A home-based exercise program for temporomandibular joint osteoarthritis: pain, functionality, and joint structure

J Korean Assoc Oral Maxillofac Surg. 2022 Feb 28;48(1):50-58. doi: 10.5125/jkaoms.2022.48.1.50.

Abstract

Objectives: Osteoarthritis (OA) is the most prevalent and disabling joint disease in the world. Temporomandibular joint (TMJ) exercise is a widely used treatment and could be a beneficial and long-term tool for treating TMJ OA. The present study aims to evaluate the effects of therapeutic exercise in the conservative treatment of TMJ OA.

Materials and methods: A single-group experimental pre-post test was performed. We included patients who met the diagnostic criteria for TMJ OA. Outcome variables were pain intensity (visual analogue scale), functionality (Helkimo index), and structural changes (ultrasound). Follow-up periods were at months 1, 3, and 6. The intervention included a home-based program with thermotherapy, manual therapy, and therapeutic exercise during the entire follow-up period.

Results: We included 15 patients and 26 joints, all women with a median age of 57 years (range, 49-62 years). Median change in pain intensity on joint palpation, mouth opening, and at rest at the first month was 47.5 mm, 51 mm, and 60 mm, respectively, and 48 mm, 49.5 mm, and 42.5 mm, at six months (P=0.001). The Helkimo index showed significant improvement in medians from baseline severe dysfunction (17 points) to minimal dysfunction at three and six months (2 points) (P=0.001). Ultrasound showed improved disc position.

Conclusion: This study demonstrated significant improvements in pain, function, and joint disc position and represents a valuable tool for the long-term treatment of patients with TMJ OA.

Keywords: Excercise; Osteoarthritis; Pain; Temporomandibular joint.