title: Effectiveness of osteopathic manipulative treatment versus osteopathy in the cranial field in temporomandibular disorders - a pilot study.
abstract: OBJECTIVE
  Temporomandibular disorders are a common musculoskeletal condition causing severe pain, physical and psychological disability. The effect and evidence of osteopathic manipulative treatment and osteopathy in the cranial field is scarce and their use are controversial. The purpose of this pilot study was to evaluate the effectiveness of osteopathic manipulative treatment and osteopathy in the cranial field in temporomandibular disorders.
  
  
  METHODS
  A randomized clinical trial in patients with temporomandibular disorders was performed. Forty female subjects with long-term temporomandibular disorders (>3 months) were included. At enrollment, subjects were randomly assigned into two groups: (1) osteopathic manipulative treatment group (20 female patients) and (2) osteopathy in the cranial field group (20 female patients). Examination was performed at baseline (E0) and at the end of the last treatment (E1), consisting of subjective pain intensity with the Visual Analog Scale, Helkimo Index and SF-36 Health Survey. Subjects had five treatments, once a week. 36 subjects completed the study (33.7 ± 10.3 y).
  
  
  RESULTS
  Patients in both groups showed significant reduction in Visual Analog Scale score (osteopathic manipulative treatment group: p = 0.001; osteopathy in the cranial field group: p< 0.001), Helkimo Index (osteopathic manipulative treatment group: p = 0.02; osteopathy in the cranial field group: p = 0.003) and a significant improvement in the SF-36 Health Survey - subscale "Bodily Pain" (osteopathic manipulative treatment group: p = 0.04; osteopathy in the cranial field group: p = 0.007) after five treatments (E1). All subjects (n = 36) also showed significant improvements in the above named parameters after five treatments (E1): Visual Analog Scale score (p< 0.001), Helkimo Index (p< 0.001), SF-36 Health Survey - subscale "Bodily Pain" (p = 0.001). The differences between the two groups were not statistically significant for any of the three target parameters.
  
  
  CONCLUSIONS
  Both therapeutic modalities had similar clinical results. The findings of this pilot trial support the use of osteopathic manipulative treatment and osteopathy in the cranial field as an effective treatment modality in patients with temporomandibular disorders. The positive results in both treatment groups should encourage further research on osteopathic manipulative treatment and osteopathy in the cranial field and support the importance of an interdisciplinary collaboration in patients with temporomandibular disorders. Implications for rehabilitation Temporomandibular disorders are the second most prevalent musculoskeletal condition with a negative impact on physical and psychological factors. There are a variety of options to treat temporomandibular disorders. This pilot study demonstrates the reduction of pain, the improvement of temporomandibular joint dysfunction and the positive impact on quality of life after osteopathic manipulative treatment and osteopathy in the cranial field. Our findings support the use of osteopathic manipulative treatment and osteopathy in the cranial field and should encourage further research on osteopathic manipulative treatment and osteopathy in the cranial field in patients with temporomandibular disorders. Rehabilitation experts should consider osteopathic manipulative treatment and osteopathy in the cranial field as a beneficial treatment option for temporomandibular disorders.
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Medical University of Vienna , Austria.
authors.forename: Christina
authors.initials: C
authors.lastname: Gesslbauer
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Medical University of Vienna , Austria.
authors.forename: Nadja
authors.initials: N
authors.lastname: Vavti
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Medical University of Vienna , Austria.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Keilani
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Medical University of Vienna , Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Mickel
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Medical University of Vienna , Austria.
authors.forename: Richard
authors.initials: R
authors.lastname: Crevenna
mesh_terms: D000328:Adult; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D026301:Manipulation, Osteopathic / Q000379:methods*; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000175:diagnosis / Q000628:therapy; D010021:Osteopathic Medicine / Q000379:methods; D010147:Pain Measurement / Q000379:methods; D010865:Pilot Projects; D011788:Quality of Life; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D016896:Treatment Outcome
keywords: Temporomandibular joint; osteopathic medicine; pain; pain management