Physical therapy treatment for facial and jaw pain associated with trigeminal neuralgia using Systemic Manual Therapy (SMT)

IF 1.7 Q2 Medicine

Advances in integrative medicine Pub Date : 2024-12-25 DOI:10.1016/j.aimed.2024.12.009

Adi Halili

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引用次数: 0

Abstract

Objective

This study aimed to evaluate the effectiveness of Systemic Manual Therapy using a HOAC-APD model to treat trigeminal neuralgia-associated facial pain (TN).

Design

Cohort retrospective multivariate analysis using a modified adaptive platform design.

Methods

Overall progress across episode of care and average rate of improvement in TN symptoms and overall complaints was measured in 85 patients after using 99 different combinations of Systemic Manual Therapy protocols.

Results

When comparing scores from the beginning and end of the episode of care, 66 % of patients reported improvement in trigeminal neuralgia or facial pain complaints. The average improvement was 1.88/9 (p < 0.001) and the overall improvement was 12.01/90 (p < 0.001). Thirteen combinations containing eight distinct protocols were found to be better than the average. Five of the protocols effectively addressed central sensitization (UD, Barral, Barral-CVVT, LAUG, VTCP); one protocol was hypothesized to have a direct effect on the trigeminal system (SYMPN), and two protocols could have been effective because of either direct or desensitization effects (CCCV and DCS).

Discussion and conclusion

This study demonstrated that TN can be effectively treated by focusing on central sensitization, which is preserved by the continuous input of several self-reinforcing loops into the LC-NA system. This study supports the hypothesis that central sensitization can be treated by creating intermittent disruption of these self-reinforcing loops.

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物理疗法治疗三叉神经痛伴面部和下颌疼痛

目的应用HOAC-APD模型评价全身手工疗法治疗三叉神经痛相关性面部疼痛（TN）的疗效。DesignCohort回顾性多变量分析采用改进的自适应平台设计。方法在使用99种不同的全身手动治疗方案组合后，测量85例患者在整个治疗期间的总体进展以及TN症状和总体主诉的平均改善率。结果当比较护理开始和结束时的评分时，66% %的患者报告三叉神经痛或面部疼痛的改善。平均改善为1.88/9 (p <； 0.001)，总体改善为12.01/90 （p <； 0.001）。包含8种不同方案的13种组合被发现优于平均水平。5个方案有效地解决了中枢致敏问题（UD、Barral、Barral- cvvt、LAUG、VTCP）；一种方案被假设对三叉神经系统（SYMPN）有直接影响，另外两种方案可能由于直接或脱敏效应而有效（CCCV和DCS）。本研究表明，通过集中治疗中枢致敏可以有效治疗TN，而中枢致敏是通过几个自我强化回路连续输入LC-NA系统来保存的。这项研究支持了这样一种假设，即中枢致敏可以通过间歇性地破坏这些自我强化回路来治疗。

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

Advances in integrative medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-

CiteScore

3.20

自引率

11.80%

发文量

审稿时长

15 weeks

期刊介绍： Advances in Integrative Medicine (AIMED) is an international peer-reviewed, evidence-based research and review journal that is multi-disciplinary within the fields of Integrative and Complementary Medicine. The journal focuses on rigorous quantitative and qualitative research including systematic reviews, clinical trials and surveys, whilst also welcoming medical hypotheses and clinically-relevant articles and case studies disclosing practical learning tools for the consulting practitioner. By promoting research and practice excellence in the field, and cross collaboration between relevant practitioner groups and associations, the journal aims to advance the practice of IM, identify areas for future research, and improve patient health outcomes. International networking is encouraged through clinical innovation, the establishment of best practice and by providing opportunities for cooperation between organisations and communities.