Publications

Myoton Clarification Note: A Guide to Interpreting the Inverse Relationship Between Logarithmic Decrement and Tissue Elasticity

Background: This study aimed to evaluate the effectiveness of myofascial release (MFR) therapy applied along fascial chains compared with a structured exercise protocol on symptoms of temporomandibular dysfunction (TMD) and low back pain (LBP)-related disability.

Methods: Forty-five participants (38 women) with coexisting TMD and LBP were randomized into 3 groups: the myofascial treatment group, the exercise group, and the control group (CG). Participants were recruited from Istanbul Medipol University Dental Hospital (Istanbul, Turkey). Treatment group received 10 sessions of MFR therapy over 4 weeks, exercise group followed a structured exercise program for 4 weeks, and CG received no intervention. Outcomes included the Oswestry Disability Index, pressure pain threshold via algometry, and muscle properties (tone, stiffness, and elasticity) measured by myotonometer. Oromotor function was assessed using the Diagnostic Criteria for Temporomandibular Disorders. Measurements were taken at baseline and at 4 weeks.

Results: Both MFR and exercise therapy resulted in significant improvements in pain tolerance, muscle tone, stiffness, and elasticity. MFR yielded greater improvements across most parameters, particularly in orofacial pain and LBP-related disability (P ≤ .004). MFR also produced significant gains in oromotor function, including maximum mouth opening and lateral excursions (P ≤ .033), while the exercise program improved pain-free mouth opening (P ≤ .012). No significant changes were observed in the CG. Improvements in TMD symptoms were paralleled by enhancements in LBP-related outcomes.

Conclusions: MFR therapy was effective in reducing symptoms of TMD and LBP-related disability and demonstrated greater benefit than exercise therapy in most outcome measures. The observed parallel improvements suggest a biomechanical and neuromuscular link between the jaw and lumbar region, supporting the integration of MFR in interdisciplinary rehabilitation for patients with comorbid TMD and LBP.

Keywords: fascia, low back pain, manual therapies, myofascial release therapy, temporomandibular dysfunction

The present study provides evidence supporting the use of MFR as an effective intervention for improving soft tissue mobility, muscle tone, and fascial stiffness. The comparable effectiveness of MFR and exercise therapy in pain reduction suggests that both approaches can be integrated into the management of TMD and LBP. However, considering the observed small effect sizes, further research is necessary to determine their long-term clinical relevance of these interventions. The integration of MFR with therapeutic exercises may lead to enhanced outcomes. Future studies should prioritize extended follow-up periods and objective biomechanical assessments to determine the sustainability of the observed improvements. By refining MFR protocols and combining them with structured exercise programs, a more comprehensive treatment strategy can be developed for musculoskeletal dysfunctions.