Telerreabilitação em indivíduos com disfunção temporomandibular: ensaio clínico randomizado e cego

Abstract

Introduction: Temporomandibular Disorder (TMD) is characterized by symptoms such as pain, limited range of motion, and joint noises. Its multifactorial origin can be linked to biological, environmental, and psychosocial factors. The multimodal approach is commonly employed in physiotherapy for TMD treatment. Physiotherapy is integrating technology to make telerehabilitation a reality, ensuring quality care reaches patients when in-person sessions are not possible. Objective: This study aimed to compare the effects of manual therapy combined with exercises through telerehabilitation and in-person sessions on outcomes of pain, range of motion, functionality, and depression in individuals with TMD. Materials and Methods: A randomized clinical trial was conducted, divided into evaluation and intervention phases. Clinical outcomes included pain, range of motion, functionality, and depression, assessed using DC/TMD criteria, Fonseca Anamnestic Index, Numeric Pain Rating Scale, and Mandibular Functional Impairment Questionnaire. Participants were randomized into two groups: Group A (in-person manual therapy and exercises) and Group B (telerehabilitation-based manual therapy and exercises). Both groups received individualized physiotherapeutic treatment pragmatically (3 to 12 weeks, twice a week) based on participants' clinical progress. Comprehensive statistical analysis involved normality testing, repeated measures ANOVA, Bonferroni post-hoc, ηp2 for effect sizes, and sample size adjustment using SPSS 20.0 and G*Power. Results: The application of telerehabilitation-based physiotherapy protocol, compared to in-person treatment, demonstrated similar efficacy, resulting in a significant improvement in Temporomandibular Disorder severity. Benefits included reduced pain, increased mandibular range, and improved depression compared to the in-person group. Conclusion: Telerehabilitation proves effective for TMD treatment, showing improvements, especially in severity outcomes, and holds promise for reducing pain, enhancing functionality, and addressing depressive states.