Electromographic evaluation of the efficiency of manual therapy in temporomandibular joint dysfunction

The aim of the study is to examine the treatment methods of manual therapy (MT) with patients with temporomandibular joint dysfunction (TMD) of myofascial origin. The 38 patients with myofascial-derived TMD included in the study were randomly assigned to an equal number of MT and control groups. The MT group was given 40 minutes of MT once a week, for a total of four sessions, while the control group did not receive any treatment during this period. Evaluations of both groups were made at the beginning and at the end of the 4th week. Pain at rest and activity (visual analog scale-VAS), mouth opening movements, number of tender points, craniovertebral angle, pressure pain threshold, activity and resting muscle activation measurements of anterior temporalis and masseter muscles (superficial electromyography (sEMG)), fear of movement (Temporomandibular Disorders Tampa Kinesiophobia Scale (TMD-TKS)), function (Functional Limitation of Jaw Scale-8 (JFLS-8)), level of anxiety and depression (Hospital Anxiety and Depression Scale (HADS)) were evaluated. The study was completed by 17 (mean age: 29.58 ± 10.20) patients in the MT group and 17 (mean age: 31,648± ,47) patients in the control group. A statistically significant difference was found in all EMG measurements except activity VAS, resting VAS, number of tender points, whole mouth opening measurements, bilateral temporalis, temporomandibular joint (TMJ) lateral, masseter pressure pain threshold and right masseter resting muscle activity in the MT group. A statistically significant difference was found in the MT group in the TMD-TSK, JFLS-8, and HADS scales, except for HADS anxiety. When the four-week changes of the measured values of the groups were compared, there was no difference between the retrusion, right TMJ lateral pressure pain threshold, HADS scales, while other measurement values were found to be significantly different in favor of the MT group (p<0.05). In EMG activity, a difference was found between the groups in the right masseter MVC (p=0.13). According to this findings, MT is an effective method that can be used in patients with TMD. Keywords; Temporomandibular Joint Dysfunction, Manual Therapy, Superficial Electromyography