derived extract that can inhibit muscle contraction, acting directly on the absorption of acetylcholine. Thanks to this property,... (Review)
Review
Botulinum toxin (BTA) is a bacterial-derived extract that can inhibit muscle contraction, acting directly on the absorption of acetylcholine. Thanks to this property, botulinum has been used in aesthetic and general medicine for several years. Nowadays, the use of botulinum toxin is being deepened to address the problem of bruxism. In this scoping review, the results of the studies in the literature of the last 10 years were analyzed. Indeed, 12 reports (found on PubMed, Web of Science, and Scopus, entering the keywords "BRUXISM" and "BOTULINUM TOXIN") were deemed eligible for inclusion in this review. In the studies reviewed, BTA was injected into different muscle groups: masseters, masseter and temporalis or masseter, temporalis, and medial pterygoid. Botulinum toxin injection is a viable therapeutic solution, especially in patients with poor compliance or without improvement in conventional treatment.
PubMed: 37510701
DOI: 10.3390/jcm12144586 -
Journal of Applied Oral Science :... 2023Temporomandibular disorder (TMD) is an umbrella term encompassing various clinical complaints involving the temporomandibular joints, masticatory muscles, and/or... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Temporomandibular disorder (TMD) is an umbrella term encompassing various clinical complaints involving the temporomandibular joints, masticatory muscles, and/or associated orofacial structures. Myogenous TMDs are the most frequent cause of chronic orofacial pain. Musculoskeletal pain is commonly associated with myofascial trigger points (MTPs), for which dry needling (DN) is a routine treatment.
OBJECTIVE
To investigate muscle oxygenation and pain immediately after DN application on an MTP in the masseter muscle of patients with myogenous TMDs.
METHODOLOGY
Masseter muscle oxygen tissue saturation indices (TSI%) were assessed by near-infrared spectroscopy (NIRS) pre- and post-interventions by a randomized, controlled, double-blind, crossover DN/Sham clinical trial (primary outcome). Pain was investigated by the visual analog scale (VAS). In total, 32 individuals aged from 18 to 37 years who were diagnosed with myogenous TMD and myofascial trigger points in their masseter muscles participated in this study. Relative deltas for the studied variables were calculated. Data normality was tested using the Shapiro-Wilk test. According to their distribution, data were analyzed by two-way ANOVA and the Student's t-, and Mann-Whitney tests. Statistical analyses were performed using Prism® 5.0 (GraphPad, USA).
RESULTS
We found a significant difference (2,108% vs. 0,142%) between masseter muscle TSI% deltas after the DN and Sham interventions, respectively (n=24). We only evaluated women since men refused to follow NIRS procedures. Pain increased immediately after DN (n=32, 8 men), in comparison to Sham delta VAS.
CONCLUSION
These findings show an increase in tissue oxygen saturation in the evaluated sample immediately after the DN intervention on the MTP of patients' masseter muscle. Pain may have increased immediately after DN due to the needling procedure.
Topics: Male; Humans; Female; Masseter Muscle; Dry Needling; Trigger Points; Temporomandibular Joint Disorders; Pain
PubMed: 37646716
DOI: 10.1590/1678-7757-2023-0099 -
The Saudi Dental Journal Dec 2023Dental occlusion contributes to the development of temporomandibular disorder.
INTRODUCTION
Dental occlusion contributes to the development of temporomandibular disorder.
OBJECTIVE
This case control study examined the influence of different occlusal conditions on the surface electromyography (sEMG) of the superficial part of the masseter muscle (MM) and anterior part of the temporalis muscle (TA) during clenching in the maximum intercuspal position (MIP).
MATERIALS AND METHODS
Twelve healthy subjects had their anterior, right posterior, or left posterior teeth added by composite resin to generate the bilateral posterior, unilateral left, or unilateral right posterior tooth losses, respectively. Muscle activity in the resting stage, MM's and TA's maximum voluntary clenching (MVC; µV) in MIP, each muscle activity's symmetry (%), and ipsilateral MM and TA synergy (%) were measured by sEMG. All parameters were analyzed by SPSS version 23.0, and the significance level was set at p < 0.05.
RESULTS
The MM's and TA's sEMG activity at the resting stage significantly differed from those at the other occlusal conditions (p < 0.05). Both muscles' MVC were highest at the MIP during clenching but lowest during anterior clenching. During unilateral posterior clenching, such MVC was higher at the occluding than at the non-occluding sides. The TA's symmetry during clenching at the anterior and unilateral posterior teeth was lower than that at the MIP during clenching. No significant difference was seen in the ipsilateral MM and TA synergy.
CONCLUSION
Different occlusal conditions influenced the MM's and TA's sEMG activity. Each masticatory muscle responded differently to the same occlusal conditions.
PubMed: 38107050
DOI: 10.1016/j.sdentj.2023.07.018