Department of Basic Science for Physical Therapy, Faculty of Physical Therapy, Cairo University, Cairo, Egypt.
Department of Physical Therapy, Faculty of Applied Medical Sciences, Al-Zaytoonah University of Jordan, Amman, Jordan.
J Back Musculoskelet Rehabil. 2024;37(5):1259-1268. doi: 10.3233/BMR-230358.
Proprioceptive neuromuscular facilitation (PNF) stretching exercises have been widely advocated for the management of patients with different musculoskeletal conditions. However, its effect on the treatment of temporomandibular dysfunction (TMD) in patients with forward head posture (FHP) has not been fully investigated.
To investigate the effect of PNF stretching exercises on the treatment of TMD in patients with FHP.
A prospective, randomized, double-blinded clinical trial. Twenty-four patients with TMD and FHP aged from 18-40 years were randomly assigned to PNF or control group. The PNF group composed of 12 patients received PNF stretching exercises of masticatory muscles in addition to routine physical therapy treatment (FHP correction exercises and ultrasound for the temporomandibular joint); the control group composed of 12 patients received routine physical therapy treatment only. Interventions were conducted twice a week for six weeks. Craniovertebral angle, pain threshold, pain intensity, temporomandibular joint ROM, and temporomandibular joint function were assessed for all participants before and after the intervention. The outcomes were analyzed using Two-way mixed MANOVA. For further multiple comparisons, post-hoc tests with the Bonferroni correction were performed.
There was no significant difference between both groups pre-treatment (p> 0.05). Comparison between groups post-treatment revealed statistically significant differences in all outcome measures (p< 0.05) in favor of the PNF group.
Adding PNF stretching exercises of masticatory muscles to routine physical therapy programs is an effective method for management of TMD in patients with FHP more than routine physical therapy programs alone.
本体感觉神经肌肉促进（PNF）拉伸运动已被广泛用于治疗各种肌肉骨骼疾病。然而，其对伴有前伸头姿势（FHP）的颞下颌功能紊乱（TMD）患者的治疗效果尚未得到充分研究。
研究 PNF 拉伸运动对伴有 FHP 的 TMD 患者的治疗效果。
前瞻性、随机、双盲临床试验。将 24 名年龄在 18-40 岁之间的 TMD 伴有 FHP 的患者随机分为 PNF 组或对照组。PNF 组由 12 名患者组成，在常规物理治疗（FHP 矫正练习和颞下颌关节超声治疗）之外还接受咀嚼肌 PNF 拉伸运动；对照组由 12 名患者组成，仅接受常规物理治疗。干预措施每周进行两次，持续六周。所有参与者在干预前后均进行颅颈角、痛觉阈值、疼痛强度、颞下颌关节活动度和颞下颌关节功能评估。使用双向混合 MANOVA 对结果进行分析。为了进行进一步的多重比较，采用 Bonferroni 校正的事后检验。
治疗前两组间无显著差异（p>0.05）。治疗后组间比较显示，所有结果测量指标均有统计学差异（p<0.05），PNF 组更优。
将咀嚼肌 PNF 拉伸运动加入常规物理治疗方案中是一种有效的治疗方法，优于单纯的常规物理治疗方案，可用于治疗伴有 FHP 的 TMD 患者。
