Metody manualnej rehabilitacji oraz ocena ich skuteczności na przykładzie pacjenta po zwichnięciu stawu skroniowo-żuchwowego

Przemysław Pasiak, Tomasz Tomaszewski

P. Pasiak, T. Tomaszewski – Methods of manual rehabilitation and assessment of their effectiveness on the example of a patient after temporomandibular joint dislocation. Fizjoterapia Polska 2020; 20(3); 108-114

Streszczenie
Wstęp. W pracy przedstawiono metody rehabilitacji stosowane przy schorzeniach w obrębie twarzoczaszki, a także omówiono najczęstsze przyczyny predysponujące do zwichnięcia stawu skroniowo-żuchwowego. Zaburzenia te są problemem wielopłaszczyznowym. W ich procesie leczniczym, na różnych etapach, konieczny jest udział zarówno specjalistów chirurgii twarzowo-szczękowej, jak i ortodontów, logopedów, psychologów oraz fizjoterapeutów.
Cel pracy. Celem pracy było omówienie metod fizjoterapii stosowanych w leczeniu zaburzeń w obrębie stawu skroniowo-żuchwowego oraz ocena ich skuteczności na przykładzie pacjenta po zwichnięciu prawego stawu skroniowo-żuchwowego.
Materiały i metody. W pracy opartej na opisie pacjenta, który zgłosił się do gabinetu fizjoterapii, u którego doszło do zwichnięcia prawego stawu skroniowo-żuchwowego, przedstawiono postępowanie lecznicze stosowane przez specjalistów z zakresu chirurgii szczękowo-twarzowej oraz fizjoterapeutów.
Wyniki. Wdrożenie rehabilitacji przyniosło następujące efekty: zwiększenie zakresu ruchomości żuchwy, zmniejszenie dolegliwości bólowych, redukcję obrzęku, rozluźnienie mięśni.
Wnioski. Fizjoterapia powinna być jednym z elementów kompleksowego leczenia pacjentów z zaburzeniami w obrębie stawów skroniowo-żuchwowych.
Słowa kluczowe:
staw skroniowo-żuchwowy, rehabilitacja, chirurgia szczękowo-twarzowa
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Effect of Immediate Versus Gradual Exercises Program on Maximum mouth opening Post Temporomandibular Joint Arthroscopy: A randomized controlled trial

Zeinab A. Ali, Marwa M. Eid

Zeinab A. Ali, Marwa M. Eid – Effect of Immediate Versus Gradual Exercises Program on Maximum mouth opening Post Temporomandibular Joint Arthroscopy: A randomized controlled trial. Fizjoterapia Polska 2020; 20(2); 52-57

Streszczenie

Objective. The purpose of this study was to compare two physiotherapy programs for rehabilitation of patients after temporomandibular joint (TMJ) arthroscopy. Methods: Sixty patients diagnosed with closed lock and treated with arthroscopic lysis and lavage participated in this study, patients were divided into two groups: Group A (immediate program): included thirty patients rehabilitated with immediate full range of motion self-exercises. Group B (gradual program): included thirty patients rehabilitated with progressively increasing range of motion self-exercises. Outcome Measures. Maximum mouth opening (MMO) by measuring distance between the upper and lower incisors while the patient actively opens the mouth were assessed by Ruler, Pain assessment was done by using visual analogue scale. The measurements taken by the end of first month of treatment, analyzed and compared between the two groups. Results. Statistical analysis showed significant improvement in MMO and pain outcomes for the immediate group than for the gradual group. Conclusion. Based on the obtained results this study concluded that, a physiotherapy program consisting of immediate postoperative full range of motion mobilizations achieves better results (in terms of pain and mouth opening) than a physiotherapy program consisting of gradual and controlled increases in range of motion of closed lock of the TMJ after arthroscopic treatment.

Słowa kluczowe: Temporomandibular Joint, Arthroscopy, Maximum mouth opening

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Galvos išstūmimo į priekį (Forward Head Posture) poveikis temporo-apatinio žandikaulio sąnario propriocepcijai moterų po brendimo laikotarpio: stebimasis tyrimas

Nehal G. Omran, Amel M. Yousef, Hamada A. Hamada, Ayman Gouda Matar, Doaa A. Osman

Nehal G. Omran, Amel M. Yousef, Hamada A. Hamada, Ayman Gouda Matar, Doaa A. Osman – Effect of Forward Head Posture on Temporomandibular Joint Proprioception in Post-Pubertal Females: An Observational Study. Fizjoterapia Polska 2019; 19(2); 142-146

Abstract
Aim: to explore the effect of forward head posture (FHP) on temporomandibular joint (TMJ) proprioception in post-pubertal females.
Material and Method. Forty post-pubertal females participated in this study. They were classified in accordance with the craniovertebral angle (CVA) into two groups. The Forward head posture (FHP) group had CVA of less than 48° (n = 21), while the control group had CVA of more than 48° (n = 19). TMJ repositioning accuracy had been measured by vernier caliper for females in both groups.
Results. Statistical analysis revealed that there were no significant (p > 0.05) differences between both groups regarding TMJ repositioning errors in all directions (mouth opening, protrusion and lateral movements) with eyes open or closed.
Conclusion and Discussion. In post-pubertal females, FHP has no negative effect on TMJ proprioception in all directions whether the eyes are open or closed.

Key words:
Forward head posture, craniovertebral angle, temporomandibular joint, proprioception, post-pubertal females

 

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The physiotherapeutic estimation of the act of temporal-mandibular joints among students of Medical University of Gdańsk

Maciej Krzyżanowski, Rita Hansdorfer-Korzon, Elżbieta Rajkowska-Labon

M. Krzyżanowski, R. Hansdorfer-Korzon, E. Rajkowska-Labon – The physiotherapeutic estimation of the act of temporal-mandibular joints among students of Medical University of Gdańsk. FP 2014; 14(4); 14-22

Abstract

Aim of the study. 1. Evaluating the activity of temporomandibular joints manifesting features of dysfunction in students of the Medical University Gdańsk, 2. Quantitative analysis of the disorders occurring in temporomandibular joints. 3. Proving the correlation between the investigated parameters and the analysed dysfunctions in temporomandibular joints
The materials and research method. For the examination, 40 students in the age of 19 to 27 years (21 women and 19 men) were classified, representing the average age of 23 years.  For the needs of this study, a card of patient examination had been constructed. The evaluation covered, among others, such parameters as: the mobility range of the jaw, the Rozencwaig’s dyskinesia index, the movement of the joint head during the jaw abduction, acoustic symptom, pain index, the presence of trigger points, the cervical spine mobility range.  The obtained results were subjected to statistical analysis with the application of Statistica 10 software .
Results. Analysis of the investigated parameters revealed that dysfunctions of mobility range, at least in one direction, occur in 87,5% (n=35) of the examined persons. The Rozencwaig’s dyskinesia index was proven in 37,5% (n=15). Asymmetric movement of the joints heads occurred in 67,5% (n=27) of the examined persons; and the disorders of the jaw guiding track and the presence of the acoustic symptom were revealed in 80% (n=32) out of the total 40 of the examined persons. Among 57,5% (n=23) of the examined, the presence of trigger points was revealed within the masseter and the temporalis muscles, or in one of them. Dysfunction of the temporomandibular joints correlates, among others, with a reduction of the mobility range in the cervical spine, with acoustic symptoms and presence of parafunctions.
Conclusions. A significant percentage of the temporomandibular joints dysfunctions was observed among students. Attention was attracted by the high percentage of people performing parafunctions. Correlations statistically significant for the temporomandibular joints were proven.

Key words:
temporomandibular joint, dysfunction, physiotherapy

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