de Oliveira-Souza Ana Izabela Sobral, do Valle Sales Laís Ribeiro, de Fontes Coutinho Alexandra Daniele, de Oliveira Daniella Araújo, Armijo-Olivo Susan
Physiotherapy Department, Federal University of Pernambuco, 50670-901 Recife, Pernambuco, Brazil.
Faculty of business and Social Sciences, University of Applied Sciences, 49076 Osnabrück, Germany.
J Oral Facial Pain Headache. 2024 Mar;38(1):40-51. doi: 10.22514/jofph.2024.005. Epub 2024 Mar 12.
To test the effectiveness of an 8-week exercise program targeted to the neck muscles compared to manual therapy, and placebo treatments on orofacial pain intensity, jaw function, oral health-related quality of life (OHRQoL), and jaw range of motion (ROM) in women with Temporomandibular Disorders (TMD). In this randomized controlled trial, fifty-four women (between 18-45 years old) with a diagnosis of myofascial or mixed TMD according to the Research Diagnostic Criteria for TMD (RDC/TMD) were randomized into three groups: Neck motor control training (NTG), Manual Therapy Group (MTG), and Placebo Group (PG). All patients were evaluated with the Visual Analog Scale, Mandibular Function Impairment Questionnaire, Oral Health Impact Profile-14, and jaw Range of Motion (ROM) at baseline, immediately after treatment (after 8 weeks of treatment), one month, and three-month follow-up. For all outcomes, a mixed analysis of variance (ANOVA) with repeated measures was conducted with a Bonferroni test. NTG was significantly better than the PG group on pain and jaw function at the end of treatment, one- and three-month follow-up (Effect Size (ES) >0.7). For OHRQoL, NTG was significantly better than MTG and PG at the end of treatment and at three-month follow-up (ES >0.7). The results of this project are encouraging, and they could be used to guide clinical practice in this field. Exercises targeted to the neck (which require low therapeutic supervision) could be a simple and conservative way to improve pain and disability for women with TMD with neck involvement.
为了测试一项针对颈部肌肉的为期8周的锻炼计划与手法治疗及安慰剂治疗相比，对颞下颌关节紊乱症（TMD）女性患者的口面部疼痛强度、下颌功能、口腔健康相关生活质量（OHRQoL）以及下颌活动范围（ROM）的有效性。在这项随机对照试验中，根据颞下颌关节紊乱症研究诊断标准（RDC/TMD）诊断为肌筋膜型或混合型TMD的54名女性（年龄在18 - 45岁之间）被随机分为三组：颈部运动控制训练组（NTG）、手法治疗组（MTG）和安慰剂组（PG）。所有患者在基线、治疗后即刻（治疗8周后）、1个月和3个月随访时，均使用视觉模拟量表、下颌功能损害问卷、口腔健康影响量表 - 14以及下颌活动范围（ROM）进行评估。对于所有结果，采用重复测量的混合方差分析（ANOVA）并进行Bonferroni检验。在治疗结束时、1个月和3个月随访时，NTG组在疼痛和下颌功能方面显著优于PG组（效应量（ES）>0.7）。对于OHRQoL，在治疗结束时和3个月随访时，NTG组显著优于MTG组和PG组（ES >0.7）。该项目的结果令人鼓舞，可用于指导该领域的临床实践。针对颈部的锻炼（所需治疗监督较少）可能是改善伴有颈部受累的TMD女性患者疼痛和功能障碍的一种简单且保守的方法。
