Anna Manzari

Dr. Anna Manzari


Research Focus & Metrics

Academic Career Length

3Years (2024-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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16 October 2024 in BMJ Open
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GAGiacomo Asquini
Giacomo Asquini
GPGiulia Pisacane
Giulia Pisacane
Filippo MaselliFilippo Maselli
Filippo Maselli
Giovanni GaleotoGiovanni Galeoto
Giovanni Galeoto
Firas MouradFiras Mourad
Firas Mourad
Deborah FallaDeborah Falla
Deborah Falla
Introduction Temporomandibular disorders (TMDs) are musculoskeletal disorders characterised by jaw pain and typically temporomandibular joint limitations. Resistance training (RT) has been shown to be effective at reducing pain and improving function for different musculoskeletal conditions (eg, neck pain, low back pain); however, the effectiveness of RT for patients with TMDs remains unclear. This systematic review will evaluate the effectiveness of RT on pain and temporomandibular joint range of motion in people with TMDs. Methods and analysis The report of this protocol aligns with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. The search strategy will be conducted from 1 March 2024 to 31 March 2024 via the following electronic databases: MEDLINE (OVID interface), EMBASE (OVID interface), SCOPUS, Web of Science, PubMed and Cochrane Central Register of Controlled Trials. Any randomised controlled trials or non-randomised studies of interventions in adults with TMD that examine RT targeting the masticatory muscles, compared to other interventions not including RT, will be included. Primary outcomes will be jaw pain intensity and maximal mouth opening. Secondary outcomes will include measures of neuromuscular performance and pressure pain thresholds. Two independent reviewers will conduct the screening of articles for inclusion, data extraction, risk-of-bias assessment using the revised Cochrane risk-of-bias tool for included studies and will evaluate the overall quality of evidence following the Grading of Recommendations Assessment, Development and Evaluation framework. A meta-analysis will be performed where applicable. Alternately, a narrative synthesis will be performed by adhering to the synthesis without meta-analysis guidelines. Data will be summarised according to the outcome measures or, when this is not possible, according to other pertinent variables such as TMD type (ie, temporomandibular joint disorders, masticatory muscle disorders and mixed disorders). Ethics and dissemination Ethical approval is not necessary, since this study does not involve the collection of primary data. The results will be disseminated through presentations at scientific conferences and publication in a peer-reviewed journal. PROSPERO registration number CRD42023476269.

29 December 2025 in Journal of Clinical Medicine
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Journal Article
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PBPaolo Bizzarri
Paolo Bizzarri
AGAndrea Giusti
Andrea Giusti
MPMarco Pernici
Marco Pernici
PBPaolo Bulzacca
Paolo Bulzacca
GAGiacomo Asquini
Giacomo Asquini
ASAldo Scafoglieri
Aldo Scafoglieri
Introduction: Temporomandibular disorders (TMDs), neck pain (NP), and cervicogenic headache (CGH) frequently co-occur. We aimed to assess TMD prevalence and orofacial clinical features in adults with NP or CGH versus asymptomatic controls. Methods: We searched PubMed, CINAHL, Web of Science, and Scopus from inception to 31 July 2025. Eligible designs were analytical cross-sectional studies comparing TMD prevalence, signs, or symptoms between NP/CGH patients and controls. Outcomes included TMD prevalence, jaw mobility, masticatory muscle pressure pain thresholds (PPT), and palpation findings. Risk of bias was appraised with the JBI analytical cross-sectional checklist. Random-effects meta-analyses synthesized odds ratios (ORs) for dichotomous and mean/standardized mean differences (MDs/SMDs) for continuous outcomes; heterogeneity was quantified with I2 (and τ2 where available). Small-study effects were inspected visually (k < 10). Certainty of evidence was assessed with GRADE. Results: From 4130 records, nine studies met the criteria (eight NP, 400 subjects; one CGH, 44 subjects). NP was associated with higher TMD prevalence versus controls (OR 3.64, 95% CI 1.35–9.84; I2 = 13%). Jaw mobility was reduced in either pain-free opening (one study), unassisted opening (one study), or maximum assisted opening (three studies; MD −6.16 mm, 95% CI −10.05; −2.28; I2 = 83%). PPTs were lower in symptomatic groups for masseter (SMD −1.11, 95% CI −1.89 to −0.32; three studies; I2 = 92.6%) and temporalis (SMD −0.77, 95% CI −1.04 to −0.50; five studies; I2 = 69%). Myofascial trigger points and pain on palpation of masticatory muscles or TMJ were more frequent in experimental groups. Discussion: The findings suggest consistent associations between NP/CGH and TMD prevalence with signs of orofacial dysfunctions. Certainty of evidence was very low due to the cross-sectional design, incomplete confounding control, and moderate heterogeneity for several outcomes. Conclusions: Adults with NP/CGH show higher TMD prevalence and reduced jaw mobility with lower masticatory PPTs. The results support integrated assessment, and prospective longitudinal studies are needed.

Verified
Journal Article
Open access
PDF file
PBPaolo Bizzarri
Paolo Bizzarri
GAGiacomo Asquini
Giacomo Asquini
CBCecilia Bagnoli
Cecilia Bagnoli
GPGiulia Pisacane
Giulia Pisacane
AMAnna Manzari
Anna Manzari
EBEdoardo Balli
Edoardo Balli
Temporomandibular disorders (TMDs) are clinically heterogeneous, and patients sharing the same diagnosis may differ substantially in pain mechanisms, functional impairments, behavioral contributors, comorbidities, psychosocial burden, prognosis, and treatment response. Although the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), the International Classification of Orofacial Pain (ICOP), and the International Classification of Headache Disorders (ICHD-3) provide essential diagnostic standards, they do not directly translate diagnosis into individualized physiotherapy management. This Masterclass proposes an evidence-informed clinical framework designed to bridge this gap and support personalized, evidence-based practice. Developed through targeted literature searches, citation tracking, and narrative synthesis of diagnostic standards, clinical practice guidelines, systematic reviews, consensus documents, and key phenotyping studies, the framework retains established diagnoses as clinical anchors while adding a physiotherapy-oriented translational layer. Assessment focuses on clinically relevant and potentially modifiable features, including familiar pain, mandibular mobility and motor control, behavioral load, regional and sleep-related comorbidities, psychosocial factors, prognosis, and pain-mechanism hypotheses. These findings are integrated with patient goals and preferences to identify dominant treatment targets, inform intervention intensity, select appropriate outcomes, and determine when interdisciplinary care is required. Education, therapeutic exercise, selected manual therapy, and behavioral strategies are therefore considered according to explicit clinical objectives rather than diagnostic labels alone. The framework distinguishes evidence-supported components from extrapolated and hypothesis-generating propositions and aims to make physiotherapy management more transparent, reproducible, patient-centered, and testable.