Efectos de un protocolo secuenciado de terapia manual en los puntos gatillo latentes miofasciales de los maseteros

Zusammenfassung

Objectives: To identify the effects of the application of a protocol (two manual soft tissue techniques) on latent myofascial trigger points (MTrPs) of the masseter muscle. Material and methods: The sample was composed of 57 men and women aged 18 to 50 years old. The subjects were randomly divided into three groups: a control group (n = 19) who underwent a placebo technique, neuromuscular technique (NMT) group (n = 17) and Jones group who underwent the strain/counterstrain technique (n = 21). Each treatment group received three sessions for 3 consecutive weeks. The following variables were evaluated before and after the intervention: pressure pain threshold by a pressure algometer in the MTrPs of the dysfunction masseter, pain using VAS elicited by the application of 2.5 Kg/cm2 (pressure algometer) on the MTrPs of the dysfunctional masseter, and active mouth opening. All assessments were made by an assessor blinded to the treatment allocated to each subject The descriptive analysis used the mean and standard deviation in quantitative variables and frequencies in qualitative variables. In the comparative analyses, the Kolmogorov-Smirnov test, student¿s T-test (unpaired data), c2 test and ANOVA (paired measures - intra-subject: session; inter-subject: study group) were used. Results: The pre-intervention values (age, sex, VAS, pressure pain threshold and active mouth opening) showed no significant differences among the three groups and quantitative variables showed normal distribution. The multiple analysis and paired comparisons of the quantitative variables in the pre-intervention and post-intervention assessments across the three sessions showed significant differences in the three outcome measures. However, in the paired analysis by groups, pressure pain threshold showed no significant differences between the NMT and Jones groups. The VAS showed no significant differences among any of the intergroup combinations. Finally, active mouth opening showed differences between the control and Jones groups only (p = 0.02), with no differences being found for the NMT group with respect to the remaining two groups. Conclusions: The Jones and NMT techniques are effective in the treatment of latent MTrPs in the masseter muscle evaluated through pressure pain threshold and active mouth opening assessment.