背景:肌源性颞下颌关节紊乱病(M-TMD)通常涉及咬合板(OS)治疗和肌肉骨骼理疗(MPT)。
目的:比较OS与MPT和教育(EG)与OS和教育(CG)相结合的效果,慢性M-TMD患者。
方法:在这项双盲随机对照试验中,62名参与者被分配到EG或CG。主要成果,休息时的疼痛水平(VAS休息),最大口腔开度(VAS打开)和咀嚼期间(VAS咀嚼),通过视觉模拟量表(VAS)以cm为单位测量。次要结果是最大口腔开放的运动范围(ROM)。两项干预持续了3个月,在基线(T0)评估结果,治疗后(T1)和治疗后3个月(T2)。
结果:意向治疗分析显示,EG有显著改善(VAS休息=-1.50cm[CI95%:-2.67,-0.32],p=.04;VAS开路=-2.00cm[CI95%:-3.23,-0.75],p<.01;VAS咀嚼=-1.71cm[CI95%:-2.90,-0.52],p=.01;ROM=4.61[CI95%:0.93,8.30],p=.04)。此外,VAS测量值受到随访时间的影响(VAS休息=-0.73cm[CI95%:-1.30,-0.17],p=0.03;VASopen=-0.97cm[CI95%:-1.57,-0.37],p<.01;VAS咀嚼=-1.15cm[CI95%:-1.73,-0.58],p<.01)。在T1时,对于VAS开放(χ2(1)=4.39,p=.04)和VAS咀嚼(χ2(1)=11.58,p<.01),与CG相比,EG表现出更高的应答者数量。
结论:将MPT添加到教育和OS中,在减轻疼痛和改善ROM方面产生更好的结果。慢性M-TMD。
背景:NCT03726060。
BACKGROUND: Myogenic temporomandibular disorders (M-TMD) commonly involve occlusal splint (OS) therapy and musculoskeletal physiotherapy (MPT).
OBJECTIVE: To compare the effects of combining OS with MPT and education (EG) against OS and education (CG), in chronic M-TMD patients.
METHODS: In this double-blind randomised controlled trial, 62 participants were assigned to either EG or CG. The primary outcomes, pain levels at rest (VAS rest), maximum oral opening (VAS open) and during chewing (VAS chew), were measured by Visual Analogue Scale (VAS) in cm. The secondary outcome was the range of motion (ROM) for maximum oral opening. Both interventions lasted 3 months, with outcomes assessed at baseline (T0), post-treatment (T1) and 3 months post-treatment (T2).
RESULTS: Intention-to-treat analysis revealed significant improvements favouring EG (VAS rest = -1.50 cm [CI95%: -2.67, -0.32], p = .04; VAS open = -2.00 cm [CI95%: -3.23, -0.75], p < .01; VAS chew = -1.71 cm [CI95%: -2.90, -0.52], p = .01; ROM = 4.61 [CI95%: 0.93, 8.30], p = .04). Additionally, VAS measures were influenced by follow-up times (VAS rest = -0.73 cm [CI95%: -1.30, -0.17], p = 0.03; VAS open = -0.97 cm [CI95%: -1.57, -0.37], p < .01; VAS chew = -1.15 cm [CI95%: -1.73, -0.58], p < .01). At T1, EG demonstrated higher number of responders compared to CG for VAS open (χ2(1) = 4.39, p = .04) and VAS chew (χ2(1) = 11.58, p < .01).
CONCLUSIONS: Adding MPT to education and OS yields better outcomes in terms of pain reduction and ROM improvement, in chronic M-TMD.
BACKGROUND: NCT03726060.