姿势控制联合运动训练对颞下颌关节盘不可复性前移手法复位后盘髁关系的影响  

The effects of combining posture control training with exercise on the disc￣condyle relationship after manipu￣lative reduction of anterior disc displacement

作　　者：魏伟[1] 吕连慧 王涛 刘玉斌 盛琳 Wei Wei;Lv Lianhui;Wang Tao;Liu Yubin;Sheng Lin(Department of Rehabilitation Medicine,Yantaishan Hospital,Yantai 264000,China;Department of Stomatology,Yantaishan Hospital of Yantai City,Shandong Province,Yantai 264000,China;Department of Pathology,Yuhuangding Hospital of Yantai,Shandong Province,Yantai 264000,China)

机构地区：[1]山东省烟台市烟台山医院康复医学科,烟台264000 [2]山东省烟台市烟台山医院口腔科,烟台264000 [3]山东省烟台毓璜顶医院病理科,烟台264000

出　　处：《中华物理医学与康复杂志》2022年第3期238-242,共5页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的观察姿势控制联合运动训练对颞下颌关节盘不可复性前移手法复位后盘髁关系的影响。方法选取颞下颌关节盘不可复性前移手法复位成功者44例,采用随机数字表法将患者分为对照组和治疗组,每组22例。2组患者均行常规运动训练,治疗组在此基础上增加姿势控制训练,康复训练每周5次,共4周。比较2组患者手法复位后即刻(训练前)和训练4周后(训练后)的疼痛视觉模拟评分(VAS)和最大主动张口度,并于6个月后复查MRI评估两组患者颞下颌关节的盘-髁关系,观察其在位情况。结果①经4周训练后,对照组和治疗组的疼痛VAS评分分别为[(5.27±4.75)和(2.50±4.01)分],明显低于组内治疗后即刻[分别为(14.68±4.14)分和(12.00±5.86)分],差异有统计学意义(P<0.05);且训练后治疗组的VAS评分较对照组改善更为明显(P<0.05);②经4周训练后,对照组和治疗组的最大主动张口度分别为[(38.05±3.51)和(41.55±4.01)mm],明显高于组内训练前[分别为(34.32±1.99)分和(35.41±2.13)分](P<0.05);且训练后治疗组的最大主动张口度较对照组改善更明显(P<0.05);③6个月后复查MRI显示,治疗组正常盘-髁关系为19例,明显高于对照组(13例),且差异有统计学意义(P<0.05)。结论与单纯运动训练相比,姿势控制训练联合运动训练能进一步改善颞下颌关节盘不可复性前移手法复位后的功能状况并维持疗效。Objective To observe the curative effect of exercise training combined with posture control among patients with displacement of the anterior disc of the temporomandibular joint(TMJ)without reduction.Methods Forty-four patients with anterior TMJ disc displacement without reduction who had successfully been treated with manual repositioning were randomly divided into a control group and a treatment group,each of 22.Both groups underwent routine exercise training,while the experimental group was additionally provided with posture training five times a week for 4 weeks.After the 4th week of training both groups were evaluated using a visual analogue scale(VAS)and their maximum active mouth opening was compared.Six months later,MRI was performed to observe the disc-condyle relationship of the temporomandibular joint and its position.Results①After 4 weeks of training,the average VAS scores of both groups were significantly lower than those before the training.The improvement in the treatment group′s average was significantly greater than among the control group.②After the 4 weeks of training the average maximum active mouth opening of both groups had increased,with the improvement in the treatment group significantly greater.③Six months later,19 persons in the treatment group had a normal disc-condyle relationship,significantly more than the 13 in the control group.Conclusions Posture control training can improve the effectiveness of sports training in maintaining manual repositioning of the TMJ after anterior disc displacement without reduction.

关 键 词：颞下颌关节紊乱 姿势控制 不可复性盘前移位 运动训练 

分 类 号：R782.6[医药卫生—口腔医学]