Use Of Different Electrical Stimulations For Treating Pain In Women With Temporomandibular Disorders [utilização De Diferentes Estimulações Elétricas Para O Tratamento Da Dor Em Mulheres Com Disfunção Temporomandibular]

Objective: To analyze pain intensity in individuals with temporomandibular disorder (TMD) who were treated with ten sessions of transcutaneous electrical nerve stimulation (TENS) or high voltage electrical stimulation (HVES). Methods: Twenty-four women (22.98±1.86 years old) with a diagnosis of TMD in accordance with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were selected. Sixty percent of the participants had a diagnosis of TMD classified as group Ia and 40% as Ia and IIa. They were divided into two groups named TENS group (TG) and high-voltage group (HVG). Each participant received ten applications of either TENS (10Hz, modulated at 50%, 200μs and motor threshold intensity) or HVES (10Hz, twin pulses of 20μs each at intervals of 100μs between the twin pulses, 100volts and positive pole) twice a week for 30 minutes. To measure the pain intensity, a visual analog scale (VAS) was used. Statistical analyses were performed using t test and simple linear regression. Results: Comparison of the pre- and post-TENS conditions showed diminished pain intensity (p<0.05) in most sessions except for sessions 6, 7 and 8. In contrast, HVES reduced the pain intensity in all sessions (p<0.05). Evaluation of the pre-application values showed that both treatments decreased the pain intensity uniformly over the ten sessions (p<0.05). Conclusions: TENS and HVES both promoted reductions in pain intensity in women with TMD. HVES is a therapeutic resource recommended for such patients. © 2009 Revista Brasileira de Fisioterapia.126476481Tvrdy, P., Methods of imaging in the diagnosis of temporomandibular joint disorders (2007) Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 151 (1), pp. 133-6Magnusson, T., Egermark, I., Carlsson, G.E., A longitudinal epidemiologic study of signs and symptoms of temporomandibular disorders from 15 to 35 years of age (2000) J Orofac Pain, 14 (4), pp. 310-9Oliveira, A.S., Bermudez, C.C., Souza, R.A., Souza, C.M.F., Dias, E.M., Castro, C.E.S., Impacto da dor na vida de portadores de disfunção temporomandibular (2003) J Appl Oral Sci, 11 (2), pp. 138-43Furto, E.S., Cleland, J.A., Whitman, J.M., Olson, K.A., Manual physical therapy interventions and exercise for patients with temporomandibular disorders (2006) Cranio, 24 (4), pp. 283-91Cappelini, V.K., Souza, G.S., Faria, C.R.S., Massage therapy in the management of myogenic TMD: a pilot study (2006) J Apllied Oral Sci, 14 (1), pp. 21-6Kato, M.T., Kogawa, E.M., Santos, C.N., Conti, P.C.R., Tens and low-level laser therapy in the Management of temporomandibular Disorders (2006) J Appl Oral Sci, 14 (2), pp. 130-5Alvarez-Arenal, A., Junquera, L.M., Fernandez, J.P., Gonzalez, I., Olay, S., Effect of occlusal splint and transcutaneous electric nerve stimulation on the signs and symptoms of temporomandibular disorders in patients with bruxism (2002) J Oral Rehabil, 29 (9), pp. 858-63Rodrigues, D., Siriani, A.O., Bérzin, F., Effect of conventional TENS on pain and eletromyographic activity of masticatory muscles in TMD patients (2004) Braz Oral Res, 18 (4), pp. 290-5Windt, D.A., Heijden, G.J., Berg, S.G., Riet, G., Winter, A.F., Bouter, L.M., Ultrasound therapy for musculoskeletal disorders: a systematic review (1999) Pain, 81 (3), pp. 257-71Gonçalves, R.N., Ordenes, I.E.U., Rodrigues-Bigaton, D., Efeito indireto da TENS sobre os músculos cervicais em portadores de DTM (2007) Fisioter Mov, 20 (2), pp. 83-90Linde, C., Isacsson, G., Jonsson, B.G., Outcome of 6-week treatment with transcutaneous electric nerve stimulation compared with splint on symptomatic temporomandibular joint disk displacement without reduction (1995) Acta Odontol Scand, 53 (2), pp. 92-8Stralka, S.W., Jackson, J.A., Lewis, A.R., Treatment of hand and wrist pain: A randomized clinical trial of high voltage pulsed, direct current built into a wrist splint (1998) AAOHN Journal, 46 (5), pp. 233-6Holcomb, W.R., A practical Guide to Electrical Therapy (1997) J Sport Rehabil, 6, pp. 272-82Nelson, R.M., Hayes, K.W., Currier, D.P., (2003) Eletroterapia Clínica, , 3a ed. Barueri: ManoleAlon, G., Os princípios da estimulação elétrica (2003) Eletroterapia Clínica, pp. 55-139. , In. Nelson RM, Hayes KW, Currier DP. 3a ed. Barueri: ManoleIdo, C., Rothenbuhler, R., Janz, L., Eletroestimulação nervosa trancutânea de baixa freqüência nos "tender points" dos pacientes fibromioálgicos juvenis (2003) Rev Fisioter Univ São Paulo, 10 (1), pp. 1-6Larsson, S.E., Bodegard, L., Henriksson, K.G., Oberg, P.A., Chronic trapezius myalgia. Morphology and blood flow studied in 17 patients (1990) Acta Orthop Scand, 61 (5), pp. 394-8Tullberg, M., Alstergren, P.J., Ernberg, M.M., Effects of low-power laser exposure on masseter muscle pain and microcirculation (2003) Pain, 105 (1-2), pp. 89-96Okada, K., Yamaguchi, T., Minowa, K., Inoue, N., The influence of hot pack therapy on the blood flow in masseter muscles (2005) J Oral Rehabil, 32 (7), pp. 480-6Wieselmann-Penkner, K., Janda, M., Lorenzoni, M., Polansky, R., A comparison of the muscular relaxation effects of TENS and EMG-biofeedback in patients with bruxism (2001) J Oral Rehabil, 28 (9), pp. 849-53Cramp, A.F.L., Gilsenan, C., Lowe, A.S., Walsh, D.M., The effect of high- and low-frequency transcutaneous electrical nerve stimulation upon cutaneous blood flow and skin temperature in healthy subjects (2000) Clin Physiol, 20 (2), pp. 150-7Goldman, R., Brewley, B., Zhou, L., Golden, M., Electrotherapy reverses inframalleolar ischemia: A retrospective, observational study (2003) Advances in Skin & Wound care, 16 (2), pp. 79-89Goldman, R., Rosen, M., Brewley, B., Golden, M., Electrotherapy promotes healing and microcirculation of infrapopliteal ischemic wounds: a prospective pilot study (2004) Adv Skin Wound Care, 17 (6), pp. 284-94Robinson, A.J., Snyder, M.L., (2001) Eletrofisiologia Clínica: eletroterapia e teste eletrofisiológico, , 2a ed. Porto Alegre: Artme

Use of different electrical stimulations for treating pain in women with temporomandibular disorders

OBJECTIVE: To analyze pain intensity in individuals with temporomandibular disorder (TMD) who were treated with ten sessions of transcutaneous electrical nerve stimulation (TENS) or high voltage electrical stimulation (HVES). METHODS: Twenty-four women (22.98±1.86 years old) with a diagnosis of TMD in accordance with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were selected. 60% of the subjects had a diagnosis of TMD classified as group Ia and 40% as Ia and IIa. They were divided into two groups named the TENS group (TG) and the high voltage group (HVG). Each individual received ten applications of either TENS (10Hz, modulated at 50%, 200µs and motor threshold intensity) or HVES (10Hz, twin pulses of 20µs each at intervals of 100µs between the twin pulses, 100volts and positive pole) twice a week for 30 minutes. To measure the pain intensity, a visual analog scale (VAS) was used. Statistical analyses were performed using Student's t test and simple linear regression. RESULTS: Comparison of the pre and post-TENS conditions showed diminished pain intensity (p<0.05) at most sessions except for sessions 6, 7 and 8. In contrast, HVES reduced the pain intensity at all sessions (p<0.05). Evaluation of the pre-application values showed that both treatments decreased the pain intensity uniformly over the ten sessions (p<0.05). CONCLUSIONS: TENS and HVES both promoted reductions in pain intensity in women with TMD. HVES is a therapeutic resource recommended for such patients.OBJETIVO: Analisar a intensidade da dor em indivíduos com disfunção temporomandibular (DTM) tratados com dez sessões de estimulação elétrica nervosa transcutânea (TENS) ou estimulação elétrica de Alta Voltagem (EEAV). MÉTODOS: Foram selecionadas 24 mulheres (22,98±1,86 anos) com diagnóstico de DTM, segundo o Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), sendo 60% com diagnóstico de DTM do grupo Ia e 40% Ia e IIa. As voluntárias foram divididas em dois grupos denominados grupo TENS (GT) e Grupo Alta Voltagem (GAV). Em ambos os grupos as voluntárias receberam dez aplicações da TENS (10Hz modulada em 50%, 200 µs e intensidade no limiar motor) ou da EEAV (10Hz, pulsos gêmeos com 20µs cada e intervalo 100µs interpulsos gêmeos, 100Volts e pólo positivo) duas vezes por semana por 30 minutos. Para mensurar a intensidade da dor, foi utilizada a escala visual analógica (EVA). Para análise estatística, utilizou-se teste t de Student e análise de regressão linear simples. RESULTADOS: Comparando-se as condições pré e pós TENS observa-se uma redução na intensidade da dor (p<0,05) na maioria das sessões, exceto na sexta, sétima e oitava, enquanto a EEAV reduziu a intensidade da dor (p<0,05) em todas as sessões. Avaliando-se os valores pré-aplicação, os dois recursos diminuíram a intensidade de dor de forma uniforme ao longo das dez sessões (p<0,05). CONCLUSÕES: A TENS e a EEAV promoveram redução da intensidade da dor em mulheres com DTM, sendo a EEAV mais um recurso indicado para o tratamento desses pacientes.47648

Effect Of Cathodal High-voltage Electrical Stimulation On Pain In Women With Tmd [efeito Da Estimulação Elétrica De Alta Voltagem Catódica Sobre A Dor Em Mulheres Com Dtm]

Background: Pain is the main symptom of patients with temporomandibular disorder (TMD). Objective: To evaluate the effect of cathodal high-voltage electrical stimulation (HVES) on pain intensity in women with TMD. Methods: Twenty women with TMD (24.25±8.90 years old) participated in the study. They were divided into experimental group (EG, n=10), which received 10 applications of HVES, and placebo group (PG, n=10), which received sham treatment with disconnected HVES equipment. For the sample selection, we used the Research Diagnostic Criteria for Temporomandibular Disorder (RDC/TMD). Pain level was evaluated using a visual analog scale (VAS) applied prior to and after the tenth application of HVES. Data were analyzed using the Wilcoxon signed-rank test and the Mann-Whitney test. Results: Ten applications of HVES reduced pain intensity in the EG (p=0.01). In the PG, there was no significant difference (p=0.20). After the application of HVES, no difference was found (p=0.65) between the groups. Conclusion: The cathodal HVES was effective in reducing pain in women with TMD. 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