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Systematic reviews

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Home-based rehabilitation versus centre-based programs in patients with temporomandibular disorders—a systematic review and meta-analysis

  • Jialin Wang1,†
  • Ruirui Wang2,†
  • Peng Zhao1,*,
  • Xiao Zhou1
  • Xuanhui Guo2

1Sports Rehabilitation Research Center, China Institute of Sport Science, 100061 Beijing, China

2College of Sports Medicine and Physical Therapy, Beijing Sport University, 100084 Beijing, China

DOI: 10.22514/jofph.2024.002 Vol.38,Issue 1,March 2024 pp.1-16

Submitted: 26 October 2022 Accepted: 12 October 2023

Published: 12 March 2024

*Corresponding Author(s): Peng Zhao E-mail: zhaopeng@ciss.cn

† These authors contributed equally.

Abstract

To compare the effects of home-based rehabilitation and occlusal splints or centre-based rehabilitation in patients with temporomandibular joint disorders (TMD). A systematic review and meta-analysis. PubMed, Embase, Cochrane Library, Web of Science and ClinicalTrials.gov electronic databases were consulted from inception to August 2023, searching for randomized controlled trials (RCTs) that compared home-based rehabilitation for TMD with splints or centre-based rehabilitation. The risk of bias was assessed using the Cochrane risk of bias tool. 23 RCTs (1402 participants, three comparator interventions) were identified. Very low-certainty evidence suggested there are no clinically difference between home-based rehabilitation and splints in pain intensity (mean difference (MD) 7.75, 95% confidence interval (CI): 2.17 to 13.32), maximal mouth opening (MMO) (MD 1.83, 95% CI: −0.27 to 3.93) at short and long-term follow-up, in sleep quality (MD: 1.67, 95% CI: −2.04 to 3.56) and quality of life (psychological: MD 0.94, 95% CI: −4.43 to 6.31; general: MD −1.18, 95% CI: −5.72 to 5.37) at short-term follow-up. Low-certainty evidence suggested that home-based rehabilitation plus manual therapy is more effective for TMD treatment compared to home-based rehabilitation at short-term follow-up (pain intensity: MD: 14.93, 95% CI: 7.72 to 21.93; MMO: MD −2.93, 95% CI: −5.3 to −0.54; sleep quality: MD 1.4, 95%CI: 0.09 to 2.71). Compared with home-based rehabilitation, Transcutaneous Electrical Nerve Stimulation (TENS) and Low-Level Laser Therapy (LLLT) was superior in pain relief at short-term follow-up. Low and very low-certainty evidence suggests home-based rehabilitation could be considered a low-cost, beneficial therapy alternative for TMD patients to relieve symptoms.


Keywords

Temporomandibular joint disorders; Home care service; Pain intensity; Maximal mouth opening; Meta-analysis


Cite and Share

Jialin Wang,Ruirui Wang,Peng Zhao,Xiao Zhou,Xuanhui Guo. Home-based rehabilitation versus centre-based programs in patients with temporomandibular disorders—a systematic review and meta-analysis. Journal of Oral & Facial Pain and Headache. 2024. 38(1);1-16.

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