Influência da mobilização mandibular específica e da massoterapia sobre o sinal eletromiográfico de músculos mastigatórios e o equilíbrio estático em indivíduos com disfunção temporomandibular - estudo clínico, aleatorizado, controlado e cego

Abstract

Introduction : Mandibular changes may contribute to the imbalance of posture chains and compromising postural balance and center of pressure , and from a reprogramming of sensory receptors , using techniques of mobilization and body massage therapy , you can reprogram them to restore body balance - overall the neuromuscular system , and thus improve body posture and its derivations . Electromyography is used to establish an objective parameter to assess the muscle activity, and thus to plan the most appropriate therapeutic intervention in patients with temporomandibular disorders as well as providing additional criteria in the analysis of treatment outcomes. The objective of this study is to investigate the influence of specific mandibular mobilization and massage therapy on the electromyographic signal of masticatory muscles, mandibular mobility and static balance in subjects with temporomandibular disorders. Materials and methods : We analyzed 26 individuals diagnosed by the Research Diagnostic Criteria for Temporomandibular Disorders - RDC / TMD and classified according to the severity of the dysfunction using the Anamnesic Index of Fonseca. Selected subjects were assessed with electromyography, stabilometry and pachymetry. After randomization, subjects were divided into 2 groups : Group Mobilization (treated with specific mandibular mobilization for 6 sessions ) and group 2 - Massage therapy group (treated with massage therapy for 10 sessions ) . At the end were reassessed using the questionnaire RDC / TMD , electromyography , stabilometry , pachymetry and classified using Anamnesic Index of Fonseca . Results: No significant differences were found in terms of postural control post- treatments . Regarding electromyography , results showed significant influence of mobilization and massage therapy for the condition Rest ( F = 5.12 , P < 0.001 and F = 4:07 , P = 0.02 ) , respectively. In terms of chewing and intercuspal , only the massage therapy showed a significant difference (F = 8.00 , P < 0.001 and F = 6.54 , P = 0.002) Conclusion : Based on the results obtained in the present study , we can conclude that only treatment with massage therapy influences the electromyographic signal provided maximal intercuspal position and influence both techniques in the resting condition , but do not influence the balance and mandibular range of motion.