Revista CEFAC
https://revistacefac.org.br/article/doi/10.1590/1982-0216/202628612025
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Effects of transcutaneous electrical nerve stimulation combined with manual therapy on pain and masticatory function in women with temporomandibular disorder: An exploratory pilot study

Efeitos da estimulação elétrica nervosa transcutânea associada à terapia manual na dor e função mastigatória de mulheres com disfunção temporomandibular: um estudo piloto exploratório

Guilherme Lemos; Fabiane Miron Stefani

http://dx.doi.org/10.1590/1982-0216/202628612025 Revista CEFAC, vol.28, n6, e12025, 2026
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Abstract

Purpose: to evaluate the efficacy of Transcutaneous Electrical Nerve Stimulation (TENS) combined with manual therapy on the masticatory function and pain in women with Temporomandibular Disorder (TMD).

Methods: an exploratory, randomized, controlled, and blinded pilot clinical trial. The sample consisted of 11 women with muscular TMD, assessed using the Visual Analog Scale (VAS) and Surface Electromyography (sEMG) with Root Mean Square (RMS) signal processing. Participants were allocated into two groups: Manual Therapy Group (MG, n=5) and Manual Therapy combined with TENS Group (TG, n=6). The protocol comprised four weekly 30-minute sessions of manual therapy for both groups, with the TG participants additionally undergoing 25 minutes of TENS.

Results: a statistically significant pain reduction was observed in both groups (MG: p=0.002; TG: p=0.026). However, only the TG showed a significant reduction in electromyographic activity for the right masseter (p=0.008) and left temporal (p=0.028) muscles, indicating a reduction of hyperactivity.

Conclusion: both interventions were effective in reducing pain. The combination of manual therapy and TENS suggests additional benefits in modulating electromyographic activity and neuromuscular balance, enhancing the efficacy of multimodal approaches in the clinical management of TMD within an exploratory framework.

Keywords

Musculoskeletal Manipulations; Temporomandibular Joint Dysfunction Syndrome; Transcutaneous Electric Nerve Stimulation; Electromyography; Mastication

Resumo

Objetivo: analisar a eficácia da Transcutaneous Electric Nerve Stimulation (TENS) associada à terapia manual na função mastigatória e na dor em mulheres com Disfunção Temporomandibular (DTM).

Método: estudo piloto exploratório de um ensaio clínico randomizado, controlado e cego. A amostra consistiu em 11 mulheres com DTM muscular, avaliadas pela Escala Visual Analógica (EVA) e Eletromiografia de Superfície (EMG), com processamento de sinal em Root Mean Square (RMS). As participantes foram alocadas em: grupo terapia manual (GM, n=5) e grupo terapia manual associada à TENS (GT, n=6). O protocolo compreendeu quatro sessões semanais de 30 minutos de terapia manual para ambos os grupos, sendo que o GT recebeu, adicionalmente, 25 minutos de TENS.

Resultados: observou-se redução estatisticamente significativa da dor em ambos os grupos (GM: p=0,002; GT: p=0,026). Contudo, apenas o GT apresentou redução significante na atividade eletromiográfica para os músculos masseter direito (p=0,008) e temporal esquerdo (p=0,028), indicando menor hiperatividade.

Conclusão: ambas as intervenções foram eficazes na redução da dor. A associação da TENS à terapia manual sugere benefícios adicionais na modulação da atividade eletromiográfica e no equilíbrio neuromuscular, reforçando a eficácia de abordagens multimodais no manejo clínico da DTM num contexto exploratório.

Palavras-chave

Manipulações Musculoesqueléticas; Síndrome da Disfunção da Articulação Temporomandibular; Estimulação Elétrica Nervosa Transcutânea; Eletromiografia; Mastigação

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Submitted date:
11/05/2025

Accepted date:
07/10/2026

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