Kalamir Allan, Pollard Henry, Vitiello Andrew, Bonello Rodney
Macquarie Injury Management Group, Department of Chiropractic, Faculty of Science, Macquarie University, Sydney, NSW, Australia.
J Man Manip Ther. 2010 Sep;18(3):139-46. doi: 10.1179/106698110X12640740712374.
Studies investigating the efficacy of intra-oral myofascial therapies (IMT) for chronic temporomandibular disorder (TMD) are rare. The objective of this randomized, controlled pilot study was to compare the effects of IMT and the addition of self-care and education over 6 months on four common TMD outcome measures: inter-incisal opening range, jaw pain at rest, jaw pain upon opening, and jaw pain upon clenching.
Thirty myogenous TMD participants between the ages of 18 and 50 years, experiencing chronic jaw pain of longer than 3-month duration, were recruited for the present study.
INCLUDED PATIENTS WERE RANDOMIZED INTO ONE OF THREE GROUPS: (1) IMT consisting of two treatment interventions per week for 5 weeks; (2) IMT plus 'self-care' involving education and exercises; and (3) wait list control.
Range of motion findings were measured in millimetres by vernier callipers and pain scores were quantified using an 11-point self-reported graded chronic pain scale. Measurements were taken at baseline, 6 weeks post-treatment, and 6 months post-treatment.
The results showed statistically significant differences in resting, opening, and clenching pain and opening range scores (P<0.05) in both treatment groups compared to control at 6 months. No significant differences were observed between the two treatment groups during the course of the trial.
This study suggests that IMT alone or with the addition of self-care may be of some benefit in the management of chronic TMD over the short-medium term. A larger scale study over a longer term (1-2 years) may be of further value.
研究口腔内肌筋膜疗法（IMT）对慢性颞下颌关节紊乱病（TMD）疗效的研究很少。这项随机对照试验性研究的目的是比较IMT以及在6个月内增加自我护理和教育对四种常见TMD结果指标的影响：切牙间开口范围、静息时颌部疼痛、开口时颌部疼痛以及紧咬时颌部疼痛。
本研究招募了30名年龄在18至50岁之间、患有持续时间超过3个月的慢性颌部疼痛的肌源性TMD参与者。
纳入的患者被随机分为三组之一：（1）IMT，每周进行两次治疗干预，共5周；（2）IMT加“自我护理”，包括教育和锻炼；（3）等待名单对照组。
用游标卡尺以毫米为单位测量运动范围结果，使用自评11级慢性疼痛量表对疼痛评分进行量化。在基线、治疗后6周和治疗后6个月进行测量。
结果显示，与对照组相比，两个治疗组在6个月时静息、开口和紧咬疼痛以及开口范围评分上有统计学显著差异（P<0.05）。在试验过程中，两个治疗组之间未观察到显著差异。
本研究表明，单独使用IMT或加上自我护理在中短期慢性TMD的管理中可能有一定益处。进行一项为期更长（1 - 2年）的大规模研究可能会有更大价值。
