Tuncer Aysenur Besler, Ergun Nevin, Tuncer Abidin Hakan, Karahan Sevilay
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
J Bodyw Mov Ther. 2013 Jul;17(3):302-8. doi: 10.1016/j.jbmt.2012.10.006. Epub 2012 Nov 16.
The purpose of this study was to compare the short-term effectiveness of home physical therapy (HPT) alone with that of manual therapy (MT) in conjunction with home physical therapy (MT-HPT) performed for four weeks in patients with temporomandibular disorders (TMD). Forty subjects (nine males and 31 females; age, 18-72 years) with TMD were randomly divided into two groups: HPT (n = 20; five males and 15 females; mean age, 34.8 ± 12.4 years) and MT-HPT (n = 20; four males and 16 females; mean age, 37.0 ± 14.6 years). Pain intensity was evaluated at rest and with stress using a visual analogue scale (VAS). Pain-free maximum mouth opening (MMO) was also evaluated. Mean change score (MCS) in VAS and the smallest detectable difference (SDD) in pain-free MMO were measured over time. The results were analysed by MANOVA to evaluate the effects of treatment over time. At baseline, the groups did not differ from each other with respect to VAS scores and pain-free MMO (p > 0.05). Within each group, VAS with stress decreased (p < 0.001) and pain-free MMO increased (p < 0.001) over time. Between groups, both timetreatment effect and treatment effect were significant for VAS with stress (p < 0.001); however, only timetreatment effect was significant for pain-free MMO (p = 0.009). In the MT-HPT group, MCS for VAS with stress was 91.3% and SDD for pain-free MMO was 10 mm. Our results suggest that a four-week period of MT-HPT has a clinically significant effect on both pain and pain-free maximum mouth opening in patients with TMD.
本研究的目的是比较单独进行家庭物理治疗（HPT）与手法治疗（MT）联合家庭物理治疗（MT-HPT）对颞下颌关节紊乱症（TMD）患者进行为期四周治疗的短期效果。40名患有TMD的受试者（9名男性和31名女性；年龄18 - 72岁）被随机分为两组：HPT组（n = 20；5名男性和15名女性；平均年龄34.8±12.4岁）和MT-HPT组（n = 20；4名男性和16名女性；平均年龄37.0±14.6岁）。使用视觉模拟量表（VAS）在静息和应激状态下评估疼痛强度。还评估了无痛最大开口度（MMO）。随时间测量VAS的平均变化分数（MCS）和无痛MMO的最小可检测差异（SDD）。通过多变量方差分析（MANOVA）分析结果，以评估治疗随时间的效果。在基线时，两组在VAS评分和无痛MMO方面彼此无差异（p>0.05）。在每组中，随时间推移，应激状态下的VAS降低（p<0.001），无痛MMO增加（p<0.001）。在两组之间，应激状态下VAS的时间治疗效应和治疗效应均显著（p<0.001）；然而，仅无痛MMO的时间治疗效应显著（p = 0.009）。在MT-HPT组中，应激状态下VAS的MCS为91.3%，无痛MMO的SDD为10毫米。我们的结果表明，为期四周的MT-HPT对TMD患者的疼痛和无痛最大开口度均具有临床显著效果。
