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家庭锻炼对咀嚼肌疼痛治疗自我管理的附加价值。一项临床试验。

The additional value of home exercises to self-management for the treatment of masticatory muscle pain. A clinical trial.

作者信息

De Nordenflycht Diego, Díaz Catalina, Salinas Javier, Toloza Héctor

机构信息

DDS, MSc. Associate Professor, Faculty of Dentistry, Universidad Andres Bello, Viña del Mar, Chile.

DDS. Private practice, La Calera, Chile.

出版信息

J Clin Exp Dent. 2024 Jun 1;16(6):e693-e699. doi: 10.4317/jced.61549. eCollection 2024 Jun.

Abstract

BACKGROUND

Initial management of temporomandibular disorders (TMD) based on self-management (SM) is strongly recommended by literature, nevertheless, research is needed to investigate the efficacy of different types of interventions under each component of SM against each other for the management of particular subtypes of TMD. The present study aimed to compare the clinical effectiveness of SM and SM with additional mandibular home exercises for the management of myalgia of masticatory muscles.

MATERIAL AND METHODS

A clinical trial was conducted with 54 subjects with a diagnosis of myalgia according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), which were randomised into two groups: treated with SM (SM group) and treated with SM and mandibular home exercises (SM+EX group). Follow-ups were carried out at 2, 6, and 10 weeks, where it was evaluated: pain in the masticatory muscles, jaw opening range of motion, and mandibular functional limitation. Data were analysed using Wilcoxon signed-rank test for comparisons between periods (baseline, and weeks 2, 6, and 10) and Wilcoxon rank-sum test for comparison between groups (=0.05).

RESULTS

All the variables showed significant improvement (<0.05) from baseline to the first follow-up and were maintained later, i.e. both groups were able to reduce pain, increase the jaw opening range of motion, and improve the mandibular functional limitation, although no significant differences were found between groups (>0.05).

CONCLUSIONS

The self-management program was able to reduce pain intensity, increase the jaw opening range of motion and improve functional limitation, but the addition of mandibular home exercises do not have a significant impact on myalgia of the masticatory muscles in the short-term. Myalgia, Self-care, Self-management, Temporomandibular joint disorders.

摘要

背景

文献强烈推荐基于自我管理(SM)的颞下颌关节紊乱病(TMD)初始管理方法,然而,需要开展研究来调查在自我管理的每个组成部分下不同类型干预措施相互比较对于特定TMD亚型管理的疗效。本研究旨在比较自我管理与自我管理加下颌家庭锻炼对咀嚼肌肌痛管理的临床效果。

材料与方法

对54名根据颞下颌关节紊乱病诊断标准(DC/TMD)诊断为肌痛的受试者进行了一项临床试验,这些受试者被随机分为两组:接受自我管理治疗(SM组)和接受自我管理加下颌家庭锻炼治疗(SM + EX组)。在第2、6和10周进行随访,评估咀嚼肌疼痛、下颌开口运动范围和下颌功能受限情况。使用Wilcoxon符号秩和检验进行各时间段(基线、第2、6和10周)之间的比较,使用Wilcoxon秩和检验进行组间比较(α = 0.05)。

结果

所有变量从基线到首次随访均显示出显著改善(P < 0.05),且随后保持稳定,即两组均能够减轻疼痛、增加下颌开口运动范围并改善下颌功能受限情况,尽管组间未发现显著差异(P > 0.05)。

结论

自我管理方案能够减轻疼痛强度、增加下颌开口运动范围并改善功能受限情况,但在短期内,增加下颌家庭锻炼对咀嚼肌肌痛没有显著影响。肌痛、自我护理、自我管理、颞下颌关节紊乱病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce23/11310976/335d1d261232/jced-16-e693-g001.jpg

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