Gavish Anat, Winocur Ephraim, Astandzelov-Nachmias Tamara, Gazit Esther
Department of Oral Rehabilitation, School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Israel.
Cranio. 2006 Jul;24(3):184-90. doi: 10.1179/crn.2006.030.
The aim of this study was to test the hypothesis that strengthening masticatory muscles using a controlled chewing exercise protocol improves muscle function, as evaluated quantitatively by electromyogram, and reduces pain at rest and during function. The study included 20 patients diagnosed with myofascial pain according to the Research Diagnostic Criteria for Temporomandibular Disorders with low masseter volume increase during maximal clench. The exercise group (ten patients) was subjected to a controlled gum chewing exercise protocol for eight weeks: the control group (ten patients) received only support and encouragement. Patients were examined at the beginning and at the end of the experiment which included an electromyogram (EMG) to assess muscle performance, masticatory muscle tenderness to palpation, mouth opening range, subjective anamnestic indices to evaluate pain perception and pain relief, and chewing tests. The EMG showed that the masticatory muscle exercise did produce objective physiologic results. In the exercise group, a significant increase was found in the electric muscle activity of the masseters during maximal voluntary clench (p=0.007). The exercise group showed significant reduction in pain during rest, pain during the chewing test, and a disability score. At the end of the study, a difference between the two groups was shown in the Pain Relief Scale: significantly greater pain relief was found in the exercise group as compared to the control group (p=0.019). For all other clinical parameters, there was no difference between the two groups or interaction between time and treatment. The results of this study seem to be equivocal. Additional experiments on larger population groups with extended chewing protocols are necessary before a more substantial conclusion can be reached.
采用受控咀嚼运动方案强化咀嚼肌可改善肌肉功能（通过肌电图进行定量评估），并减轻静息时和功能活动时的疼痛。该研究纳入了20例根据颞下颌关节紊乱研究诊断标准被诊断为肌筋膜疼痛且最大紧咬时咬肌体积增加较少的患者。运动组（10例患者）接受了为期8周的受控口香糖咀嚼运动方案：对照组（10例患者）仅获得支持和鼓励。在实验开始和结束时对患者进行检查，检查内容包括用于评估肌肉性能的肌电图（EMG）、咀嚼肌触诊压痛、开口度、用于评估疼痛感知和疼痛缓解的主观回忆指标以及咀嚼测试。肌电图显示咀嚼肌运动确实产生了客观的生理结果。在运动组中，发现最大自主紧咬时咬肌的电肌肉活动显著增加（p = 0.007）。运动组在静息时的疼痛、咀嚼测试时的疼痛以及残疾评分方面均显著降低。在研究结束时，两组在疼痛缓解量表上显示出差异：与对照组相比，运动组的疼痛缓解明显更大（p = 0.019）。对于所有其他临床参数，两组之间没有差异，时间与治疗之间也没有相互作用。本研究的结果似乎不明确。在得出更实质性的结论之前，有必要对更大规模的人群进行额外的实验，并采用更长时间的咀嚼方案。
