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一项针对颞下颌关节骨关节炎的居家锻炼计划:疼痛、功能及关节结构

A home-based exercise program for temporomandibular joint osteoarthritis: pain, functionality, and joint structure.

作者信息

Macías-Hernández Salvador Israel, Morones-Alba Juan Daniel, Tapia-Ferrusco Irene, Vélez-Gutiérrez Oscar Benjamín, Hernández-Diaz Cristina, Nava-Bringas Tania Inés, Cruz-Medina Eva, Toro Lya Contreras-Del, Soria-Bastida Ma de Los Angeles

机构信息

Sports Rehabilitation Departament, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico.

Military School of Dentistry, Oral and Maxillofacial Surgery, University of the Army and Air Force of Mexico, Mexico City, Mexico.

出版信息

J Korean Assoc Oral Maxillofac Surg. 2022 Feb 28;48(1):50-58. doi: 10.5125/jkaoms.2022.48.1.50.

Abstract

OBJECTIVES

Osteoarthritis (OA) is the most prevalent and disabling joint disease in the world. Temporomandibular joint (TMJ) exercise is a widely used treatment and could be a beneficial and long-term tool for treating TMJ OA. The present study aims to evaluate the effects of therapeutic exercise in the conservative treatment of TMJ OA.

MATERIALS AND METHODS

A single-group experimental pre-post test was performed. We included patients who met the diagnostic criteria for TMJ OA. Outcome variables were pain intensity (visual analogue scale), functionality (Helkimo index), and structural changes (ultrasound). Follow-up periods were at months 1, 3, and 6. The intervention included a home-based program with thermotherapy, manual therapy, and therapeutic exercise during the entire follow-up period.

RESULTS

We included 15 patients and 26 joints, all women with a median age of 57 years (range, 49-62 years). Median change in pain intensity on joint palpation, mouth opening, and at rest at the first month was 47.5 mm, 51 mm, and 60 mm, respectively, and 48 mm, 49.5 mm, and 42.5 mm, at six months (=0.001). The Helkimo index showed significant improvement in medians from baseline severe dysfunction (17 points) to minimal dysfunction at three and six months (2 points) (=0.001). Ultrasound showed improved disc position.

CONCLUSION

This study demonstrated significant improvements in pain, function, and joint disc position and represents a valuable tool for the long-term treatment of patients with TMJ OA.

摘要

目的

骨关节炎(OA)是世界上最常见且致残的关节疾病。颞下颌关节(TMJ)运动是一种广泛应用的治疗方法,可能是治疗颞下颌关节骨关节炎的一种有益且长期有效的手段。本研究旨在评估治疗性运动在颞下颌关节骨关节炎保守治疗中的效果。

材料与方法

进行单组实验前后测试。我们纳入了符合颞下颌关节骨关节炎诊断标准的患者。结果变量包括疼痛强度(视觉模拟评分)、功能(赫尔基莫指数)和结构变化(超声检查)。随访期为第1、3和6个月。干预措施包括在整个随访期内进行的家庭治疗方案,其中包括热疗、手法治疗和治疗性运动。

结果

我们纳入了15名患者和26个关节,均为女性,中位年龄为57岁(范围49 - 62岁)。第一个月关节触诊、张口和静息时疼痛强度的中位变化分别为47.5毫米、51毫米和60毫米,六个月时分别为48毫米、49.5毫米和42.5毫米(P = 0.001)。赫尔基莫指数显示,从基线时的严重功能障碍(17分)到三个月和六个月时的轻度功能障碍(2分),中位数有显著改善(P = 0.001)。超声检查显示盘状位置改善。

结论

本研究表明在疼痛、功能和关节盘位置方面有显著改善,是颞下颌关节骨关节炎患者长期治疗的一种有价值的手段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/821b/8890964/8796e39dcc94/jkaoms-48-1-50-f1.jpg

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