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A home-based exercise program for temporomandibular joint osteoarthritis: pain, functionality, and joint structure

Journal of the Korean Association of Oral and Maxillofacial Surgeons / Journal of the Korean Association of Oral and Maxillofacial Surgeons, (P)2234-7550; (E)2234-5930
2022, v.48 no.1, pp.50-58
https://doi.org/10.5125/jkaoms.2022.48.1.50
Salvador Israel Macías-Hernández (Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra)
Juan Daniel Morones-Alba (University of the Army and Air Force of Mexico)
Irene Tapia-Ferrusco (Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra)
Oscar Benjamín Vélez-Gutiérrez (Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra)
Cristina Hernández-Diaz (Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra)
Tania Inés Nava-Bringas (Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra)
Eva Cruz-Medina (Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra)
Lya Contreras-del Toro (Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra)
Ma. de los Angeles Soria-Bastida (Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra)

Abstract

Objectives: Osteoarthritis (OA) is the most prevalent and disabling joint disease in the world. Temporomandibular joint (TMJ) exercise is a widely used treatment and could be a beneficial and long-term tool for treating TMJ OA. The present study aims to evaluate the effects of therapeutic exercise in the conservative treatment of TMJ OA. Materials and Methods: A single-group experimental pre-post test was performed. We included patients who met the diagnostic criteria for TMJ OA. Outcome variables were pain intensity (visual analogue scale), functionality (Helkimo index), and structural changes (ultrasound). Follow-up peri-ods were at months 1, 3, and 6. The intervention included a home-based program with thermotherapy, manual therapy, and therapeutic exercise during the entire follow-up period. Results: We included 15 patients and 26 joints, all women with a median age of 57 years (range, 49-62 years). Median change in pain intensity on joint palpation, mouth opening, and at rest at the first month was 47.5 mm, 51 mm, and 60 mm, respectively, and 48 mm, 49.5 mm, and 42.5 mm, at six months (P=0.001). The Helkimo index showed significant improvement in medians from baseline severe dysfunction (17 points) to minimal dys-function at three and six months (2 points) (P=0.001). Ultrasound showed improved disc position. Conclusion: This study demonstrated significant improvements in pain, function, and joint disc position and represents a valuable tool for the long-term treatment of patients with TMJ OA.

keywords
Osteoarthritis, Temporomandibular joint, Excercise, Pain

Journal of the Korean Association of Oral and Maxillofacial Surgeons