title: Effectiveness of exercise therapy in patients with internal derangement of the temporomandibular joint.
abstract: This study intended in evaluating the effectiveness of exercise therapy in patients with craniomandibular disorders (CMD). Twenty consecutive patients suffering from CMD with anterior disc displacement without reduction consulting a CMD service were included in the study if they met following criteria: (i) pain in the temporomandibular region, (ii) reduced incisal edge clearance (<35 mm), (iii) magnet resonance imaging confirmed anterior disc displacement without reduction and (iv) evidence of postural dysfunction. All patients were assigned to a waiting list, serving as a no-treatment control period, according to a before-after trial. The treatment consisted of active and passive jaw movement exercises, correction of body posture and relaxation techniques. A total of 18 patients completed the study, no adverse effects occurred. Following main outcome measures were evaluated: (1) pain at rest (2) pain at stress (3) impairment (4) mouth opening at base-line, before and after treatment and at 6 month follow-up. As a result of treatment pain, impairment and mouth opening improved significantly more than during control period (paired samples t-test P < 0.05). After treatment four patients had no pain at all (chi-square: P < 0.05) and only seven patients revealed an impaired incisal edge clearance after treatment. (chi-square Test, P < 0.001). At follow up, seven patients had no pain and experienced no impairment. Exercise therapy seems to be useful in the treatment of anterior disc displacement without reduction.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Vienna, AKH Wien, Austria. peter.nicolakis@akh-wien.ac.at
authors.forename: P
authors.initials: P
authors.lastname: Nicolakis
authors.forename: B
authors.initials: B
authors.lastname: Erdogmus
authors.forename: A
authors.initials: A
authors.lastname: Kopf
authors.forename: G
authors.initials: G
authors.lastname: Ebenbichler
authors.forename: J
authors.initials: J
authors.lastname: Kollmitzer
authors.forename: E
authors.initials: E
authors.lastname: Piehslinger
authors.forename: V
authors.initials: V
authors.lastname: Fialka-Moser
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D017271:Craniomandibular Disorders / Q000628:therapy; D005081:Exercise Therapy; D005157:Facial Pain / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology; D004204:Joint Dislocations / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008334:Mandible / Q000503:physiopathology; D008410:Masticatory Muscles / Q000503:physiopathology; D016555:Matched-Pair Analysis; D009068:Movement; D015999:Multivariate Analysis; D026741:Physical Therapy Modalities; D011187:Posture / Q000502:physiology; D012064:Relaxation Therapy; D018709:Statistics, Nonparametric; D019224:Temporomandibular Joint Disc / Q000473:pathology; D013705:Temporomandibular Joint Disorders / Q000628:therapy*; D016896:Treatment Outcome