Nozaki S, Kawai M, Shimoyama R, Futamura N, Matsumura T, Adachi K, Kikuchi Y
Hyogo University of Health Science, School of Rehabilitation, Kobe, Hyogo, Japan.
Acta Myol. 2010 Dec;29(3):392-7.
The purpose of this study is to evaluate whether the range of motion exercise of the temporo-mandibular joint (jaw ROM exercise) with a hot pack and massage of the masseter muscle improve biting disorder in Duchenne muscular dystrophy (DMD). The subjects were 18 DMD patients (21.3+/- 4.1 years old). The jaw ROM exercise consisted of therapist-assisted training (2 times a week) and self-training (before each meal every day). The therapist-assisted training consisted of the application of a hot pack on the cheek of the masseter muscle region (15 minutes), the massage of the masseter (10 minutes), and jaw ROM exercise (5 minutes). The self-training involved jaw ROM exercise by opening the mouth to the maximum degree, ten times. These trainings continued for six months. Outcomes were evaluated by measuring the greatest occlusal force and the distance at the maximum degree of mouth opening between an incisor of the top and that of the bottom. Six months later, the greatest occlusal force had increased significantly compared with that at the start of jaw ROM exercise (intermediate values: from 73.8N to 97.3N) (p = 0.005) as determined by the Friedman test and Scheffi's nonparametric test. The patients' satisfaction with meals increased. However, the maximum degree of mouth opening did not change after six months of jaw ROM exercise. Jaw ROM exercise in DMD is effective for increasing the greatest occlusal force.
本研究的目的是评估颞下颌关节活动度训练（下颌活动度训练）结合热敷和咬肌按摩是否能改善杜氏肌营养不良症（DMD）患者的咬合障碍。研究对象为18名DMD患者（年龄21.3±4.1岁）。下颌活动度训练包括治疗师辅助训练（每周2次）和自我训练（每天每餐饭前）。治疗师辅助训练包括在咬肌区域脸颊上热敷（15分钟）、按摩咬肌（10分钟）以及下颌活动度训练（5分钟）。自我训练是将嘴巴最大限度张开进行下颌活动度训练，共10次。这些训练持续6个月。通过测量最大咬合力以及上下门牙在最大张口度时的距离来评估训练效果。6个月后，经Friedman检验和Scheffi非参数检验确定，最大咬合力与下颌活动度训练开始时相比显著增加（中间值：从73.8N增至97.3N）（p = 0.005）。患者对进食的满意度提高。然而，下颌活动度训练6个月后，最大张口度并未改变。DMD患者的下颌活动度训练对于增加最大咬合力是有效的。
