Häggman-Henrikson Birgitta, Wiesinger Birgitta, Wänman Anders
a Department of Odontology/Clinical Oral Physiology , Umeå University, Umeå , Sweden.
b Department of Orofacial pain and Jaw function , Malmö University, Malmö , Sweden.
Acta Odontol Scand. 2018 Jan;76(1):6-12. doi: 10.1080/00016357.2017.1373304. Epub 2017 Sep 4.
To evaluate the effect of a supervised exercise program in patients with localized/regional temporomandibular disorder (TMD) pain and with TMD associated with generalized pain.
Consecutively referred patients with localized/regional TMD pain (n = 56; 46 women and 10 men, mean age 44 years) and TMD associated with generalized pain (n = 21; 21 women, mean age 41 years) participated. Patients underwent a 10-session structured supervised exercise program over 10-20 weeks that included relaxation, and coordination and resistance training of the jaw and neck/shoulders. The outcomes were jaw pain intensity on the Numerical Rating Scale, endurance time for jaw opening and protrusion against resistance and chewing, and effect of pain on daily activities.
After the exercise program, a reduction in jaw pain was reported by the local (p = .001) and general (p = .011) pain groups. There were no significant differences in jaw pain intensity between the groups, before (p = .062) or after treatment (p = .121). Endurance time increased for both groups for jaw opening/protrusion (both p < .001) and chewing (both p = .002). The effect of jaw pain on daily activities decreased after exercise compared to baseline for both the local (p < .001) and general (p = .008) pain groups.
Supervised exercise can reduce TMD pain and increase capacity in patients with TMD. The results suggest that activation of the jaw motor system with exercise has a positive effect in patients with localized/regional TMD pain and TMD associated with generalized pain.
评估有监督的运动计划对局限性/区域性颞下颌关节紊乱病(TMD)疼痛患者以及与全身性疼痛相关的TMD患者的影响。
连续纳入局限性/区域性TMD疼痛患者(n = 56;46名女性,10名男性,平均年龄44岁)和与全身性疼痛相关的TMD患者(n = 21;21名女性,平均年龄41岁)。患者在10 - 20周内接受了为期10节的结构化有监督运动计划,包括放松以及颌部和颈部/肩部的协调与阻力训练。观察指标包括数字评分量表上的颌部疼痛强度、对抗阻力的张口和前伸以及咀嚼的耐力时间,以及疼痛对日常活动的影响。
运动计划后,局部疼痛组(p = 0.001)和全身性疼痛组(p = 0.011)均报告颌部疼痛减轻。两组之间在治疗前(p = 0.062)或治疗后(p = 0.121)的颌部疼痛强度均无显著差异。两组的张口/前伸(均p < 0.001)和咀嚼(均p = 0.002)耐力时间均增加。与基线相比,运动后局部疼痛组(p < 0.001)和全身性疼痛组(p = 0.008)的颌部疼痛对日常活动的影响均降低。
有监督的运动可减轻TMD患者的疼痛并提高其能力。结果表明,通过运动激活颌部运动系统对局限性/区域性TMD疼痛患者以及与全身性疼痛相关的TMD患者有积极作用。