Şenel Topaloğlu Ebru, Budak Miray, Atilgan Esra, Kurt Hanefi
Department of Physical Therapy and Rehabilitation, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Türkiye.
Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Türkiye.
Medicine (Baltimore). 2025 Aug 22;104(34):e44086. doi: 10.1097/MD.0000000000044086.
This study aimed to evaluate the effectiveness of myofascial release (MFR) therapy applied along fascial chains compared with a structured exercise protocol on symptoms of temporomandibular dysfunction (TMD) and low back pain (LBP)-related disability.
Forty-five participants (38 women) with coexisting TMD and LBP were randomized into 3 groups: the myofascial treatment group, the exercise group, and the control group (CG). Participants were recruited from Istanbul Medipol University Dental Hospital (Istanbul, Turkey). Treatment group received 10 sessions of MFR therapy over 4 weeks, exercise group followed a structured exercise program for 4 weeks, and CG received no intervention. Outcomes included the Oswestry Disability Index, pressure pain threshold via algometry, and muscle properties (tone, stiffness, and elasticity) measured by myotonometer. Oromotor function was assessed using the Diagnostic Criteria for Temporomandibular Disorders. Measurements were taken at baseline and at 4 weeks.
Both MFR and exercise therapy resulted in significant improvements in pain tolerance, muscle tone, stiffness, and elasticity. MFR yielded greater improvements across most parameters, particularly in orofacial pain and LBP-related disability (P ≤ .004). MFR also produced significant gains in oromotor function, including maximum mouth opening and lateral excursions (P ≤ .033), while the exercise program improved pain-free mouth opening (P ≤ .012). No significant changes were observed in the CG. Improvements in TMD symptoms were paralleled by enhancements in LBP-related outcomes.
MFR therapy was effective in reducing symptoms of TMD and LBP-related disability and demonstrated greater benefit than exercise therapy in most outcome measures. The observed parallel improvements suggest a biomechanical and neuromuscular link between the jaw and lumbar region, supporting the integration of MFR in interdisciplinary rehabilitation for patients with comorbid TMD and LBP.
本研究旨在评估沿筋膜链应用肌筋膜松解（MFR）疗法与结构化运动方案相比，对颞下颌关节紊乱病（TMD）症状和下腰痛（LBP）相关残疾的有效性。
45名同时患有TMD和LBP的参与者（38名女性）被随机分为3组：肌筋膜治疗组、运动组和对照组（CG）。参与者从土耳其伊斯坦布尔梅迪波尔大学牙科医院招募。治疗组在4周内接受10次MFR治疗，运动组进行4周的结构化运动计划，CG不接受干预。结果包括Oswestry残疾指数、通过压力痛觉计测量的压力痛阈值以及通过肌张力计测量的肌肉特性（张力、硬度和弹性）。使用颞下颌关节紊乱病诊断标准评估口面部运动功能。在基线和4周时进行测量。
MFR和运动疗法均使疼痛耐受性、肌肉张力、硬度和弹性有显著改善。MFR在大多数参数上有更大改善，尤其是在口面部疼痛和LBP相关残疾方面（P≤0.004）。MFR还使口面部运动功能有显著提高，包括最大开口度和侧向运动（P≤0.033），而运动计划改善了无痛开口度（P≤0.012）。CG未观察到显著变化。TMD症状的改善与LBP相关结果的改善平行。
MFR疗法在减轻TMD症状和LBP相关残疾方面有效，并且在大多数结果测量中比运动疗法显示出更大益处。观察到的平行改善表明下颌和腰椎区域之间存在生物力学和神经肌肉联系，支持将MFR纳入TMD和LBP合并症患者的多学科康复中。
