ORCID Profile
0000-0002-5043-8946
Current Organisation
Université catholique de Louvain
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Publisher: Wiley
Date: 31-01-2022
DOI: 10.1111/JOOR.13303
Abstract: The mouth‐opening muscular performance in patients with temporomandibular disorders (TMDs) is unclear. Understanding the impairments of this muscle group within specific TMDs is important to develop proper management strategies. To characterise the mouth‐opening muscular performance in adults with and without TMDs. PubMed, EMBASE, CINAHL, Scopus, Web of Science and Cochrane databases were searched from inception to 12 November 2020. Bibliographies were searched for additional articles, including grey literature. Case‐control, cross‐sectional and interventional studies reporting mouth‐opening muscular strength and/or endurance were included. Risk of bias was assessed by the SIGN checklist for case‐control studies and by the NIH quality assessment tool for cross‐sectional studies. Results were pooled with a random‐effects model. Confidence in cumulative evidence was determined by means of the GRADE guidelines. Fourteen studies were included most were rated as having a moderate risk of bias. Only three studies assessed patients with TMDs and the other 11 assessed healthy adults. Significant sex differences in muscular performance were found for healthy adults in the review (strength deficit for females versus males). There was a significant reduction in maximal mouth opening performance (strength and endurance) in the three studies that assessed patients with temporomandibular disorders. Sex plays a significant role in maximal mouth opening strength. There is a lack of reliable data on the normal mouth‐opening strength and endurance of healthy adults as well as for patients with TMDs. Lack of reliable TMDs patient data and comparable healthy adult data highlight future direction for research.
Publisher: Wiley
Date: 17-01-2022
DOI: 10.1111/JOOR.13299
Abstract: Within physical therapy, manual therapy is known to be effective for managing temporomandibular disorders (TMDs). However, manual therapy is a broad term including different approaches applied to different body regions. This is the first systematic review that aims to evaluate the effectiveness of manual therapy applied specifically to the craniomandibular structures (Cranio‐Mandibular Manual Therapy [CMMT]) on pain and maximum mouth opening in people with TMD. This systematic review was developed based on a pre‐determined published protocol which was prospectively registered with PROSPERO (CRD42019160213). A search of MEDLINE, Embase, CINAHL, ZETOC, Web of Science, SCOPUS, PEDro, PubMed, Cochrane Library and Best Evidence, EBM reviews–Cochrane Central Register of Controlled Trials, Index to Chiropractic Literature ChiroAccess and Google Scholar databases was conducted from inception until October 2020. Randomised controlled trials comparing the effect of CMMT on pain and maximum mouth opening versus other types of treatment in TMDs were included. Two reviewers independently screened articles for inclusion, extracted data, assessed risk of bias with the revised Cochrane risk of bias tool for randomised trials and evaluated the overall quality of evidence with the Grading of Recommendations, Assessment, Development and Evaluations. A total of 2720 records were screened, of which only 6 (293 participants) satisfied the inclusion criteria. All studies showed some concerns in risk of bias, except for one, which was high risk of bias. The overall quality of evidence was very low for all outcomes because of high heterogeneity and small s le sizes. All studies showed a significant improvement in pain and maximum mouth opening for CMMT from baseline in the mid‐term, but only two showed superiority compared to other interventions. Given the high heterogeneity and small s le sizes of the included studies, a quantitative synthesis was not performed. There is the need for future high methodology research investigating different manual therapy techniques applied to different regions and different populations (e.g., chronic versus acute TMD) to determine what is most effective for pain and maximum mouth opening in patients with TMDs.
Publisher: Oxford University Press (OUP)
Date: 10-2020
DOI: 10.1093/PM/PNAA210
Abstract: The goal of this study was to identify central sensitization–related symptom severity subgroups in a large multicountry s le composed of patients with chronic pain and pain-free in iduals using the Central Sensitization Inventory (CSI). A large, pooled international (N = 8 countries) s le of chronic pain patients plus healthy subjects (total N = 2,620) was randomly ided into two subs les for cross-validation purposes. First, a hierarchical cluster analysis (HCA) was performed using CSI item-level data as clustering variables (test s le N = 1,312). Second, a latent profile analysis (LPA) was conducted to confirm the optimal number of CSI clusters (validation s le N = 1,308). Finally, to promote implementation in real-world clinical practice, we built a free online Central Sensitization Inventory Symptom Severity Calculator. In both HCA (N = 1,219 valid cases) and LPA (N = 1,245 valid cases) analyses, a three-cluster and three-profile solution, respectively, emerged as the most statistically optimal and clinically meaningful. Clusters were labeled as follows: (i) Low Level of CS-Related Symptom Severity, (ii) Medium Level of CS-Related Symptom Severity, and (iii) High Level of CS-Related Symptom Severity. Our results indicated that a three-cluster solution clearly captured the heterogeneity of the CSI data. The calculator might provide an efficient way of classifying subjects into the cluster groups. Future studies should analyze the extent to which the CSI cluster classification correlates with other patient-reported and objective signs and symptoms of CS in patients with chronic pain, their associations with clinical outcomes, health-related costs, biomarkers, (etc.), and responsiveness to treatment.
Publisher: Wiley
Date: 16-04-2021
DOI: 10.1111/JOOR.13168
Abstract: Temporomandibular disorders (TMD) are characterised by complex symptomatology and their assessment can be enhanced using pain drawings (PD). To evaluate the location and extent of pain in people TMD using digital PD, and to explore their association with clinical features. Reliability of pain extent and pain location using PD was also assessed. Forty volunteers with TMD completed two consecutive digital PDs. Clinical features were captured from self‐reported questionnaire. Additionally, secondary hyperalgesia was measured using the pressure pain threshold (PPT). The correlation between pain extent and clinical features was investigated using Spearman rank correlation coefficients. Reliability of pain extent was evaluated using intraclass correlation coefficient (ICC) and Bland‐Altman plots. The Jaccard index was computed to assess the reliability of pain location. Analysis of the PDs indicated that people with TMD commonly experience pain in other body regions including the neck, the shoulder and the low back. Except for PPT and pain catastrophising, all other clinical features were significantly correlated with pain extent. The ICCs of pain extent for all body charts were very high (ICCs 95% CI from 0.73 to 0.96), and Bland‐Altman plots showed mean biases close to zero with narrow limits of agreement. The reliability of pain location was also supported by Jaccard index mean scores above 0.68. People with TMD showed widespread pain, and pain extent was associated with pain intensity, neck and headache‐related disability, depression, anxiety, hyperventilation and central sensitivity. The reliability of measuring pain extent and pain location was confirmed.
Publisher: Springer Science and Business Media LLC
Date: 08-03-2021
DOI: 10.1186/S13643-021-01623-7
Abstract: The term temporomandibular disorder (TMD) includes disorders of the temporomandibular joints (TMJ), masticatory muscles and adjacent tissues. Several studies have examined the effectiveness of manual therapy (MT) for TMDs by evaluating changes in pain and maximum mouth opening (MMO). Nevertheless, the effectiveness of MT exclusively applied to the craniomandibular structures (craniomandibular manual therapy (CMMT)) on pain and TMJ range of motion remains unclear. This review aims to evaluate the effectiveness of CMMT on pain and TMJ range of motion in people with TMDs. This protocol is reported in line with the preferred reporting items for systematic reviews and meta-analysis protocols (PRISMA-P). Databases including MEDLINE, Embase, CINAHL, ZETOC, Web of Science, SCOPUS, PEDro, PubMed, Cochrane Library and Best Evidence, EBM reviews–Cochrane Central Register of Controlled Trials, Index to Chiropractic Literature ChiroAccess and Google Scholar will be searched from inception as well as key journals and grey literature. Randomised controlled trials involving adults with TMD that compare the effect of any type of CMMT (e.g. mobilisation) on pain and range of motion with a placebo intervention, controlled care intervention or other types of treatment will be included. Two reviewers will independently screen articles for inclusion, extract data, assess risk of bias (revised Cochrane risk of bias tool) for included studies and evaluate overall quality of evidence (Grading of Recommendations Assessment, Development and Evaluation). A meta-analysis will be conducted if possible. If not, a narrative synthesis will be conducted reporting the effectiveness of CMMT according to disorder type (TMJ disorders, masticatory muscle disorders and mixed disorders). In this review, the effectiveness of MT applied to craniomandibular structures for the treatment of TMD will be evaluated. Results will be submitted for publication in a peer-reviewed journal and presented at conferences. We expect our findings will facilitate treatment planning for manual therapists managing patients with TMD and provide future clinical research implications. PROSPERO CRD42019160213
Publisher: Wiley
Date: 04-05-2001
DOI: 10.1111/JOOR.12959
Publisher: Elsevier BV
Date: 12-2018
DOI: 10.1016/J.JELEKIN.2018.07.007
Abstract: Isometric bite force control, via measures of force accuracy, force steadiness and force proprioception, was assessed in patients with myogenic temporomandibular disorders (TMDs) compared to healthy controls. Twelve people with myogenic TMDs and twelve age- and gender-matched asymptomatic controls performed maximal voluntary contractions (MVC) of unilateral jaw clenching followed by submaximal isometric contractions, with and without visual feedback of force, at 10, 30 50% and 70% MVC. Force performance was assessed with indices of accuracy (mean distance, MD) and precision (standard deviation, SD) and reported as a percentage of the MVC. A mixed-effect model was used to evaluate differences in MVC, MD and SD. The MVC was lower in the TMD group when clenching either ipsilateral or contralateral to the side of greatest pain (p < 0.05). No difference in MD was observed between groups. The SD depended on the interaction between group and painful side (p = 0.04) with the TMD group displaying higher SD when executing the task with the most painful side when compared to the ipsilateral or contralateral sides of the control group. The reduced maximal bite force and force steadiness observed in people with myogenic pain may interfere with masticatory function and should be considered when planning therapeutic interventions for TMDs.
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.JPAIN.2017.11.006
Abstract: Central sensitization (CS) involves the lification of neural signaling within the central nervous system, which evokes pain hypersensitivity. The Central Sensitization Inventory (CSI) assesses 25 overlapping health-related symptom dimensions that have been reported to be associated with CS-related disorders. Previous studies have reported satisfactory test-retest reliability and internal consistency, but factor analyses have exhibited conflicting results in different language versions. The purpose of this cross-sectional study was to thoroughly examine the dimensionality and reliability of the CSI, with pooled data from 1,987 in iduals, collected in several countries. The principal component analysis suggested that 1 general factor of CS best described the structure. A subsequent confirmatory factor analysis revealed that a bifactor model, which accounted for the covariance among CSI items, with regard to 1 general factor and 4 orthogonal factors, fit the CSI structure better than the unidimensional and the 4-factor models. Additional analyses indicated substantial reliability for the general factor (ie, Cronbach α = .92 ω = .95 and ω hierarchical = .89). Reliability results for the 4 specific factors were considered too low to be used for subscales. The results of this study clearly suggest that only total CSI scores should be used and reported. As far as we know, this is the first study that has examined the factor structure and reliability of the CSI in a large multicountry s le. The CSI is currently considered the leading self-report measure of CS-related symptoms worldwide.
Publisher: Informa UK Limited
Date: 26-02-2021
Publisher: Elsevier BV
Date: 07-2015
DOI: 10.1016/J.JMPT.2015.06.013
Abstract: The purpose of this clinical study was to compare the immediate- and short-term effects of lumbar Mulligan sustained natural apophyseal glides (SNAGs) on patients with nonspecific low back pain with respect to 2 new kinematic algorithms (KA) for range of motion and speed as well as pain, functional disability, and kinesiophobia. This was a 2-armed randomized placebo-controlled trial. Subjects, blinded to allocation, were randomized to either a real-SNAG group (n = 16) or a sham-SNAG group (n = 16). All patients were treated during a single session of real/sham SNAG (3 × 6 repetitions) to the lumbar spine from a sitting position in a flexion direction. Two new KA from a validated kinematic spine model were used and recorded with an optoelectronic device. Pain at rest and during flexion as well as functional disability and kinesiophobia was recorded by self-reported measures. These outcomes were blindly evaluated before, after treatment, and at 2-week follow-up in both groups. Of 6 variables, 4 demonstrated significant improvement with moderate-to-large effect sizes (ES) in favor of the real-SNAG group: KA-R (P = .014, between-groups ES Cliff δ = -.52), pain at rest and during flexion (visual analog scale, P < .001 ES = -.73/-.75), and functional-disability (Oswestry Disability Index, P = .003 and ES = -.61). Kinesiophobia was not considered to be significant (T a scale, P = .03) but presented moderate ES = -.46. Kinematic algorithms for speed was not significantly different between groups (P = .118) with a small ES = -.33. All 6 outcome measures were significantly different (P ≤ .008) during within-group analysis (before and after treatment) only in the real-SNAG group. No serious or moderate adverse events were reported. This study showed evidence that lumbar spine SNAGs had a short-term favorable effect on KA-R, pain, and function in patients with nonspecific low back pain.
Publisher: Elsevier BV
Date: 02-2015
No related grants have been discovered for Laurent Pitance.