Effectiveness of Manual Therapy in Comparison to a Multimodal Physiotherapeutic Programme in Female Patients with Craniomandibular Disorders

Background:TMD is the most common form of facial pain with many different symptoms. Since more than 10 % of the population above 18 years are severely restricted in their daily activities due to TMD effective treatment modalities play a vital role.

Objective:This pilot study compared the effectiveness of Manual therapy with a multimodal physiotherapy programme in the treatment of female patients with temporomandibular disorders (TMD).

Methods:16 female test persons with TMD diagnosed by a dentist were randomized into 2 groups (Manual therapy: n = 7, therapeutic exercises: n = 9). The measuring parameters of the pilot study were pain, subjective sensation, jaw opening, deviation, muscle pain and clicking. There were 5 treatments per test person, on the sixth day of the treatment the final examination as well as an introduction to the therapy of the other treatment group took place. The data were analysed by means of descriptive and inductive statistics.

Results:Manual therapy had no statistically significant better results. Both therapies showed a statistically significant improvement of subjective sensation, jaw opening and muscle pain. However, a detailed analysis of the findings detected that pain only statistically significantly improved in manual therapy and deviation only within therapeutic exercises. In neither treatment group clicking was completely reduced.

Conclusions: Manual therapy and the multimodal physiotherapeutic programme produced a different kind of effectiveness and were both indicated for the treatment of TMD. The pilot study serves as preparatory work for a large-scale study and provides important expertise which should be taken into consideration in future projects.