title: The effects of exercise therapy for the improvement of jaw movement and psychological intervention to reduce parafunctional activities on chronic pain in the craniocervical region.
abstract: OBJECTIVE
  Apparent organic abnormalities are sometimes not identified among patients suffering from chronic pain in the craniocervical region. In some cases, parafunctional activities (PAs) are recognized. PAs are nonfunctional oromandibular activities that include jaw clenching and bruxism, but are considered as factors that contribute to craniomandibular disorders (CMDs). It is now recognized that PAs and CMDs influence musculoskeletal conditions of the upper quarter. Exercise therapy (ET) to improve jaw movement and psychological intervention (PI) to reduce PAs are useful for PAs and CMDs. We hypothesized that ET and PI would be effective for craniocervical pain without organic abnormalities.
  
  
  METHODS
  Thirty-nine subjects suffering from craniocervical chronic pain were allocated into 3 groups: The control group received only pharmacological treatment; the ET group received jaw movement exercise (JME); and the ET-PI group received JME and PI. Pain and jaw movement were evaluated using a numerical rating scale (NRS).
  
  
  RESULTS
  After interventions, the NRS scores were significantly lower in the ET-PI group, compared with those in the other groups. Jaw movement improved 100% in the ET group, 92% in the ET-PI group, and 0% in the control group.
  
  
  CONCLUSIONS
  A combination of jaw exercise and psychological intervention to reduce parafunctional activities is more effective than jaw exercise alone for the improvement of craniocervical pain without apparent organic abnormalities.
authors: Multidisciplinary Pain Centre, School of Medicine, Aichi Medical University, Nagakute, Japan.
authors: Izumi
authors: I
authors: Makino
authors: Young-Chang P
authors: YC
authors: Arai
authors: Shuichi
authors: S
authors: Aono
authors: Kazuhiro
authors: K
authors: Hayashi
authors: Atsuko
authors: A
authors: Morimoto
authors: Makoto
authors: M
authors: Nishihara
authors: Tatsunori
authors: T
authors: Ikemoto
authors: Shinsuke
authors: S
authors: Inoue
authors: Miyuki
authors: M
authors: Mizutani
authors: Takako
authors: T
authors: Matsubara
authors: Takahiro
authors: T
authors: Ushida
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002012:Bruxism / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D002574:Cervical Vertebrae / Q000473:pathology; D059350:Chronic Pain / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005081:Exercise Therapy / Q000379:methods* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007568:Jaw / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D019547:Neck Pain / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D012886:Skull / Q000473:pathology; D016896:Treatment Outcome; D055815:Young Adult
keywords: craniocervical pain; craniomandibular disorders; education; exercise therapy; parafunctional activities