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物理治疗对全身关节过度活动并发颞下颌关节紊乱患者的疗效——一项横断面研究

The Effectiveness of Physical Therapy in Patients with Generalized Joint Hypermobility and Concurrent Temporomandibular Disorders-A Cross-Sectional Study.

作者信息

Kulesa-Mrowiecka Małgorzata, Piech Joanna, Gaździk Tadeusz S

机构信息

Department of Physiotherapy, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 12 Michalowskiego Str., 31-143 Krakow, Poland.

Faculty of Health Sciences, Jagiellonian University Medical College, 12 Michalowskiego Str., 31-143 Krakow, Poland.

出版信息

J Clin Med. 2021 Aug 25;10(17):3808. doi: 10.3390/jcm10173808.

Abstract

Temporomandibular disorders (TMD) consist of a group of symptoms such as: pain of temporomandibular joints, masticatory muscles or surrounding tissues, dysfunctions of TMJs' mobility, and crepitation. The Hypermobility Joint Syndrome (HJS) manifests in the flaccidity of joint structures, an increase in the range of joint motion, and occurs more often in the young and women. The aim of this study was to present the occurrence of HJS among patients with myogenic TMD and disc displacement with reduction. The secondary goal was to assess the effectiveness of physiotherapy directed to TMD with coexisting HJS. The study involved 322 patients with symptoms of TMD. HJS was diagnosed using the Beighton Scale, which confirmed its occurrence in 26 cases. 79 subjects (7 males and 72 females; mean age, 33.9 ± 10.4 years) were selected and divided into two groups: HJS + TMD ( = 26; 2 males and 24 females; mean age, 27.1 ± 9.4 years) and TMD ( = 53; 5 males and 48 females; mean age, 37.4 ± 9.2 years). These patients completed 3-week physiotherapy management. Before and after physiotherapy, the myofascial pain severity on Numeric Pain Rating Scale, linear measurement of maximum mouth opening, and opening pattern, were assessed. To demonstrate differences between the results, the level of significance for statistical analysis was set at α = 0.05. A statistically significant improvement was obtained in decreasing myofascial pain in both groups. Coordination of mandibular movements was achieved in both groups. Generalized joint hypermobility occurred among patients with TMD. Physiotherapy directed to TMD was effective in reducing myofascial pain and restoring TMJ's coordination also in patients with HJS.

摘要

颞下颌关节紊乱病(TMD)由一组症状组成,如:颞下颌关节、咀嚼肌或周围组织疼痛,颞下颌关节活动功能障碍以及关节弹响。关节活动过度综合征(HJS)表现为关节结构松弛、关节活动范围增大,且在年轻人和女性中更为常见。本研究的目的是呈现肌源性TMD和可复性盘移位患者中HJS的发生率。次要目标是评估针对合并HJS的TMD进行物理治疗的效果。该研究纳入了322例有TMD症状的患者。使用贝ighton量表诊断HJS,确诊26例。选取79名受试者(7名男性和72名女性;平均年龄33.9±10.4岁)并分为两组:HJS + TMD组(n = 26;2名男性和24名女性;平均年龄27.1±9.4岁)和TMD组(n = 53;5名男性和48名女性;平均年龄37.4±9.2岁)。这些患者完成了为期3周的物理治疗。在物理治疗前后,评估数字疼痛评分量表上的肌筋膜疼痛严重程度、最大张口度的线性测量以及张口模式。为了显示结果之间的差异,将统计分析的显著性水平设定为α = 0.05。两组在减轻肌筋膜疼痛方面均获得了具有统计学意义的改善。两组均实现了下颌运动的协调性。TMD患者中出现了全身性关节活动过度。针对TMD的物理治疗对于减轻HJS患者的肌筋膜疼痛和恢复颞下颌关节协调性也是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b48/8432079/9be42f7394ab/jcm-10-03808-g001.jpg

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