Predictors of pain reduction following manual therapy in patients with temporomandibular disorders: a protocol for a prospective observational study
Introduction Temporomandibular disorders (TMDs) are principally characterised by pain in the craniomandibular area and probable limitations of jaw opening. Manual therapy, like other recommended conservative treatments included in clinical guidelines, is commonly used to treat patients with TMD to r...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2019-11-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/11/e032113.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846149615335768064 |
|---|---|
| author | Alison B Rushton Nicola R Heneghan Deborah Falla Giacomo Asquini Andrea Edoardo Bianchi Giulia Borromeo Matteo Locatelli |
| author_facet | Alison B Rushton Nicola R Heneghan Deborah Falla Giacomo Asquini Andrea Edoardo Bianchi Giulia Borromeo Matteo Locatelli |
| author_sort | Alison B Rushton |
| collection | DOAJ |
| description | Introduction Temporomandibular disorders (TMDs) are principally characterised by pain in the craniomandibular area and probable limitations of jaw opening. Manual therapy, like other recommended conservative treatments included in clinical guidelines, is commonly used to treat patients with TMD to reduce pain and improve function. However, outcomes may be variable. The aim of this study is to identify predictors associated with pain reduction in patients with TMD following manual therapy by analysing a combination of patient-reported outcome measures and clinical tests. Such knowledge will support a more personalised management approach by facilitating clinical decision-making.Methods/analysis An observational prospective design will recruit a cohort of 100 adults with a diagnosis of TMD (according to Axis I of the Diagnostic Criteria for TMD) at a Dental Hospital in Italy. Patients will be treated with four weekly sessions of manual therapy applied to craniomandibular structures. An array of predictors has been chosen based on previous research on prognostic factors for TMD and altered pain modulation in musculoskeletal disorders. Candidate predictors including demographic variables, general health variables, psychosocial features, TMD characteristics and clinical tests of the temporomandibular joint and masticatory muscles will be collected at baseline. Definition of good outcome is a clinically significant reduction of pain intensity over the last week (≥30% reduction Visual Analogue Scale) immediately following the four week intervention. Exploratory factor analysis will be applied to analyse factor loading of candidate predictors for good outcome at four weeks. Subsequently, a logistic multivariable regression model will be performed to calculate low and high risk of good outcome.Ethics and dissemination Ethical approval has been obtained from the ‘Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico’ and University of Birmingham Ethics Committee. The results will be submitted for publication in a peer-reviewed journal and presented at conferences.Trial registration number NCT03990662; Pre-results. |
| format | Article |
| id | doaj-art-a21b9c80b9a24d1ca67f63bd6949f721 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-a21b9c80b9a24d1ca67f63bd6949f7212024-11-29T14:20:08ZengBMJ Publishing GroupBMJ Open2044-60552019-11-0191110.1136/bmjopen-2019-032113Predictors of pain reduction following manual therapy in patients with temporomandibular disorders: a protocol for a prospective observational studyAlison B Rushton0Nicola R Heneghan1Deborah Falla2Giacomo Asquini3Andrea Edoardo Bianchi4Giulia Borromeo5Matteo Locatelli6School of Physical Therapy, Western University Faculty of Health Sciences, London, Ontario, CanadaCentre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham,Edgbaston, Birmingham, UKCentre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sports, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK1 University of Birmingham, Birmingham, UKDepartment of Craniomandibular Disorders, Italian Stomatologic Institute, Milan, ItalyCraniomandibular Physiotherapy Service, Istituto Stomatologico Italiano, Milano, ItalyDepartment of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, ItalyIntroduction Temporomandibular disorders (TMDs) are principally characterised by pain in the craniomandibular area and probable limitations of jaw opening. Manual therapy, like other recommended conservative treatments included in clinical guidelines, is commonly used to treat patients with TMD to reduce pain and improve function. However, outcomes may be variable. The aim of this study is to identify predictors associated with pain reduction in patients with TMD following manual therapy by analysing a combination of patient-reported outcome measures and clinical tests. Such knowledge will support a more personalised management approach by facilitating clinical decision-making.Methods/analysis An observational prospective design will recruit a cohort of 100 adults with a diagnosis of TMD (according to Axis I of the Diagnostic Criteria for TMD) at a Dental Hospital in Italy. Patients will be treated with four weekly sessions of manual therapy applied to craniomandibular structures. An array of predictors has been chosen based on previous research on prognostic factors for TMD and altered pain modulation in musculoskeletal disorders. Candidate predictors including demographic variables, general health variables, psychosocial features, TMD characteristics and clinical tests of the temporomandibular joint and masticatory muscles will be collected at baseline. Definition of good outcome is a clinically significant reduction of pain intensity over the last week (≥30% reduction Visual Analogue Scale) immediately following the four week intervention. Exploratory factor analysis will be applied to analyse factor loading of candidate predictors for good outcome at four weeks. Subsequently, a logistic multivariable regression model will be performed to calculate low and high risk of good outcome.Ethics and dissemination Ethical approval has been obtained from the ‘Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico’ and University of Birmingham Ethics Committee. The results will be submitted for publication in a peer-reviewed journal and presented at conferences.Trial registration number NCT03990662; Pre-results.https://bmjopen.bmj.com/content/9/11/e032113.full |
| spellingShingle | Alison B Rushton Nicola R Heneghan Deborah Falla Giacomo Asquini Andrea Edoardo Bianchi Giulia Borromeo Matteo Locatelli Predictors of pain reduction following manual therapy in patients with temporomandibular disorders: a protocol for a prospective observational study BMJ Open |
| title | Predictors of pain reduction following manual therapy in patients with temporomandibular disorders: a protocol for a prospective observational study |
| title_full | Predictors of pain reduction following manual therapy in patients with temporomandibular disorders: a protocol for a prospective observational study |
| title_fullStr | Predictors of pain reduction following manual therapy in patients with temporomandibular disorders: a protocol for a prospective observational study |
| title_full_unstemmed | Predictors of pain reduction following manual therapy in patients with temporomandibular disorders: a protocol for a prospective observational study |
| title_short | Predictors of pain reduction following manual therapy in patients with temporomandibular disorders: a protocol for a prospective observational study |
| title_sort | predictors of pain reduction following manual therapy in patients with temporomandibular disorders a protocol for a prospective observational study |
| url | https://bmjopen.bmj.com/content/9/11/e032113.full |
| work_keys_str_mv | AT alisonbrushton predictorsofpainreductionfollowingmanualtherapyinpatientswithtemporomandibulardisordersaprotocolforaprospectiveobservationalstudy AT nicolarheneghan predictorsofpainreductionfollowingmanualtherapyinpatientswithtemporomandibulardisordersaprotocolforaprospectiveobservationalstudy AT deborahfalla predictorsofpainreductionfollowingmanualtherapyinpatientswithtemporomandibulardisordersaprotocolforaprospectiveobservationalstudy AT giacomoasquini predictorsofpainreductionfollowingmanualtherapyinpatientswithtemporomandibulardisordersaprotocolforaprospectiveobservationalstudy AT andreaedoardobianchi predictorsofpainreductionfollowingmanualtherapyinpatientswithtemporomandibulardisordersaprotocolforaprospectiveobservationalstudy AT giuliaborromeo predictorsofpainreductionfollowingmanualtherapyinpatientswithtemporomandibulardisordersaprotocolforaprospectiveobservationalstudy AT matteolocatelli predictorsofpainreductionfollowingmanualtherapyinpatientswithtemporomandibulardisordersaprotocolforaprospectiveobservationalstudy |