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Diss. (sammanfattning) Uppsala : Sveriges lantbruksuniv., 2002. / Härtill 6 uppsatser.

A ocorrência de lesões intra-articulares é uma das principais causas de incapacidade em atletas, sejam eles humanos ou da espécie eqüina. Um dos grandes avanços observados na medicina esportiva foi o advento das cirurgias intra-articulares minimamente invasivas, realizadas com auxílio de um artroscópio. A artroscopia é técnica diagnóstica ou cirúrgica que se caracteriza principalmente por causar mínimo dano tecidual, permitir ampla inspeção das estruturas intra-articulares, com baixo índice de morbidade e complicações. Apesar da realização da artroscopia ser tradicionalmente realizada por distensão líquida, a utilização do gás dióxido de carbono (CO2) como meio para distensão capsular e suas inúmeras vantagens já foram relatadas em diversos estudos. Embora os efeitos inflamatórios causados pela distensão capsular durante a artroscopia sejam discretos e sobrepujados pelos benefícios decorrentes de sua indicação, já foi descrito, em eqüinos, a ocorrência de sinovite de grau leve e caráter transitório. Entretanto, observa-se ausência de estudos referentes aos efeitos inflamatórios causados pela distensão capsular gasosa com dióxido de carbono. Desta forma, este estudo visou avaliar o grau de injúria sinovial decorrente do uso de CO2 intra-articular comparativamente à distensão líquida. Foram utilizados nove eqüinos adultos hígidos, seis machos e três fêmeas, de idade e raças variadas. Cada animal foi submetido a artroscopia bilateral da articulação tarsocrural e realização de biopsia da membrana sinovial no início, ao término do procedimento (30 minutos) e após 48 horas. Em uma articulação, a distensão para realização da artroscopia foi realizada com solução de Ringer com lactato (Grupo DL) e na articulação contra-lateral foi utilizada distensão gasosa com CO2 (Grupo DG). Para avaliação da resposta inflamatória, foram realizadas artrocenteses seriadas 0, 6, 12, 24 e 48 horas após o procedimento para mensuração de leucócitos totais, PT, Hb, PGE2, TNF-α e avaliação do burst oxidativo das células no líquido sinovial, assim como exame histopatológico e imunoistoquímico para COX-2 e E-selectina da membrana sinovial. Ambos os meios utilizados para distensão capsular causaram aumento nas concentrações de leucócitos, PT, Hb, TNF-α e PGE2. Também foi observado aumento do burst oxidativo de neutrófilos e macrófagos presentes no líquido sinovial. Em geral, as variáveis analisadas no líquido sinovial apresentaram discretas diferenças entre os grupos, sendo significativas em momentos isolados. A análise histológica da membrana sinovial demonstrou alterações inflamatórias agudas e de pouca intensidade em ambos os grupos. Apesar de semelhante entre os grupos, a imunoistoquímica para COX-2 na membrana sinovial apresentou discreta correlação com o grau de sinovite demonstrada nos outros parâmetros analisados, enquanto a E-selectina se mostrou um bom marcador em alterações inflamatórias precoces da membrana sinovial. A utilização do CO2 como meio para distensão capsular durante o exame artroscópico em eqüinos causou uma sinovite de grau leve e caráter transitório, promovendo alterações inflamatórias no líquido e membrana sinovial de forma semelhante às observadas com a utilização da solução de Ringer com lactato como meio para distensão capsular. Além disso, ambos os meios para distensão capsular causaram mínimas manifestações clínicas e ausência de complicações pós-operatórias aos animais. / Intra-articular disorders are the leading cause of human and equine athlete´s functional incapacity. The development of arthroscopy as a minimal invasive intra-articular surgery was one of the greatest medical advances in sports medicine. The defining characteristic of diagnostic or surgical arthroscopy is featured by minimal tissue damage and broad inspection of internal structures inside the joint associated with low morbidity and complications. Although liquid distension is widely used for arthroscopy, gas distension using carbon dioxide (CO2) has already been described and has pointed out a larger number of advantages of this technique in several studies. The inflammatory response to liquid capsular distension was studied in horses and described as minimal, transient and frequently overwhelmed by its benefits to treatment. However none of these effects had been investigated employing CO2 during arthroscopic examination. Therefore, the aim of this study was to asses comparatively the inflammatory damage followed by CO2 joint capsular distension to that of Ringer´s lactate solution distension. Nine healthy adult horses of various breeds, genders and ages were used. Each animal was submitted to a bilateral tarsocrural arthroscopy employing gas distention (group GD) in one joint and fluid distention (group LD) in the contralateral joint, both for 30 minutes. Synovial membrane specimens were collected before, at the end of the procedure and after 48 hours. Arthrocentesis were aseptically performed at 0, 6, 12, 24 and 48 hours after arthroscopy in order to assess the degree of inflammation within the joint. Synovial fluid was collected for cytological examination and determination of total protein, hemoglobin, TNF-α and PGE2 contents and evaluation of synovial fluid cell oxidative burst. The synovial membrane was examined histologically and also imunostained for COX-2 and E-selectin. Either distension protocol caused an increase in total white blood cells, total protein, hemoglobin, TNF-α, PGE2 and also in neutrophil and macrophage oxidative burst. In general terms, those parameters analyzed in the synovial fluid demonstrated minimal differences between groups with only a few isolate significant differences. Histological evaluation of synovial membrane shows a rapid, but mild inflammatory response in both groups. Imunostaining for COX-2 was similar between DG and DL, but showed a weak correlation to the degree of synovitis demonstrated by other parameters. Contrarily, the imunostaining for E-selectin revealed that this molecule is a good biomarker for early inflammatory changes in the synovial membrane. The use of carbon dioxide for capsular joint distension during arthroscopic examination causes an acute and mild synovitis that promotes inflammatory changes in the synovial fluid and membrane that are similar to the effects caused by the liquid capsular distension using Ringer´s lactate solution. Moreover, both distension protocols induced minimal manifestations of clinical signs and no post-surgery complications.

Dissertation submitted in partial compliance with the requirements for a Masters Degree in Technology: Chiropractic, Durban University of Technology, 2011. / The relationship between TMD and dysfunction in the cervical spine has been reported in the literature and there are many case studies which have shown favourable results when treatment was aimed at the TMJ, cervical spine relationship. However, the numerous TMD treatment protocols described in the literature concerning this relationship, and the effectiveness of these treatments have not been well established. In spite of this many chiropractors treat TMD. TMD is a multifactoral condition and conservative treatment options need to be further investigated in order to determine if manual interventions directed at the cercival spine in the treatment of TMD are beneficial. Objectives: The purpose of this study was to compare myofascial trigger point therapy and manipulative therapy of either the TMJ, cervical spine or a combination of the two in order to determine their effectiveness for the TMD. Method: Thirty participants with TMD were randomly assigned to one of three treatment groups. Participants in each group received two treatments per week for two weeks with a follow up consultation in the third week. Data were collected before the commencement of the first, second, and fourth treatments and at the follow up consultation. Outcome measures included algometer readings, CROM, Mouth opening readings, NRS and a disability questionnaire. SPSS version 15.0 was used for analysis of the data. A p value <0.05 was considered as statistically significant. Multivariate testing was used for intra- and inter-group comparisons. Profile plots were generated to assess the direction and trend of the effect and to visually compare the trends in the different treatment groups. Results: Inter-group comparisons did not reveal any statistically significant different improvements between the three treatment groups. Conclusion: All groups responded favourably to treatment and showed trends towards improvement. However, statistically analysis revealed that no one treatment protocol was superior to the other. Although no definitive inferences may be drawn regarding the effectiveness of each treatment approach, within group trends indicated that the combination of the two treatment approaches may be preferred.

Dissertation submitted in partial compliance with the requirements for a Masters Degree in Technology: Chiropractic, Durban University of Technology, 2011. / The relationship between TMD and dysfunction in the cervical spine has been reported in the literature and there are many case studies which have shown favourable results when treatment was aimed at the TMJ, cervical spine relationship. However, the numerous TMD treatment protocols described in the literature concerning this relationship, and the effectiveness of these treatments have not been well established. In spite of this many chiropractors treat TMD. TMD is a multifactoral condition and conservative treatment options need to be further investigated in order to determine if manual interventions directed at the cercival spine in the treatment of TMD are beneficial. Objectives: The purpose of this study was to compare myofascial trigger point therapy and manipulative therapy of either the TMJ, cervical spine or a combination of the two in order to determine their effectiveness for the TMD. Method: Thirty participants with TMD were randomly assigned to one of three treatment groups. Participants in each group received two treatments per week for two weeks with a follow up consultation in the third week. Data were collected before the commencement of the first, second, and fourth treatments and at the follow up consultation. Outcome measures included algometer readings, CROM, Mouth opening readings, NRS and a disability questionnaire. SPSS version 15.0 was used for analysis of the data. A p value <0.05 was considered as statistically significant. Multivariate testing was used for intra- and inter-group comparisons. Profile plots were generated to assess the direction and trend of the effect and to visually compare the trends in the different treatment groups. Results: Inter-group comparisons did not reveal any statistically significant different improvements between the three treatment groups. Conclusion: All groups responded favourably to treatment and showed trends towards improvement. However, statistically analysis revealed that no one treatment protocol was superior to the other. Although no definitive inferences may be drawn regarding the effectiveness of each treatment approach, within group trends indicated that the combination of the two treatment approaches may be preferred. / M

Les synoviocytes jouent un rôle crucial dans la pathogénèse des maladies articulaires chroniques, et particulièrement dans la phase de destruction ostéoarticulaire en devenant résistants à l’apoptose. Une première étude a mise en évidence une efficacité antiproliférative du cadmium minéral sur ces synoviocytes. Une preuve de concept d’un nouveau produit thérapeutique intra-articulaire à base de cadmium a été élaborée. Cette préparation pharmaceutique innovante, développée pour éviter la dissémination du cadmium minéral dans l’organisme, contenait des nanoparticules à base de cadmium, administrable sous forme liquide à température ambiante et se gélifiait à la température corporelle, en formant des micelles contenant des nanoparticules, ne traversant ainsi pas la cavité synoviale. Initialement, la reproductibilité de l’effet antiprolifératif du cadmium entre la forme minérale et les nanoparticules a été vérifiée dans un modèle in vitro de synoviocytes humains atteints de polyarthrites rhumatoïdes. Une captation différente des nanoparticules selon l’environnement inflammatoire ou pathologique des synoviocytes a été ensuite expliquée par la modification accrue de leurs morphologies. Similairement, l’effet de l’inflammation sur les propriétés physiques des vésicules, sécrétées par les synoviocytes, ont consolidé le choix des caractéristiques de la formulation. Les essais sur des modèles d’arthrite chez le rat ont permis de démontrer l’efficacité de cette nouvelle préparation originale, facilement injectable en intra-articulaire, en réduisant les scores cliniques avec une unique injection. Cette thérapie locale peut être une technique rapide et réalisable en ambulatoire / Synoviocytes play a crucial role in the pathogenesis of chronic joint diseases, particularly in the osteoarticular destruction phase by becoming resistant to apoptosis. A first study has demonstrated an antiproliferative efficacy of cadmium mineral on these synoviocytes. A proof of concept of a new intra-articular cadmium-based therapeutic product has been developed. This innovative pharmaceutical preparation, developed to prevent the spread of mineral cadmium in the body, contained cadmium-based nanoparticles, which can be administered in liquid form at room temperature and gelled at body temperature, forming micelles containing nanoparticles, thus crossing the synovial cavity. Initially, the reproducibility of the antiproliferative effect of cadmium between the mineral form and the nanoparticles was verified in an in vitro model of human synoviocytes with rheumatoid arthritis. A different uptake of nanoparticles according to the inflammatory or pathological environment of synoviocytes was then explained by the massive modification of their morphologies. Similarly, the effect of inflammation on the physical properties of the vesicles, secreted by synoviocytes, consolidated the choice of the characteristics of the formulation.Tests on arthritis models in rats have demonstrated the effectiveness of this new original preparation, easily injectable intra-articular, reducing clinical scores with a single injection. This local therapy can be a quick technique and achievable in outpatient

Diss. (sammanfattning) Uppsala : Sveriges lantbruksuniv., 2007. / Härtill 5 uppsatser.

Thesis (MScEng)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Osteoarthritis (OA), also known as degenerative joint disease is a progressive disorder of the joints caused by gradual loss of cartilage and resulting in the development of bony spurs and cysts at the margins of the joints. The degradation of the musculoskeletal system, which is mainly caused by joint injury, obesity (leading to musculoskeletal fatigue) and aging can also lead to osteoarthritis. The hands, feet, spine, and large weight-bearing joints, such as the hips and knees are commonly affected. The only medical solution to severe cases of osteoarthritis is the surgical reconstruction or replacement of a malformed or degenerated joint, better known as arthroplasty. Arthroplasty makes use of biomedical implants and replacements to restore functionality of the joints. Biomedical engineering in arthroplasty is an ever increasing field of interest as a result of its innovative improvements to surgical quality. Certain cases of partial osteoarthritis require less surgical action. Partial knee replacement surgery, also known as unicondylar (or unicompartmental) knee arthroplasty involves a covering which is placed over the affected area to resurface the affected bone and protect the patient from further degeneration. Advantages of partial replacement include faster recovery time and less post-operative pain. The biomedical implants used for these operations consist of a standardized implant that is fit onto the bone by modifying (cutting away) the outer structure of the bone. The result is known to cause post-operative discomfort among some patients. The problem with these standard designs includes the requirement of the removal of unaffected (healthy) bone matter, leading to induced trauma and pain for patients during the recovery phase of the operations. A preferred alternative to the standard design would be to create a custom implant for every patient, reducing the need to remove parts of unaffected bone matter. The implementation of this proposed method tends toward Minimally Invasive Surgery (MIS). MIS is normally preferred as it reduces the risk of various negative consequences of normal arthroplasty such as nerve or tendon damage during surgery. It could be argued that the proposed method may cause less damage to the fragile tendon, bloodflow, and nerve networks of the knee. Increasing material costs of metal products introduce great interest in more cost efficient forming processes to reduce the loss of redundant blank material. Incremental Sheet Forming (ISF), a relatively new class of forming process, has the potential to meet the need for this more efficient forming process. The ISF process is highly flexible, can be developed in normal milling machines, and can reduce production cost by up to 90% in comparison to processes such as stamping. The ISF process is a non-patented process, as the existing patents are referred to the designed machines and not the process. The availability of the ISF process contributes greatly to its attractiveness. ISF can be implemented in any facility that has access to a three- or more-axis CNC machine. The advantage of ISF implemented in CNC machines is that CNC technology has already reached a mature stage in development, contributing to the accuracy and methodology (such as feed rate or angular velocity of the tool) of the ISF process. The forming of valuable lightweight materials is well covered by ISF processes. A variety of studies contribute to research on the forming of titanium and titanium based alloys as part of ISF of lightweight materials. The ISF process utilizes the functionality of commercial CNC machines, improving the process availability of many manufacturing companies. The ISF process offers fast setup times and flexibility of the forming process. The purpose of this project is to define a process chain for creating a customized biomedical implant as well as determining the validity of the process chain by applying each step. The design and development procedure of a titanium based biomedical arthroplasty implant using innovative Incremental Sheet Forming (ISF) techniques will be documented, as well as an investigation of the financial cost and potential gain that this implant can offer. / AFRIKAANSE OPSOMMING: Osteoartritis is 'n gewrig siekte wat degeneratiewe newe-effekte behels in die gewrigte. Hierdie siekte lei to die geleidelike verlies van kraakbeen en lei tot die onreelmatige ontwikkeling van abnormale beengroei. Osteoartritis kan ook deur beserings in die gewrig veroorsaak word. Die hande, voete, ruggraat, en enige groter gewigdraende gewrigte, soos die heupe en knieë kan geaffekteer word. Die enigste mediese oplossing tot ernstige gevalle van die siekte is chirurgiese rekonstruksie of vervanging van die gewrig, meer bekend as artroplastie. Artroplastie maak gebruik van biomediese implantate om funksionaliteit van die gewrig te herstel. Biomediese ingenieurswese in artroplastie is 'n toenemende navorsingsveld as gevolg van die innoverende aspekte om chirurgiese kwaliteit te verhoog. Sekere gevalle van gedeeltelike osteoartritis vereis veel minder chirurgiese behandeling. Gedeeltelike knie vervanging chirurgie, meer bekend as unikompartementele knie artroplastie, behels 'n bedekking wat slegs die geaffekteerde been bedek, om die pasiënt van verdere degenerasie te beskerm. Voordele van gedeeltelike vervanging sluit vinniger herstel tyd en minder pyn in. Die biomediese implantate wat gebruik word vir hieride operasies bestaan uit standaard ontwerpe wat aan die been gepas word deur die wysiging (of wegsny) van die buitenste beenstruktuur. Die nagevolg van hierdie chirurgie is lang herstel periodes en kan ongemaklikheid in die knie veroorsaak. Die probleem met die bogenoemde standaard is dat die prosedure die verweidering van selfs ongeaffekteerde (of gesonde) been in sluit, wat lei tot verdere kniepyn en ongemak vir pasiënte lei tydens die herstelperiode. 'n Verkiesde alternatief tot die standaard ontwerpe is om 'n persoonlikke implantaat vir elke pasiënt te skep, en so kan die behoefte om dele van ongeaffekteerde been te behou moontlik wees. Die toepassing van die voorgestelde metode neig na Minimale Skade Chirurgie (MSC). MSC word gewoonlik verkies om die risiko van verskeie negatiewe nagevolge te verminder, en skade aan die tendon, bloed- en senunetwerke van die knie te beperk. Die toenemende materiaalkoste vand metal produkte lei tot 'n groot belangstelling in meer koste besparing vormings prosesse, om sodoende die verlies van oortollige materiaalverlies te verminder. Inkrementele Plaat Vervorming (IPV), 'n relatiewe nuwe klas van vervorming, is 'n waardige kanidaat om hierdie doel te bereik. Die IPV proses is baie toepaslik, en kan deur die gebruik van Rekenaar Numeriese Kontrole (RNK) masjienerie toegepas word. Verder sal dit vervaardigingskoste kan verlaag met soveel as 90% in vergelyking met ander prosese soos die stempel metode. Die beskikbaarheid van die IPV proses dra grootliks by tot die proses se aantreklikheid in die industrie. IPV kan geimplementeer word in enige fasiliteit wat toegang tot 'n drie-as RNK masjien het. Die voordeel van dit is die feit dat RNK masjienerie klaar ontwikkel en volwasse is, wat kan bydra tot goeie akkuraatheid in die vormingsproses. Die vervaardiging van laegewig materiale soos titaan of aluminium is gedokumenteer. 'n Verskeidenheid van studies dra waarde tot navorsing van die vormingsproses van titaan as deel hiervan. Die IPV proses bied vinnige opstel tye en goeie buigsaamheid met die vormingsproses, veral met behulp van 'n vyf-as masjien. Die doel van hierdie projek is om 'n proses ketting te ontwerp. Die proses ketting, wat uit vele stappe bestaan, sal die ontwerp en vervaardigingsproses van 'n persoonlike biomediese knie implantaat bevestig deur middel van die IPV vormings tegniek. Validasie van die proses ketting sal dus plaasvind deur die stappe van die voorgestelde proses ketting uit te voer. 'n Finale ondersoek sal die finansiele en regalutoriese aspekte van die projek aanspreek.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2018. / BACKGROUND: Temporomandibular disorders (TMDs) affect up to fifteen percent of adults. It produces craniofacial pain of musculoskeletal structures within the head and neck. One particular cause of TMDs is said to be myofascial pain syndrome (MFPS), which according to various research papers, if not considered and/or assessed, the general cause of a patient’s pain could be disregarded and incorrect treatment offered. Numerous studies conducted internationally on dental management of temporomandibular joint disorder (TMJD) concluded that there is a significant gap in dentists’ education and training regarding the identification and management of MFPS. Upon reviewing the current literature available in South Africa, very little research existed on dentists’ knowledge and the management strategies that they utilised regarding MFPS in TMJD patients. OBJECTIVES: To determine the dentists’ knowledge regarding MFPS of the temporomandibular joint (TMJ). What assessment and treatment/management strategies they use, and whether they make use of referral networks and if the respondents’ demographics influence their knowledge, utilisation, perception and referral patterns. METHODOLOGY: The researcher developed a research questionnaire, which was validated by both an expert and a pilot study group. This questionnaire was then used as a research tool in this cross-sectional study. General dental practitioners from the Greater eThekwini Region received an invitation to participate. The questionnaire-based survey consisted of five sections: biographical profile of respondents; topic background; perception; knowledge; utilisation and management (including referral patterns) of MFPS. RESULTS: The majority of respondents did receive basic education in MFPS, with 76.9% reporting that they received undergraduate education and 57.7% indicating that they had attended post-graduate courses/talks on MFPS. There was a 100% response from dentists indicating their willingness to attend post-graduate courses/talks on MFPS. The results indicated that the respondents, who felt that their curriculum regarding MFPS was sufficient, were more knowledgeable and more competent in diagnosing and managing MFPS. Overall, the average score for knowledge was 65.17%. Clinical features (78.85%) and the perpetuating and relieving factors (72.11%) scored the highest while causes (58.06%) and differential diagnoses (51.16%) scored the lowest knowledge levels. Respondents mostly made use of allopathic medical fields, and not of alternative medical fields, however a high number of respondents (73.1%) indicated that they would consider chiropractic co–management of patients with MFPS. CONCLUSION: This study adds new information in the South African context regarding dentists’ understanding of the myofascial component of TMDs. It also provides the dental profession with information about the knowledge and practices related to MFPS as well as information regarding the strengths and weaknesses on its educational component. It is recommended that dentists receive additional training on differential diagnoses and causes. It is also recommended that the chiropractic profession take this opportunity to offer courses/talks on MFPS and join forces with the dentistry profession on how they can assist in managing patients with MFPS. / M

Orientador: Vera Aparecida Madruga / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Educação Fisica / Made available in DSpace on 2018-08-14T15:22:08Z (GMT). No. of bitstreams: 1 DiGrazia_RenataCristina_D.pdf: 1299085 bytes, checksum: 4cc0c3ffae29b36284e45a1007c24f5a (MD5) Previous issue date: 2009 / Resumo: O presente estudo teve como objetivo analisar e verificar os efeitos do programa de terapia manual (Método Mulligan associado à massagem clássica) nas queixas de dor e na qualidade de vida de mulheres adultas com disfunção da articulação temporomandibular (DTM). Participaram da pesquisa 29 mulheres, com idades entre 28 e 59 anos (média de idade de 47,41 (dp±6,71) anos), encaminhadas pelo serviço odontológico do Centro de saúde da Comunidade da Unicamp (CECOM). Todas as voluntárias apresentavam DTM e foram avaliadas antes e após programa de terapia manual utilizando-se a escala visual-numérica de dor e o questionário de qualidade de vida SF-36. O programa de terapia manual foi realizado no setor de Fisioterapia do Cecom-Unicamp durante 16 semanas, com 02 sessões/semanais de 30 minutos, em dias alternados. Utilizou-se estatística descritiva para analise dos dados da anamnese e o teste de Wilcoxon (software SPSS, V. 13.0), com nível de significância de 5% (p< 0,05) para os dados coletados na escala de dor e no SF36. Os resultados mostraram na analise das respostas obtidas com a escala visual numérica de dor, onde as voluntárias responderam de 0 a 10, qual era o número que representava sua dor naquele momento, sendo encontrados na condição pré-terapia os valores: 5 (17,2%); 6 (3,4%); 7 (20,7%); 8 (31%); 9 (10,3%) e 10 (17,2%). Após a terapia manual pode-se verificar que o nível de dor caiu, ou seja, para o valor 0 (37,9%), para o valor 1 (24,1%) e para o valor 2 (31%). Os resultados obtidos no questionário de Qualidade de Vida SF-36 mostraram diferenças estatisticamente significantes com p<0,05. Concluindo pode-se inferir que o programa envolvendo tratamento fisioterapêutico através da terapia manual mostrou-se eficiente para o grupo de mulheres com DTM, pois antes do tratamento elas apresentavam um nível de dor elevado e após o programa de terapia manual esse valor mostrou-se reduzido, com melhora do quadro álgico. / Abstract: The actual study had the objective to analyze and verify the effects of a manual therapy program (Mulligan Method associated with classical massage) in the pain complaints and in the quality of life of the adults' woman with the temporomandibular joint diseases (TMJ). Participated of the study, 29 woman, aged between 28- 59 years old (mean 47,41 (dp±6,71)), referred by the dental department in the health center of Unicamp community (CECOM). All the volunteers had TMJ disease and were assessed before and after program of manual therapy using the visual numeric scale of pain and the quality of life questionnaire SF-36. The manual therapy program had been realized in the Physical therapy of Cecom-Unicamp, during 16 weeks, with 2 sections/ week with 30 minutes, in alternate days. We used decrypted statistics to analyze the anamneses dates and the Wilcoxon test (SPSS, V.13.0), the level of significance was 5% (p< 0,05) for dates from visual numeric pain scale and SF-36. The results showed in the answers analysis obtained with the visual numeric scale of pain, where the volunteers must have to answer among 0 and 10, how are the number that represents their pain in that moment, and we had been in the beginning of the therapy the values: 5 (17,2%); 6 (3,4%); 7 (20,7%); 8 (31%); 9 (10,3%) e 10 (17,2%). After the manual therapy we verify that the values decreased so much, to value : 0 (37,9%); 1 (24,1%) ; 2 (31%) e 3 ( 6,9%) 0 (37,9%). In relation from the analyses of the results of the Quality of life questionnaire SF-36, these showed significant statistics differences with p< 0,05. Concluding, we could infer that the program evolved physiotherapy treatment through manual therapy was efficient for the arrange TMJ disease woman, before the therapy they had a high pain level and after these value decrease, with grow better of the pain. / Doutorado / Ciencia do Desporto / Doutor em Educação Física