Article

Manual therapy (MT) and exercise have been extensively used to treat
people with musculoskeletal conditions such as temporomandibular disorders (TMD).
The evidence regarding their effectiveness provided by early systematic reviews
is outdated. PURPOSE: The aim of this study was to summarize evidence from and
evaluate the methodological quality of randomized controlled trials that examined
the effectiveness of MT and therapeutic exercise interventions compared with
other active interventions or standard care for treatment of TMD. DATA SOURCES:
Electronic data searches of 6 databases were performed, in addition to a manual
search. STUDY SELECTION: Randomized controlled trials involving adults with TMD
that compared any type of MT intervention (eg, mobilization, manipulation) or
exercise therapy with a placebo intervention, controlled comparison intervention,
or standard care were included. The main outcomes of this systematic review were
pain, range of motion, and oral function. Forty-eight studies met the inclusion
criteria and were analyzed. DATA EXTRACTION: Data were extracted in duplicate on
specific study characteristics. DATA SYNTHESIS:
The overall evidence for this
systematic review was considered low. The trials included in this review had
unclear or high risk of bias. Thus, the evidence was generally downgraded based
on assessments of risk of bias. Most of the effect sizes were low to moderate,
with no clear indication of superiority of exercises versus other conservative
treatments for TMD. However, MT alone or in combination with exercises at the jaw
or cervical level showed promising effects. LIMITATIONS: Quality of the evidence
and heterogeneity of the studies were limitations of the study. CONCLUSIONS: No
high-quality evidence was found, indicating that there is great uncertainty about
the effectiveness of exercise and MT for treatment of TMD.
CI - (c) 2016 American Physical Therapy Association.

Langue : ANGLAIS