The aim of this meta-meta-analysis was to assess the current evidence regarding the effect of physical therapy (PT) interventions on pain and functional variables in temporomandibular disorders (TMD). We conducted an umbrella systematic review (SR) and four meta-meta-analyses (MMA) and created an evidence map to determine the effectiveness of PT on pain intensity and maximum mouth opening in patients with TMD. The quality of the included SR was assessed with the AMSTAR 2, and the risk of bias with ROBIS. Of the 31 SR included in the umbrella SR, only 10 were included in the MMA. The MMA showed moderate effects for manual therapy and therapeutic exercise, and large effects for low-level laser therapy on improving pain intensity and maximum mouth opening in patients with TMD, with a limited to moderate quality of evidence. The overlapping analyses showed only a slight overlap for all the MMA according to the corrected covered area (range from 0.07 to 0.2), 23.1% to 41.6%. This umbrella SR showed that manual therapy and exercise interventions, as well as low-level laser therapy interventions, are effective in the reduction in pain intensity and improvement of maximum mouth opening in TMD. This article presents a synthesis of the available evidence related to the various physical therapy interventions used in patients presenting with temporomandibular disorders. These results could help clinicians to select the optimal intervention for their patients and to reject those that are less useful.

The frequency of a high Central Sensitization Inventory (CSI) total score and the prevalence of pain have already been established among breast cancer survivors (BCS). However, the psychological factors’ influence based on the clinical features of pain is still unknown, as well as BCS characteristics with no pain. Thus, our main aim was to evaluate the presence of a high CSI total score in BCS with pain and compare it with BCS without pain and to evaluate the influence of psychosocial factors. A cross-sectional comparative study was designed to compare BCS with nociceptive pain (n = 19), pain with neuropathic features (n = 19) or no pain (n = 19), classified by the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS). CSI, pain catastrophizing, fear of movement, anxiety and depression symptoms were analyzed and compared among the three groups. The CSI total score was higher in both BCS pain groups compared to BCS without pain, but there were no statistical differences between the pain groups. The same observation was made when comparing pain catastrophizing. The neuropathic feature group showed greater levels of fear of movement, anxiety and depression compared to the no pain group. Thus, CS-psychosocial associated comorbidities and pain-catastrophizing thoughts were more prevalent among BCS with pain, regardless of the clinical features of pain. BCS with neuropathic pain features showed greater psychological disturbances.

Background and Objectives: Chronic low back pain (CLBP) is the most common occupational disorder due to its associated disability and high risk of recurrence and chronicity. However, the mechanisms underlying physical and psychological variables in patients with CLBP remain unclear. The main objective of this study was to assess whether there were differences between physically active patients with nonspecific CLBP compared with asymptomatic individuals in sensorimotor and psychological variables. Materials and Methods: This was an observational cross-sectional design with a nonprobabilistic sample. The sample was divided into two groups: individuals with nonspecific CLBP (n = 30) and asymptomatic individuals as a control (n = 30). The psychological variables assessed were low back disability, fear of movement, pain catastrophizing, and self-efficacy. The sensorimotor variables assessed were two-point discrimination, pressure pain threshold, lumbopelvic stability, lumbar flexion active range of motion, and isometric leg and back strength. Results: Statistically significant differences between the groups in terms of catastrophizing levels (p = 0.026) and fear of movement (p = 0.001) were found, but no statistically significant differences between groups were found in self-efficacy (p > 0.05). No statistically significant differences between the groups in any of the sensorimotor variables were found (p > 0.05). Conclusion: No sensorimotor differences were found between patients with asymptomatic and chronic low back pain, but differences were found in the psychological variables of catastrophizing and fear of movement.

Objectives: The aim of this study was to identify the possible relationships between psychological, pain, and disability variables with respect to the perception of change/recovery from physiotherapy in patients with chronic musculoskeletal pain (CMP). Methods: A cross-sectional observational study was performed with 150 patients. All patients completed a series of self-administered questionnaires and a series of self-reports to quantify the perception of change with respect to the physiotherapy they underwent, the level of disability and pain intensity, the level of fear of movement, the level of catastrophism, the degree of self-efficacy, the level of therapeutic alliance and their adherence to the physiotherapy. Results: The strongest correlations were between the subjective perception of change and the number of sessions, treatment beliefs, self-efficacy, pain intensity, collaboration, and bonding. The linear regression model showed that the number of sessions, treatment beliefs, self-efficacy, compliance, pain intensity, and bonding were predictors of subjective perception of improvement, with 50% of the variance. Conclusions: Treatment beliefs, therapeutic alliance, degree of self-efficacy, and pain intensity have been shown to be predictors of a subjective perception of improvement in patients with CMP. In turn, multimodal treatments had the greatest positive impact on the subjective perception of improvement.

Previous research has focused on the possibility of cervical dysfunction in migraine patients, similar to what is observed in patients with tension-type headaches. However, there is no evidence concerning the physical function of other body regions, even though lower levels of physical activity have been reported among migraine patients. The aim of this study was to compare cervical and extra-cervical range of motion, muscular strength, and endurance, as well as overall levels of physical activity, between patients with chronic migraine (CM) and asymptomatic participants. The secondary objective included the analysis of associations between CM-related disability and various physical and psychological variables. A total of 90 participants were included in this cross-sectional study: 30 asymptomatic participants (AG) and 60 patients with CM. Cervical and lumbar range of motion, strength and endurance, as well as handgrip strength were measured. Headache-related disability, kinesiophobia, pain behaviors, physical activity level and headache frequency were assessed through a self-report. Lower values were found in CM vs AG for cervical and lumbar ranges of motion (p < 0.05; effect sizes ranging from 0.57 to 1.44). Also, for neck extension strength (p = 0.013; d = - 0.66), lumbar strength (p < 0.001; d = - 1.91) and handgrip strength (p < 0.001; d = - 0.98), neck endurance (p < 0.001; d = - 1.81) and lumbar endurance (p < 0.001; d = - 2.11). Significant differences were found for physical activity levels (p = 0.01; d = - 0.85) and kinesiophobia (p < 0.001; d = - 0.93) between CM and AG. Headache-related disability was strongly associated with headache frequency, activity avoidance, and rest, which together explained 41% of the variance. The main findings of this study suggest that patients with CM have a generalized fitness deficit and not specifically cervical dysfunction. These findings support the hypothesis that migraine patients have not only neck-related issues but also general body conditions.

Background and Objectives: Facial paralysis involves the complete or partial loss of facial movement due to damage to the facial nerve, leading to impaired voluntary muscle function and facial asymmetry. Given its significant physical and psychosocial impact, there is an urgent need to strengthen the evidence supporting non-pharmacological treatments. This umbrella review aims to compile the most reliable and current data to establish a consensus on the effectiveness of such interventions for patients with facial paralysis. Materials and Methods: This study is an umbrella review. A systematic search was conducted in PubMed, Embase, Scopus, and CINAHL (28 July 2024). The variables assessed included overall healing/recovery rate, facial disability, and facial function. Methodological quality was evaluated using the AMSTAR and ROBIS tools. Screening was performed independently by two reviewers, with a third reviewer resolving any discrepancies. Results: Five systematic reviews were included, all evaluating the impact of non-pharmacological interventions in facial paralysis. The findings suggest that acupuncture and electrical stimulation may improve recovery rates and facial function, although high heterogeneity and methodological limitations were noted in some studies. No definitive conclusions could be drawn regarding facial disability. Conclusions: The combination of electrotherapy with other complementary techniques, such as facial exercises or laser therapy, appears to be a safe and potentially effective approach for facial paralysis rehabilitation. Nonetheless, further research employing standardized protocols and higher methodological quality is necessary to establish more robust conclusions for physiotherapeutic practice.