Dijkstra P U, Sterken M W, Pater R, Spijkervet F K L, Roodenburg J L N
Department of Physical Therapy, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, The Netherlands.
Oral Oncol. 2007 Apr;43(4):389-94. doi: 10.1016/j.oraloncology.2006.04.003. Epub 2006 Sep 18.
The aim of this study was to analyze retrospectively effects of exercise therapy on trismus related to head and neck cancer or as a consequence of its treatment, and to compare these effects with trismus not related to head and neck cancer. Medical records of patients referred to the department of physical therapy with the diagnosis trismus were retrieved and analyzed. Data of 27 patients with trismus related to head and neck cancer and data of eight patients with trismus not related to cancer were found. The number and type of exercises were registered from the records, as was the extent of mouth opening before and after exercise therapy. The median (IQR) number of exercise treatments was 4 (3-9.3). Exercises included active range of motion exercises, hold relax techniques, manual stretching and joint distraction. The increase in mouth opening was significantly (p<or= 0.05) less in the group of patients with trismus related to head and neck cancer (mean increase: 5.5, sd: 6.0) as compared to the increase in mouth opening in the group with trismus not related to cancer (mean increase: 17.1, sd: 9.0). The mean number of treatments given to the group with trismus related to head and neck cancer (7.7) and the group with trismus not related to head and neck cancer (6.1) did not differ significantly. It is concluded that trismus related to head and neck cancer is difficult to treat with exercise therapy.
本研究的目的是回顾性分析运动疗法对与头颈癌相关或因头颈癌治疗导致的牙关紧闭的影响，并将这些影响与非头颈癌相关的牙关紧闭进行比较。检索并分析了被转诊至物理治疗科且诊断为牙关紧闭的患者的病历。发现了27例与头颈癌相关的牙关紧闭患者的数据以及8例非癌症相关的牙关紧闭患者的数据。从记录中登记了锻炼的次数和类型，以及运动疗法前后的张口程度。运动治疗的中位数（四分位间距）为4次（3 - 9.3次）。锻炼包括主动活动范围练习、保持放松技术、手法拉伸和关节牵张。与非癌症相关牙关紧闭组的张口增加情况（平均增加：17.1，标准差：9.0）相比，头颈癌相关牙关紧闭组患者的张口增加明显较少（p≤0.05）（平均增加：5.5，标准差：6.0）。给予头颈癌相关牙关紧闭组（7.7次）和非头颈癌相关牙关紧闭组（6.1次）的平均治疗次数无显著差异。得出的结论是，与头颈癌相关的牙关紧闭难以通过运动疗法进行治疗。
