Aims:This service evaluation explored
and reported findings from a new multi-disciplinary service where
physiotherapists were incorporated into an orofacial team who managed patients
with chronic Temporomandibular Dysfunction (TMD). Methods: We collected
data before the physiotherapists’ involvement and on discharge from
physiotherapy management. Outcomes were patient-reported pain (numerical rating
scale (NRS 0 to 10)), patient specific functional score (PSFS), health-related
quality of life (EQ-5D) and range of mandibular depression (mm). Exploratory
analyses compared baseline
to follow-up scores on discharge from physiotherapy. Results: 79
patients (mean age 40 (SD 18); female 87%) received physiotherapy. At discharge, there was a mean reduction in pain: 2.8 (95% CI 2.0 to 3.6), improvement
in function: ﹣4.0 (95% CI ﹣4.7 to ﹣3.3), improvement in
health: ﹣0.139 (95% CI ﹣0.196 to ﹣0.082) and increase in
mandible depression: ﹣6.6. (95% CI ﹣9.1 to ﹣4.1). Conclusions: The
results provide early, exploratory evidence that patients with chronic
temporomandibular dysfunction treated by physiotherapists achieve clinically
important
References
[1]
Romera-Reyes, M. and Uyanik, J.M. (2014) Orofacial Pain Management: Current Perspectives. Journal of Pain Research, 7, 99-115.
https://doi.org/10.2147/JPR.S37593
[2]
Gremillion, H.A. (2000) The Prevalence and Etiology of Temporomandibular Disorders and Orofacial Pain. Texas Dental Journal, 117, 30-39.
https://pubmed.ncbi.nlm.nih.gov/11858062
[3]
Oral, K., Bal Kucuk, B., Ebeoglu, B. and Dincer, S. (2009) Etiology of Temporomandibular Disorder Pain. ARGI, 21, 89-94.
https://www.journalagent.com/agri/pdfs/AGRI_21_3_89_94.pdf
[4]
Okeson, J. (2005) Bell’s Orofacial Pains. The Clinical Management of Orofacial Pain. 6th Edition, Quintessence Publishing Co., Inc., Carol Stream.
[5]
McNeely, M., Armijo and Magee, D. (2006) A Systematic Review of the Effectiveness of Physical Therapy Interventions of Temporomandibular Disorders. Physical Therapy, 86, 710-725. https://www.ncbi.nlm.nih.gov/books/NBK72924
https://doi.org/10.1093/ptj/86.5.710
[6]
List, T. and Axelsson, S. (2010) Management of TMD: Evidence from Systematic Reviews and Meta-Analyses. Oral Rehabilitation, 37, 430-451.
https://doi.org/10.1111/j.1365-2842.2010.02089.x
[7]
Gil-Martinez, A., Paris-Alemany, A., Lopez-de-Uralde-Villanuera, I. and La Touche, R. (2018) Management of Pain in Patients with Temporomandibular Disorder (TMD): Challenges and Solutions. Journal of Pain Research, 16, 571-587.
https://doi.org/10.2147/JPR.S127950
[8]
Medlicott, M. and Harris, S. (2006) A Systematic Review of the Effectiveness of Exercise, Manual Therapy, Electrotherapy, Relaxation Training, and Biofeedback in the Management of Temporomandibular Disorder. Physical Therapy, 86, 955-973.
https://www.ncbi.nlm.nih.gov/books/NBK72553
https://doi.org/10.1093/ptj/86.7.955
[9]
Lin, C. (2013) Pain Catastrophizing in Dental Patients: Implications for Treatment Management. Journal of the American Dental Association, 144, 1244-1251.
https://doi.org/10.14219/jada.archive.2013.0052
[10]
Paco, M., Peleteriro, B., Duarte, J. and Pinho, T. (2016) The Effectiveness of Physiotherapy in the Management of Temporomandibular Disorders: A Systematic Review and Meta-Analyses. Journal of Oral and Facial Pain and Headache, 30, 210-220.
https://doi.org/10.11607/ofph.1661
[11]
SQUIRE (2020) Revised Standards for Quality Improvement Reporting Excellence.
http://squire-statement.org/index.cfm?fuseaction=Page.ViewPageandPageID=471
[12]
van Grootel, R.J. and van der Glas, H.W. (2009) Statistically and Clinically Important Change of Pain Scores in Patients with Myogenous Temporomandibular Disorders. European Journal of Pain, 13, 506-510.
https://doi.org/10.1016/j.ejpain.2008.06.002
[13]
Kalamir, A., Graham, P., Vitiello, A., Bonello, R. and Pollard, H. (2013) Intra-Oral Myofascial Therapy versus Education and Self-Care in the Treatment of Chronic, Myogenous Temporomandibular Disorder: A Randomised Clinical Trial. Chiropractic and Manual Therapies, 21, Article No. 17.
https://doi.org/10.1186/2045-709X-21-17
https://link.springer.com/article/10.1186%2F2045-709X-21-17
[14]
Kraaijenga, S., Molen, L., Tinteren, H., Hilgers, F. and Smeele, L. (2014) Treatment of Myogenic Temprormandibular Disorder: A Prospective Randomized Clinical Trial, Comparing a Mechanical Stretching Device (TheraBite) with Standard Physical Therapy Exercise. Journal of Craniomandibular and Sleep Practice, 32, 208-216.
https://doi.org/10.1179/0886963413Z.00000000016
[15]
Haxby Abbott, J. and Schmitt, J. (2014) Minimum Important Differences for the Patient-Specific Functional Scale, 4 Region-Specific Outcome Measures, and the Numeric Pain Rating Scale. Journal of Orthopaedic and Sports Physical Therapy, 44, 560-564. https://doi.org/10.2519/jospt.2014.5248
Revicki, D.A., Kawata, A., Harnam, N., Chen, W., Hays, R.D. and Cella, D. (2009) Predicting EuroQol (EQ-5D) Scores from the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Items and Domain Item Banks in a United States Sample. Quality of Life Research, 18, 783-791.
https://doi.org/10.1007/s11136-009-9489-8
[18]
Yoshizawa, K., Kobayashi, H., Fujie, M., Ogawa, Y., Yajima, T. and Kawai, K. (2016) Estimation of Minimal Clinically Important Change of the Japanese Version of EQ-5D in Patients with Chronic Noncancer Pain: A Retrospective Research Using Real-World Data. Health and Quality of Life Outcomes, 14, Article No. 35.
https://doi.org/10.1186/s12955-016-0438-2
https://hqlo.biomedcentral.com/articles/10.1186/s12955-016-0438-2
[19]
Li, X.Y., et al. (2016) The Normal Range of Maximum Mouth Opening and Its Correlation with Height or Weight in the Young Adult Chinese Population. Journal of Dental Sciences, 21, 56-59. https://doi.org/10.1016/j.jds.2016.09.002
[20]
Agrawal, J., Shenai, P., Chatra, L. and Kumar, P. (2015) Evaluation of Normal Range of Mouth Opening Using Three Finger Index: South India Perspective Study. Indian Journal of Dental Research, 26, 361-365.
http://www.ijdr.in/text.asp?2015/26/4/361/167638
https://doi.org/10.4103/0970-9290.167638
[21]
Kropmans, T.J., Dukstra, P.U., Stegenga, B., Stewart, R. and de Bont, L.G. (1999) Smallest Detectable Difference in Outcome Variables Related to Painful Restriction of the Temporomandibular Joint. Journal of Dental Research, 78, 784-789.
https://doi.org/10.1177/00220345990780031101
