{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:41:53Z","timestamp":1791830513346,"version":"4.3.4"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2019,10,29]],"date-time":"2019-10-29T00:00:00Z","timestamp":1572307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This randomized clinical trial investigated the effects of adding cervico-mandibular manual therapies into an exercise and educational program on clinical outcomes in individuals with tinnitus associated with temporomandibular disorders (TMDs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sixty-one patients with tinnitus attributed to TMD were randomized into the physiotherapy and manual therapy group or physiotherapy alone group. All patients received six sessions of physiotherapy treatment including cranio-cervical and temporomandibular joint (TMJ) exercises, self-massage, and patient education for a period of one month. Patients allocated to the manual therapy group also received cervico-mandibular manual therapies targeting the TMJ and cervical and masticatory muscles. Primary outcomes included TMD pain intensity and tinnitus severity. Secondary outcomes included tinnitus-related handicap (Tinnitus Handicap Inventory [THI]), TMD-related disability (Craniofacial Pain and Disability Inventory [CF-PDI]), self-rated quality of life (12-item Short Form Health Survey [SF-12]), depressive symptoms (Beck Depression Inventory [BDI-II]), pressure pain thresholds (PPTs), and mandibular range of motion. Patients were assessed at baseline, one week, three months, and six months after intervention by a blinded assessor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The adjusted analyses showed better outcomes (all, P\u2009&amp;lt;\u20090.001) in the exercise\/education plus manual therapy group (large effect sizes) for TMD pain (\u03b7 2 P = 0.153), tinnitus severity (\u03b7 2 P = 0.233), THI (\u03b7 2 P = 0.501), CF-PDI (\u03b7 2 P = 0.395), BDI-II (\u03b7 2 P = 0.194), PPTs (0.363 &amp;lt; \u03b7 2 P\u2009&amp;lt;\u20090.415), and range of motion (\u03b7 2 P = 0.350), but similar changes for the SF-12 (P\u2009=\u20090.622, \u03b7 2 P = 0.01) as the exercise\/education alone group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This clinical trial found that application of cervico-mandibular manual therapies in combination with exercise and education resulted in better outcomes than application of exercise\/education alone in individuals with tinnitus attributed to TMD.<\/jats:p><\/jats:sec>","DOI":"10.1093\/pm\/pnz278","type":"journal-article","created":{"date-parts":[[2019,10,2]],"date-time":"2019-10-02T03:33:40Z","timestamp":1569987220000},"page":"613-624","source":"Crossref","is-referenced-by-count":66,"title":["Effects of Cervico-Mandibular Manual Therapy in Patients with Temporomandibular Pain Disorders and Associated Somatic Tinnitus: A Randomized Clinical Trial"],"prefix":"10.1093","volume":"21","author":[{"given":"Pablo","family":"Delgado de la Serna","sequence":"first","affiliation":[{"name":"Department of Physical Therapy, Universidad Francisco de Vitoria, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo","family":"Plaza-Manzano","sequence":"first","affiliation":[{"name":"Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San 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