Article

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.

Langue : ANGLAIS