Nedeljak Joni, Armijo-Olivo Susan, Hernandez Ivonne A, Nayar Suresh, McNeel Margaret L
Primary Healthcare Research Unit, Memorial University of Newfoundland, St. John's, Newfoundland, Canada.
Ambulatory Care Physiotherapy, Eastern Health Regional Health Authority, St. John's, Newfoundland, Canada.
Physiother Can. 2021 Jun 15;74(2):173-183. doi: 10.3138/ptc-2020-0068. eCollection 2022 May.
, or restricted mouth opening, is a common side effect of treatment for head and neck cancer. This scoping review examined the characteristics, extent, and nature of existing research on manual therapy and jaw-mobilizing devices to prevent and manage trismus related to head and neck cancer. Six electronic databases were searched using the terms , and and the associated MeSH terms. The review focused on the factors related to intervention delivery: timing, adherence, completion rates, and adverse events. Nine studies were included. Eight examined the use of a jaw-mobilizing device, and one explored the benefit of remote telephone support. Two studies involved cancer survivors at risk of trismus, five involved survivors with trismus, and two included survivors both with and at risk of trismus. No studies were found examining physiotherapist provision of manual therapy. Within-group comparisons supported the benefit of using a jaw-mobilizing device to manage trismus, whereas significant between-groups differences were found only in non-randomized controlled trials. Survivor symptoms and intervention burden were reported reasons for poor adherence and completion rates. No benefit was found for the use of jaw-mobilizing devices for the prevention of trismus. Given the potential of manual therapy to enhance outcomes, physical therapist-led research is warranted.
牙关紧闭，即张口受限，是头颈癌治疗常见的副作用。本综述探讨了关于手法治疗和下颌活动装置预防及处理头颈癌相关牙关紧闭的现有研究的特征、范围和性质。使用相关术语及相关医学主题词检索了六个电子数据库。该综述聚焦于与干预实施相关的因素：时机、依从性、完成率和不良事件。纳入了九项研究。八项研究考察了下颌活动装置的使用，一项研究探讨了远程电话支持的益处。两项研究涉及有牙关紧闭风险的癌症幸存者，五项研究涉及患有牙关紧闭的幸存者，两项研究纳入了既有牙关紧闭又有牙关紧闭风险的幸存者。未发现有研究考察物理治疗师提供的手法治疗。组内比较支持使用下颌活动装置处理牙关紧闭的益处，而仅在非随机对照试验中发现组间存在显著差异。幸存者症状和干预负担是依从性和完成率低的报告原因。未发现使用下颌活动装置预防牙关紧闭有任何益处。鉴于手法治疗可能改善治疗效果，有必要开展由物理治疗师主导的研究。
