J Korean Assoc Oral Maxillofac Surg.  2022 Feb;48(1):50-58. 10.5125/jkaoms.2022.48.1.50.

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

• Macías-Hernández SI
• Morones-Alba JD
• Tapia-Ferrusco I
• Vélez-Gutiérrez OB
• Hernández-Diaz C
• Nava-Bringas TI
• Cruz-Medina E
• Contreras-del Toro L
• Soria-Bastida MdlA

• KMID: 2526810
• DOI: http://doi.org/10.5125/jkaoms.2022.48.1.50

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 periods 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 dysfunction 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 longterm treatment of patients with TMJ OA.

Keyword

Osteoarthritis; Temporomandibular joint; Excercise; Pain

Figure

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  Fig. 1 A. Intraoral massage with circular movements of index and middle fingers in a clockwise direction. B. Intraoral massage with circular movements of the middle finger in a counterclockwise direction. C. Kneading the inner muscles of the cheeks, stroking from the base to the apex for protrusion and retraction. D. Hot pack placing prior the exercise performance.

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  Fig. 2 External massage. A. Up and down movements. B. Circling and kneading movements. C. Gliding and sliding massage movements with full hand. D. Thumb gliding movements.

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  Fig. 3 A, B. Patient with the mouth open grasped from the inside with the index finger in two positions. C. Grasp from the inside with two fingers and slight deviation. D. Sustained maximum tolerated mouth opened.

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  Fig. 4 A, B. Lateral right and left mobilization. C. Descensus and elevation (opening and closing the mouth). D. Protrusion and retrusion (forward and backward projection).

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  Fig. 5 A. Descent placing the hand on the lower part of the chin and trying to open the mouth without letting it close. B. Patient advanced to placing her hand in front of their chin and pushing their chin forward. C. The patient places her hand on one side of her chin and makes a lateral movement in the direction of the hand that offers resistance. D. For elevation, the patient places a pencil between the teeth (molars) and presses.

Reference

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