Lee Byung-Ki
Department of Physical Therapy, Daewon University College, Jecheon, Korea.
J Exerc Rehabil. 2018 Dec 27;14(6):1074-1079. doi: 10.12965/jer.1834406.203. eCollection 2018 Dec.
The purpose of this study was to determine the effect of therapeutic exercise for a woman with temporomandibular joint disorder. She was 31 year old and had limitation in the opening of mouth. When opening the mouth, she complained pain in the temporomandibular joint and noise. The health status of the patient was classified based on International Classification Functioning, Disability, and Health regarding the activity of the patient. The activity limitation was determined by the ability of opening the mouth, while the impairments in the body structure and body function were determined by the forward-headed posture due to the hypertension and shortening of upper cervical extensors. The proprioceptive neuromuscular facilitation (PNF) program consists of eight types of therapeutic exercises considering the alignment of the cervical spine and the pain in the temporomandibular joint. The application of the PNF program was composed of 12 sessions over 4 weeks and each session continued 30 min. Before and after the application of the PNF program, the up-down length and the left-right width of the bite mark on the apple were measured (activity limitation test). The length of the apple that was bitten was measured using a tape measure (activity limitation test). The test on the abnormal alignment of the cervical spine was conducted using a plastic goniometer to measure the angle to the cervical spine (impairment test). After a 4-week PNF program, patient could open mouth wide without pain. The present results suggest that PNF program can be used to enhance the stability and mobility of the temporomandibular joint. With this, the impairment in the body structure and body function and activity of patient were improved.
本研究的目的是确定治疗性运动对一名患有颞下颌关节紊乱症女性的影响。她31岁，存在张口受限的情况。张口时，她诉说颞下颌关节疼痛并伴有弹响。根据《国际功能、残疾和健康分类》对该患者的活动情况进行健康状况分类。活动受限通过张口能力来确定，而身体结构和身体功能的损伤则由高血压导致的头部前倾姿势以及上颈段伸肌缩短来确定。本体感觉神经肌肉促进法（PNF）方案包括八种治疗性运动，考虑了颈椎的排列和颞下颌关节的疼痛情况。PNF方案的应用包括在4周内进行12次治疗，每次治疗持续30分钟。在应用PNF方案前后，测量苹果上咬痕的上下长度和左右宽度（活动受限测试）。使用卷尺测量咬苹果的长度（活动受限测试）。使用塑料角度计对颈椎异常排列进行测试，以测量颈椎角度（损伤测试）。经过为期4周的PNF方案治疗后，患者能够无痛地张大嘴巴。目前的结果表明，PNF方案可用于增强颞下颌关节的稳定性和活动度。由此，患者的身体结构、身体功能及活动方面的损伤均得到改善。
