Changes in cervical movement impairment and pain following orofacial treatment in patients with chronic arthralgic temporomandibular disorder with pain: A prospective case series
MetadataShow full item record
The purpose of this study was to investigate the influence of isolated temporomandibular joint (TMJ) manual therapy on pain and range of motion (ROM) of the TMJ and cervical spine including flexion-rotation test (FRT) in people suffering chronic pain arising from chronic arthralgic temporomandibular disorder (TMD). An experienced clinician managed a case series of 12 patients with TMD (mean duration 28.6 months +/- 26.9). The intervention comprised four-weekly sessions of transverse medial accessory TMJ mobilization and advice. Patients were examined prior to and one-week following the intervention period. Outcome measures included jaw disability (JFLS-20), jaw pain measured by Visual Analogue Scale (VAS), maximal mouth opening ROM, cervical ROM including FRT, and pain during cervical movement. A paired t-test revealed significant improvement following the intervention in disability (p < 0.001), VAS pain score at rest (p < 0.001) and at maximum mouth opening (p < 0.001), jaw opening ROM (p < 0.001), FRT ROM to the left (p = 0.024) and right (p = 0.001). In contrast, no significant change was identified for total cervical ROM (p = 0.905). After the intervention, five patients (41.66%) had no pain at rest or at maximal mouth opening, and all had a negative FRT. The effect sizes indicate a moderate to strong, clinically significant effect for all variables apart from total cervical ROM. While a case series cannot identify a cause and effect relationship, these results provide preliminary evidence for the influence of TMJ manual therapy on measures of TMD including pain, as well as upper but not whole cervical movement and associated pain in patients with a diagnosis of TMJ arthralgia.
This is an Author's Original Manuscript of an article published by Taylor & Francis in Physiotherapy Theory and Practice on 02/12/2016 available online at http://www.tandfonline.com/10.1080/09593985.2016.1247934
Showing items related by title, author, creator and subject.
The role of functional, radiological and self-reported measures in predicting clinical outcome in spondylotic cervical radiculopathyAgarwal, Shabnam (2011)BackgroundCervical radiculopathy (CR) results in significant disability and pain and is commonly treated conservatively with satisfactory clinical outcomes. However, a considerable number of patients require surgery to ...
Grondin, F.; Hall, Toby; Laurentoye, M.; Ella, B. (2014)Aims: Clinicians increasingly suggest assessment and treatment of the cervical spine in patients with temporomandibular dysfunction (TMD); however, few studies have investigated upper cervical spine mobility in people who ...
Do subjects with acute/subacute temporomandibular disorder have associated cervical impairments: A cross-sectional studyvon Piekartz, H.; Pudelko, A.; Danzeisen, M.; Hall, Toby; Ballenberger, N. (2016)Background There is preliminary evidence of cervical musculoskeletal impairment in some temporomandibular disorder (TMD) pain states. Objectives To determine whether people with TMD, classified as either mild or moderate/severe ...