Evidenz von Physiotherapie bei kraniomandibulärer Dysfunktion

Zusammenfassung

Hintergrund: Kraniomandibuläre Dysfunktionen (CMD) bezeichnen umfassende Beschwerden der Kiefergelenkregion. Multifaktoriell bedingt haben sie einen beträchtlichen Einfluss auf die Lebensqualität.

Ziel: Dieser Review zeigt die Effektivität physiotherapeutischer Maßnahmen bei kraniomandibulären Dysfunktionen auf.

Methode: Im November 2011 erfolgte eine systematische Suche in den Datenbanken PubMed, CINAHL und PEDro. Eingeschlossen wurden deutsch- und englischsprachige RCT der letzten 5 Jahre zur Diagnose CMD und mindestens einer physiotherapeutischen Intervention. Ausgeschlossen wurden postoperative Therapie sowie Probanden mit Zahnprothesen und/oder systemischer Grunderkrankung.

Ergebnisse: 15 randomisierte kontrollierte Studien erfüllten die Einschlusskriterien. Die Arbeiten waren laut PEDro-Score von mittlerer bis hoher Qualität. Sowohl kombinierte Physio-, Übungs- als auch Low-level-Lasertherapie kann zur Symptomminderung bei CMD empfohlen werden.

Schlussfolgerung: Eine Level Ib-Empfehlung für den Einsatz von Physiotherapie bei CMD wird ausgesprochen. Weitere qualitativ hochwertige Studien sind jedoch zukünftig notwendig.

Abstract

Background: Craniomandibular disorders (CMD) indicate comprehensive discomfort in the temporomandibular joint area. Multifactorially conditioned they have significant impact on quality of life.

Objective: This review illustrates the evidence of physiotherapeutic treatment modalities for craniomandibular disorders.

Method: In November 2011a systematic search in the databases PubMed, CINAHL and PEDro was performed. German and English RCT over the past five years were included according to CMD diagnosis and at least one physiotherapy intervention. Post-operative therapy, patients with dentures or systemic disease were excluded.

Results: 15 randomized controlled studies fulfilled the inclusion criteria. According to PEDro-Scores they were of medium or high quality. Combined physical therapy, exercise therapy and low level laser therapy can be recommended for reducing CMD symptoms.

Conclusion: Level Ib for the use of physiotherapy in CMD is recommended. In Future further high quality studies are required.

Schlüsselwörter

kraniomandibuläre Dysfunktion - Physiotherapie - Behandlungsergebnis

Key words

craniomandibular disorders - physiotherapy modalities - treatment outcome

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