But, what happens when that bond leads to a release of negative emotions or a physically violent reaction from a patient? According to an article published by the American Psychological Association, the risk of confrontations with patients during therapy is more common than is often thought.
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No use, distribution or reproduction is permitted which does not comply with these terms. This article has been cited by other articles in PMC. Tinnitus is a very common symptom that often causes distress and decreases the patient's quality of life.
Apart from the well-known causes, tinnitus can in some cases be elicited by dysfunctions of the cervical spine or the temporomandibular joint TMJ. To date however, it is unclear whether alleviation of these dysfunctions, by physical therapy treatment, also decreases the tinnitus complaints.
Such physical therapy could be an interesting treatment option for patients that are now often left without treatment. The aim of this review was to investigate the current evidence regarding physical therapy treatment in patients with tinnitus.
Two independent reviewers conducted the data extraction and methodological quality assessment. Only randomized controlled trials and quasi-experimental trials were included in the review. Studies had to be written in English, French, Dutch, or German.
The included studies investigated the effect of physical therapy treatment modalities on tinnitus severity in patients suffering from subjective tinnitus.
Six studies were included in this review, four investigating cervical spine treatment and two investigating TMJ treatment. These studies show positive effects of cervical spine treatment manipulations, exercises, triggerpoint treatment on tinnitus severity.
Additionally, decrease in tinnitus severity and intensity was demonstrated after TMJ treatment, following splints, occlusal adjustments as well as jaw exercises.
Additionally, risk of bias is present due to incomplete presentation of the data and selective reporting. A major issue of the reviewed papers is the heterogeneity of the included study populations, treatments and outcome measures, which inhibit data pooling and meta-analysis.
Despite the methodological issues in the included studies and the consequent low quality evidence, it is noteworthy that all included studies show positive treatment effects. Before recommendations can be made, these results need to be confirmed in larger, high quality studies, using unambiguous inclusion criteria, state-of-the-art treatment, and high quality outcome measures.
The ability to do intellectual work can be negatively affected and sleeping difficulties are frequently reported Baguley et al. Various types and causes of tinnitus have been described, with two main subtypes of tinnitus described: A subjective and an objective type.
Tinnitus is in most cases subjective, meaning that the patient experiences the tinnitus in the absence of any auditory stimulus.
In some cases, an internal, measurable, stimulus can cause the tinnitus, for instance turbulences of the blood flow. In these cases the perceived somatosounds can be considered an objective tinnitus Baguley et al.
Several risk factors for subjective tinnitus have been described, such as hearing loss Domenech et al. Tinnitus can also occur in association with otological conditions, such as noise exposure or presbyacusis and can co-exist with anxiety or depression McKenna et al.
In these last two cases, tinnitus can be elicited by the somatosensory system of the cervical spine or temporomandibular area. A physiological explanation is proposed by several animal studies, which have found connections between the somatosensory system of the cervical spine and temporomandibular area on the one hand and the cochlear nuclei CN on the other hand Pfaller and Arvidsson, ; Zhan et al.
Cervical and temporomandibular somatosensory information is conveyed to the brain by afferent fibers, the cell bodies of which are located in the dorsal root ganglia or the trigeminal ganglion.
Some of these afferent fibers also project to the central auditory system and more specifically to the dorsal CN.
This makes the somatosensory system able to influence the auditory system by altering the spontaneous rates i. In this way, the somatosensory system is able to alter the intensity and the character of the tinnitus for instance by forceful muscle contractions of the neck or jaw musculature Levine, ; Shore et al.
InSanchez et al. Sanchez and Rocha, published a literature overview on the diagnosis and treatment of somatic tinnitus, proposing the now currently used diagnostic criteria for somatic tinnitus.
Regarding therapy however, this literature overview was not systematically performed and was based on case studies and case series that do not provide high quality evidence for the effect of physical therapy treatment in tinnitus patients.
Physical therapy could be an interesting treatment option for patients that are now often left without treatment. Therefore, the aim of this review was to investigate the current evidence regarding physical therapy treatment in patients with tinnitus.
The search strategy was based on the PICO-framework and the following search was entered in the different databases: Study selection For inclusion in the review, studies needed to meet the following inclusion criteria:It also enabled judgments that informed treatment decisions, regarding when to move on to treat another area and whether the treatment is at an appropriate point to finish.
Structural palpation also informed treatment decisions by giving specific feedback about joint restrictions, ranges of movement, and tissue health, and allowing decisions to be made regarding modes of treatment and patient management.
Table 4 shows the means and SDs for the therapist treatment suitability ratings for Case 3. The patient's preference for a particular treatment had a statistically significant main effect on the therapists' judgments (F (4, ) = , p.
Emotional, financial and other costs of treatment. We found that 24 patients and 13 providers judged treatment in terms of costs such as being dependent on loved ones for care, loss of productivity, loss of financial savings, or the presence of pain and suffering.
Decisions regarding the treatment and duration of DAPT require an individualized assessment of the risk-benefit equation for each patient. Aspirin Therapy. For most patients with stable ischemic heart disease (SIHD), aspirin therapy should be continued indefinitely. Choosing to participate in a study is an important personal decision.
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For . Nov 29, · Physical therapy could be an interesting treatment option for patients that are now often left without treatment. Therefore, the aim of this review was to investigate the current evidence regarding physical therapy treatment in patients with tinnitus.