Critical Appraisal of Clinical Trials Evaluating Physical Therapy Treatments for Temporomandibular Disorders: A Scoping Review.

IF 3.1 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of oral rehabilitation Pub Date : 2024-12-01 Epub Date: 2024-09-20 DOI:10.1111/joor.13864

Jorge Ballesteros-Frutos, Ruben Fernandez-Matias, Pablo Gallardo-Zamora, Daniel Pecos-Martín

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引用次数: 0

Abstract

Background: Physical therapy seems the most promising treatment for temporomandibular disorders (TMD), although their effectiveness is controversial in general, due to high heterogeneity regarding study designs, applied treatments and outcomes measures.

Objectives: The aim of this scoping review is to analyse the methodological characteristics of clinical trials evaluating physical therapy treatments in subjects with TMD.

Methods: A systematic search was conducted in Medline/PubMed, SPORTDiscus, Scopus, Web of Science, SciELO, Cochrane, ScienceDirect and EMBASE databases on 31 October 2023. Clinical trials evaluating physical therapy interventions in patients older than 18 years with TMD, published in English or Spanish languages. Data regarding content reporting of study designs, sample characteristics, interventions and outcome measures was extracted. Descriptive summary statistics were reported.

Results: The search retrieved 15 322 records, and 136 were included. There were 107 randomised clinical trials, 5 non-randomised controlled trials and 24 non-controlled trials. Most studies had moderate to high risk of bias, small sample sizes (median, 44 subjects) and short follow-up periods (1-3 months). The most common diagnostic criteria used was the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) (48.9%). The most reported experimental interventions were manual therapy (40.4%), exercise (30.2%) and electrotherapy modalities (27.2%), and the most common outcome measure domains were pain (83.8%), range of movement (61.8%), disability (45.6%) and mechanosensitivity (29.4%). There was poor content reporting of experimental interventions.

Conclusions: Current literature of clinical trials of physical therapy interventions for TMD has moderate to high risk of bias, poor content reporting, small sample size and short-term follow-ups which limit internal and external validity, as well as applicability into clinical practice.

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对评估颞下颌关节紊乱症物理疗法的临床试验进行严格评估：范围界定综述》。

背景：物理疗法似乎是治疗颞下颌关节紊乱症（TMD）最有前途的方法，但由于研究设计、应用疗法和结果测量方面的高度异质性，其有效性总体上存在争议：本综述旨在分析对 TMD 患者的物理治疗进行评估的临床试验的方法特点：于 2023 年 10 月 31 日在 Medline/PubMed、SPORTDiscus、Scopus、Web of Science、SciELO、Cochrane、ScienceDirect 和 EMBASE 数据库中进行了系统检索。评估针对 18 岁以上 TMD 患者的物理治疗干预措施的临床试验，以英语或西班牙语发表。提取了有关研究设计、样本特征、干预措施和结果测量的内容报告数据。结果：搜索共检索到 15 322 条记录，其中 136 条被纳入。其中包括 107 项随机临床试验、5 项非随机对照试验和 24 项非对照试验。大多数研究存在中度至高度偏倚风险，样本量小（中位数为 44 例受试者），随访时间短（1-3 个月）。最常用的诊断标准是颞下颌关节紊乱研究诊断标准（RDC/TMD）（48.9%）。报告最多的实验干预措施是手法治疗（40.4%）、运动（30.2%）和电疗模式（27.2%），最常见的结果测量领域是疼痛（83.8%）、活动范围（61.8%）、残疾（45.6%）和机械敏感性（29.4%）。实验干预的内容报告较少：目前有关 TMD 物理治疗干预的临床试验文献存在中度到高度的偏倚风险、内容报告不完善、样本量小以及短期随访等问题，这些问题限制了试验的内部和外部有效性，也限制了试验在临床实践中的适用性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of oral rehabilitation 医学-牙科与口腔外科

CiteScore

5.60

自引率

10.30%

发文量

116

审稿时长

4-8 weeks

期刊介绍： Journal of Oral Rehabilitation aims to be the most prestigious journal of dental research within all aspects of oral rehabilitation and applied oral physiology. It covers all diagnostic and clinical management aspects necessary to re-establish a subjective and objective harmonious oral function. Oral rehabilitation may become necessary as a result of developmental or acquired disturbances in the orofacial region, orofacial traumas, or a variety of dental and oral diseases (primarily dental caries and periodontal diseases) and orofacial pain conditions. As such, oral rehabilitation in the twenty-first century is a matter of skilful diagnosis and minimal, appropriate intervention, the nature of which is intimately linked to a profound knowledge of oral physiology, oral biology, and dental and oral pathology. The scientific content of the journal therefore strives to reflect the best of evidence-based clinical dentistry. Modern clinical management should be based on solid scientific evidence gathered about diagnostic procedures and the properties and efficacy of the chosen intervention (e.g. material science, biological, toxicological, pharmacological or psychological aspects). The content of the journal also reflects documentation of the possible side-effects of rehabilitation, and includes prognostic perspectives of the treatment modalities chosen.