Kalamir Allan, Bonello Rodney, Graham Petra, Vitiello Andrew L, Pollard Henry
Faculty of Science, Macquarie University, Sydney, Australia.
J Manipulative Physiol Ther. 2012 Jan;35(1):26-37. doi: 10.1016/j.jmpt.2011.09.004. Epub 2011 Nov 10.
Studies investigating the efficacy of intraoral myofascial therapies (IMTs) for chronic temporomandibular disorder (TMD) are rare. The present study was an expansion of a previously published pilot study that investigated whether chiropractic IMT and the addition of education and self-care were superior to no-treatment or IMT alone for 5 outcome measures-interincisal opening range, jaw pain at rest, jaw pain upon opening, jaw pain upon clenching, and global reporting of change-over the course of 1 year.
Ninety-three participants with myogenous TMD between the ages of 18 and 50 years experiencing chronic jaw pain of longer than 3 months in duration were recruited for the study. Successful applicants were randomized into 1 of 3 groups: (1) IMT consisting of 2 treatment interventions per week for 5 weeks, (2) IMT plus education and "self-care" exercises (IMTESC), and (3) wait-list control. The main outcome measures were used. Range of motion findings were measured by vernier callipers in millimeters, and pain scores were quantified using an 11-point self-reported graded chronic pain scale. Global reporting of change was a 7-point self-reported scale, balanced positively and negatively around a zero midpoint.
There were statistically significant differences in resting, opening and clenching pain, opening scores, and global reporting of change (P < .05) in both treatment groups compared with the controls at 6 months and 1 year. There were also significant differences between the 2 treatment groups at 1 year.
The study suggests that both chiropractic IMT and IMTESC were superior to no-treatment of chronic myogenous TMD over the course of 1 year, with IMTESC also being superior to IMT at 1 year.
研究口腔内肌筋膜疗法(IMT)对慢性颞下颌关节紊乱病(TMD)疗效的研究较少。本研究是对先前发表的一项初步研究的扩展,该初步研究调查了整脊IMT以及增加教育和自我护理在5项结局指标上是否优于不治疗或单独的IMT,这5项结局指标分别为切牙间开口度、静息时颌痛、开口时颌痛、紧咬时颌痛以及1年期间变化的整体报告。
招募了93名年龄在18至50岁之间、患有肌源性TMD且慢性颌痛持续时间超过3个月的参与者进行该研究。成功的申请者被随机分为3组中的1组:(1)IMT,每周进行2次治疗干预,共5周;(2)IMT加教育和“自我护理”练习(IMTESC);(3)等待名单对照组。采用主要结局指标。活动度结果用游标卡尺以毫米为单位测量,疼痛评分使用11点自我报告的分级慢性疼痛量表进行量化。变化的整体报告是一个7点自我报告量表,以零中点为中心正负平衡。
在6个月和1年时,与对照组相比,两个治疗组在静息、开口和紧咬疼痛、开口评分以及变化的整体报告方面均有统计学显著差异(P < .05)。在1年时,两个治疗组之间也存在显著差异。
该研究表明,在1年的时间里,整脊IMT和IMTESC均优于慢性肌源性TMD的不治疗,且在1年时IMTESC也优于IMT。