Department of Rehabilitation Services, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA.
Luna Physical Therapy, Chicago, IL, USA.
Cranio. 2022 Sep;40(5):454-467. doi: 10.1080/08869634.2020.1779483. Epub 2020 Jun 18.
This case report describes the successful use of multi-modal physical therapy (PT), including orthopedic manual physical therapy (OMPT) and graded exposure, in a patient with chronic temporomandibular dysfunction (TMD).
A 41-yr old female presented with a five-year history of bilateral chronic myofascial TMD and comorbid neck/right arm pain. The patient was treated for 12 weeks with a focus on OMPT and graded exposure. The patient demonstrated clinically significant improvements on the Tampa Scale of Kinesiophobia-TMD, maximal mouth opening, Global Rating of Change, and Jaw Functional Limitation Scale.
Mechanisms underlying chronic TMD are complex. Current evidence supports PT management of physical impairments; however, neglecting central drivers or psychosocial factors may result in suboptimal outcomes. Physical therapists are able to address both peripheral and central mechanisms of pain, and future research should examine the utilization of multi-modal PT to improve kinesiophobia and function in patients with chronic TMD.
本病例报告描述了多模式物理疗法（PT）在慢性颞下颌功能紊乱（TMD）患者中的成功应用，包括骨科手法物理疗法（OMPT）和分级暴露。
一名 41 岁女性，双侧慢性肌筋膜 TMD 病史 5 年，伴有颈/右臂疼痛。该患者接受了 12 周的 OMPT 和分级暴露治疗。Tampa 运动恐惧症 - TMD 量表、最大张口度、总体变化评级和下颌功能限制量表显示出临床显著改善。
慢性 TMD 的发病机制较为复杂。现有证据支持 PT 管理身体机能障碍；然而，忽视中枢驱动因素或心理社会因素可能导致治疗效果不佳。物理治疗师能够解决疼痛的外周和中枢机制，未来的研究应探讨多模式 PT 的应用，以改善慢性 TMD 患者的运动恐惧症和功能。
