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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前位头部错姿对青春期后女性的颞下颔关节本体感觉的影响:观察性研究

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

摘要
目的。探讨前位头部错姿(FHP)对青春期后女性的颞下颔关节(TMJ)本体感觉的影响。
材料和方法。共40名青春期后女性参与研究,她们将背依照颅锥角(CVA)分为两组。前位头部错姿(FHP)组的CVA小于48° (n=21),而对照组的CVA大于48° (n=19)。通过游标卡尺测量两组女性的TMJ复位的准确度。
结果。统计分析显示两组间在睁眼或闭眼的TMJ各方向复位(张口、突出和侧向运动)间无显著差异(p>0.05)。
结论和讨论。在青春期后女性中FHP对所有方向的TMJ本体感觉都没有负面影响,无论眼睛是张开或闭合。

关键词:
前位头部错姿、颅锥角、颞下颔关节、本体感觉、青春期后的女性

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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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