The additional value of a home physical therapy regimen versus patient education only for the treatment of myofascial pain of the jaw muscles: short-term results of a randomized clinical trial.
OBJECTIVE
To compare the short-term efficacy of patient education only versus the combination of patient education and home exercises for the treatment of myofascial pain of the jaw muscles.


METHODS
Seventy myogenous temporomandibular disorder patients were assigned to 2 treatment groups. One group received patient education supplemented by general information about self-care of the jaw musculature. The other group received both education and a home physical therapy program. Treatment contrast, calculated from the mean normalized relative changes in anamnestic and clinical scores, was used to determine treatment success. Clinical outcome measures included pressure pain threshold (PPT) of the masseter, anterior temporalis, and Achilles tendon; pain-free maximal jaw opening; and pain on chewing, spontaneous muscle pain, and headache as rated on visual analog scales.


RESULTS
After 3 months the success rate was 57% for the group that received education only and 77% for the group that received both education and home physical therapy (P = .157). The patients were then redivided into 2 groups: successfully treated patients and unsuccessfully treated patients. In the unsuccessfully treated group, pain-free maximal jaw opening increased significantly more among those who had been in the education and physical therapy group than among those who had been in the education-only group (P = .019). The change in PPT was significantly greater in successfully treated patients than in unsuccessfully treated patients (.009 < P < .039), independent of the treatment modality, with higher PPTs among successful patients. There were no significant differences between the successfully and unsuccessfully treated groups or between treatment modalities for any other variable.


CONCLUSIONS
Over a period of 3 months, the combination of education and a home physical therapy regimen, as used in this protocol, is slightly more clinically effective than education alone for the treatment of myofascial pain of the jaw muscles.
Michelotti
Ambra
A
Department of Orthodontics, School of Dentistry, University of Naples "Federico II", Naples, Italy. michelot@unina.it
Steenks
Michel H
MH
Farella
Mauro
M
Parisini
Francesca
F
Cimino
Roberta
R
Martina
Roberto
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008410:Masticatory Muscles / Q000503:physiopathology; D008875:Middle Aged; D010147:Pain Measurement; D017288:Pain Threshold; D010353:Patient Education as Topic; D026741:Physical Therapy Modalities; D012648:Self Care; D018709:Statistics, Nonparametric; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000628:therapy*; D016896:Treatment Outcome