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Immediate effect of nonspecific mandibular mobilization on postural control in subjects with temporomandibular disorder: a single-blind, randomized, controlled clinical trial
Amaral AP, Politti F, Hage YE, Arruda EEC, Amorin CF, Biasotto-Gonzalez DA
Brazilian Journal of Physical Therapy 2013 Mar-Apr;17(2):121-127
clinical trial
6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: Yes; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Temporomandibular disorder (TMD) is considered multifactorial and is defined as a group of pain conditions characterized by functional stomatognathic system alterations, which may be affected by or related disrupted postural control. OBJECTIVE: Assess the immediate effect of nonspecific mandibular mobilization (NMM) on the postural control of subjects diagnosed or not with TMD. METHOD: A simple-blind, randomized, controlled clinical trial was performed involving 50 subjects of both genders assigned to two groups: the TMD group and the control group. TMD was diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). A stabilometric assessment was performed by testing subjects in a quiet stance on a dual force platform under two visual conditions (eyes open and eyes closed). The center of pressure (CoP)-related variables analyzed were displacement, amplitude, speed of anterior-posterior (AP) and medial-lateral (ML) displacements and CoP sway area. The mean values of each variable were compared, considering the accepted significance value of p < 0.05. RESULTS: A significant difference between the pre- and post-NMM means could be observed in subjects diagnosed with TMD under the closed-eyes visual condition. There was a statistically significant difference in the CoP sway area (p < 0.03) in the ML displacement COPML (p < 0.006) and ML amplitude COPML (p < 0.01) and in the variable speed in the AP COPAP (p < 0.03) and ML COPML (p < 0.03) directions, simultaneously. CONCLUSION: These results indicate that nonspecific temporomandibular joint mobilization contributes to the immediate improvement of postural control in patients with TMD. Article registered in the Brazilian Registry of Clinical Trials (Registro de Ensaio Clinico Brasileiro, REBEC): RBR-63gdgg.

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