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颞下颌关节节律性关节松动术对颞下颌关节紊乱病患者疼痛、张口度和肌电图活动的即刻影响。

Immediate effects of rhythmic joint mobilization of the temporomandibular joint on pain, mouth opening and electromyographic activity in patients with temporomandibular disorders.

机构信息

Department of Physical Therapy, Musculoskeletal Research Unit - UIM, University Center for Assistance, Teaching and Research - CUADI, University of Gran Rosario - UGR, Rosario, Argentina.

Department of Physical Therapy, Musculoskeletal Research Unit - UIM, University Center for Assistance, Teaching and Research - CUADI, University of Gran Rosario - UGR, Rosario, Argentina.

出版信息

J Bodyw Mov Ther. 2021 Oct;28:563-569. doi: 10.1016/j.jbmt.2021.09.001. Epub 2021 Sep 23.

Abstract

BACKGROUND

Rhythmic joint mobilizations (RJM) of the temporomandibular joint (TMJ) are employed to relieve pain and improve function in patients with temporomandibular disorders (TMD). However, the evidence on the immediate effects of RJM in patients with TMD is scarce. The aim of this study was to assess the immediate clinical and functional effects of RJM in patients with TMD.

MATERIALS AND METHODS

This was a one-group quasi-experimental before and after study. Thirty-eight patients with TMD were assessed by means of pain intensity (visual analogue score, VAS), pressure pain threshold (PPT, measured through pressure algometry on the masseter and temporal muscles), mouth opening (MO, measured with a ruler), and surface electromyographic activity of the masseter and temporal muscles (asymmetry index, AI). Measurements were performed before and after a single, 1-min session of RJM of each TMJ. All statistical analyses were performed using the SPSS version 20.0 statistical package.

RESULTS

A statistical significant difference was found in pain intensity, PPT and MO after the intervention (p < 0.05). No difference was found in the AI. A large effect size was observed for pain intensity, PPT of the left and right masseter muscles and MO (d = 0.85-1.13), whereas for the left and right temporal muscles the effect size was moderate (d = 0.62) and small, respectively (d = 0.49).

CONCLUSION

In this sample of patients with TMD, a single session of RJM of the TMJ seemed to be effective in reducing pain intensity, increasing PPT and improving MO immediately after the intervention, without differences in the AI.

摘要

背景

节律性关节松动术(RJM)被用于缓解颞下颌关节(TMJ)疼痛和改善颞下颌关节紊乱症(TMD)患者的功能。然而,RJM 对 TMD 患者即刻效果的证据有限。本研究旨在评估 RJM 对 TMD 患者的即刻临床和功能效果。

材料和方法

这是一项单组准实验前后研究。通过视觉模拟评分(VAS)评估 38 例 TMD 患者的疼痛强度,通过压力测痛法(在咀嚼肌和颞肌上测量)评估压力疼痛阈值(PPT),通过尺子测量张口度(MO),通过表面肌电图评估咀嚼肌和颞肌的表面肌电活动(不对称指数,AI)。在每侧 TMJ 接受 1 分钟单次 RJM 后进行测量。所有统计分析均使用 SPSS 版本 20.0 统计软件包进行。

结果

干预后疼痛强度、PPT 和 MO 均有统计学显著差异(p<0.05)。AI 无差异。疼痛强度、左右侧咀嚼肌 PPT 和 MO 的效应量较大(d=0.85-1.13),而左右侧颞肌的效应量为中度(d=0.62)和较小(d=0.49)。

结论

在本 TMD 患者样本中,单次 TMJ 的 RJM 似乎在干预后即刻有效减轻疼痛强度、增加 PPT 和改善 MO,而 AI 无差异。

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