Effects of phototherapy on muscle activity and pain in individuals with temporomandibular disorder: a study protocol for a randomized controlled trial

• Published in: Trials 2014-12, Vol.15 (1), p.491-491, Article 491
• Main Authors: Herpich, Carolina Marciela, Leal-Junior, Ernesto Cesar Pinto, Amaral, Ana Paula, Tosato, Juliana de Paiva, Glória, Igor Phillip dos Santos, Garcia, Marília Barbosa Santos, Barbosa, Bruno Roberto Borges, El Hage, Yasmin, Arruda, Éric Edmur Camargo, Gomes, Cid Ándre Fidelis de Paula, Rodrigues, Monique Sampaio, de Sousa, Dowglas Fernando Magalhães, de Carvalho, Paulo de Tarso Camillo, Bussadori, Sandra Kalil, Gonzalez, Tabajara de Oliveira, Politti, Fabiano, Biasotto-Gonzalez, Daniela Aparecida
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Analysis; Biomechanical Phenomena; Brazil; Clinical Protocols; Double-Blind Method; Electromyography; Evidence-based medicine; Facial Pain - diagnosis; Facial Pain - physiopathology; Facial Pain - therapy; Female; Health aspects; Humans; Low-Level Light Therapy - methods; Masseter Muscle - physiopathology; Pain Measurement; Pain Threshold; Physical therapy; Range of Motion, Articular; Research Design; Study Protocol; Temporal Muscle - physiopathology; Temporomandibular Joint - physiopathology; Temporomandibular Joint Disorders - diagnosis; Temporomandibular Joint Disorders - physiopathology; Temporomandibular Joint Disorders - therapy; Therapeutics, Physiological; Time Factors; Treatment Outcome; Young Adult
• ISSN: 1745-6215; 1745-6215
• DOI: 10.1186/1745-6215-15-491

According to the International Association for the Study of Pain (IASP), the term temporomandibular disorder (TMD) regards a subgroup of orofacial pain, the symptoms of which include pain or discomfort in the temporomandibular joint, ears, masticatory muscles and neck on one or both sides, as well as joint sounds, limited mandibular movements or mandibular deviation and difficulties chewing. Phototherapy, such as low-level laser therapy (LLLT) and light-emitting diode (LED) therapy, is one of the resources used to treatment muscle pain. Thus, there is a need to investigate therapeutic resources that combine different wavelengths as well as different light sources (LLLT and LED) in the same apparatus. The aim of the proposed study is to evaluate the effects of four different doses of phototherapy on pain, activity of the masticatory muscles (masseter and bilateral anterior temporal) and joint mobility in individuals with temporomandibular disorder. A further aim is to determine the cumulative effect 24 and 48 hours after a single session. A placebo-controlled, double-blind, randomized, clinical trial will be carried out involving 72 women between 18 and 40 years of age with a diagnosis of myogenous TMD. The participants will then be randomly allocated to four groups totaling 18 individuals per group. Three groups will be submitted to a single session of phototherapy with different light sources, and one group will receive placebo therapy: Group A (2.62 Joules); Group B (5.24 Joules); Group C (7.86 Joules); and Group D (0 Joules). The following assessment tools will be administered on four separate occasions (baseline and immediately after, 24 h after and 48 h after phototherapy). Pain intensity will be assessed using the visual analog scale for pain, while pain thresholds will be determined using algometer, and electromyographic (EMG) analysis on the masseter and anterior temporal muscles. The study will contribute to the practice of the evidence-based use of phototherapy in individuals with a myogenous TMD. Data will be published after the study is completed. This study is registered with the Brazilian Registry of Clinical Trials, NCT02018770, date of registration: 7 December 2013.