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Success predictive factors of a multimodal treatment consisting of manual therapy, therapeutic exercises and pain education in individuals with temporomandibular disorders

Grant number: 23/03475-1
Support Opportunities:Scholarships in Brazil - Doctorate
Effective date (Start): April 01, 2024
Effective date (End): June 30, 2026
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal Investigator:Débora Bevilaqua Grossi
Grantee:Luana Maria Ramos Mendes
Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil


Temporomandibular Disorders (TMDs) are a significant public health problem, as they are one of the primary sources of orofacial pain and directly affect daily activities. There is moderate to insufficient evidence for the effectiveness of treating these disorders with manual therapy techniques and therapeutic exercises. And better results are found when these techniques are combined, with a significant reduction in pain and improvement in range of motion. Adding pain education to these interventions, even more, promising results are expected. The objective of this study is to identify predictive factors of the success of a multimodal treatment consisting of manual therapy, therapeutic exercises and pain education for individuals with TMD. A prospective cohort study will be conducted with 70 individuals with TMD. They will undergo an initial assessment and undergo a 6-week treatment protocol, with two sessions per week. The protocol will consist of manual therapy techniques, passive and active mandibular exercises, exercises aimed at the cervical spine and postural exercises, and pain education based on Neuroscience. They will be reassessed one week after and one month after the end of treatment. Pre- and post-treatment assessments will include craniofacial and mandibular disability, signs and symptoms of anxiety and depression, pressure pain threshold, presence of central sensitization, cervical disability and cervical mobility. To determine the success of the intervention protocol will be used the percentage of disability improvement will be. If it is >50%, the treatment success is characterized, thus dividing individuals into two groups: those who were successful and those who were not. Potential predictor variables will be entered into a stepwise logistic regression model to determine the most accurate set of variables for predicting treatment success.

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