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作 者:叶济灵 吴智刚 蔡宗远[3] 蔡斌[1,2] 徐丽丽 YE Jiling;WU Zhigang;CAI Zongyuan(Department of Rehabilitation Medicine,Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,200011)
机构地区:[1]上海交通大学医学院附属第九人民医院康复医学科,上海市200011 [2]海南西部中心医院 [3]上海交通大学生物医学工程学院
出 处:《中国康复医学杂志》2024年第11期1644-1650,共7页Chinese Journal of Rehabilitation Medicine
基 金:上海交通大学“交大之星”计划医工交叉研究基金项目(YG2021QN68);海南省自然科学基金项目(822QN492)。
摘 要:目的:对存在头前伸姿势的肌源性颞下颌关节紊乱病(temporomandibular disorders,TMD)患者进行头颈姿势训练,探索头颈姿势训练对患者头颈姿势的影响。方法:采用前瞻性对照研究设计,门诊招募2019年1月—2021年2月就诊于上海交通大学医学院附属第九人民医院的肌源性TMD患者45例(男性:6例,女性:39例;年龄29.24±6.13岁),随机分为试验组(23例)和对照组(22例)。试验组进行为期3周的头颈姿势训练,每次训练30min;对照组仅接受健康教育,3周后门诊随访。测定治疗前后患者的张口度大小、疼痛程度,并采用矢状面照片法测定头部旋转角及头颈角。结果:治疗后,试验组(n=22)患者头颈角度增加,与对照组(n=20)相比有显著性差异(55.3°±2.3°vs 48.4°±4.4°,P<0.001);试验组疼痛评分显著低于对照组(1.9±0.7 vs 2.9±0.8,P<0.001),2组的头部旋转角及张口度改善无显著性差异(P=0.437,P=0.313)。结论:头颈姿势训练可以改善肌源性TMD患者的头前伸姿势,更有助于改善患者的疼痛症状。Objective:To investigate the effect of posture training on head posture in myogenic temporomandibular disorders(TMD)patients with forward head posture.Method:Forty-five myogenic TMD patients(6 male,39 female;age 29.24±6.13y)were recruited from the outpatient rehabilitation clinics of the Ninth People's Hospital of Shanghai Jiaotong University School of Medicine from January 2019 to February 2021.Under the design of a prospective controlled study,all patients were randomly divided into the posture training group(23 cases)and the control group(22 cases).The posture training group received posture training for 3 weeks with 30 minutes each time;the control group only received health education.The patients in two groups received outpatient follow-up after 3 weeks.The maximum mouth opening(MMO)and pain intensity were measured before and after treatment,and the head rotation and craniovertebral angle were measured using the sagittal photograph.Result:The craniovertebral angle of the posture training group(n=22)after treatment were significantly higher than the control group(n=20)(55.3°±2.3°vs 48.4°±4.4°,P<0.001).The pain score in the posture training group was significantly lower than that in the control group(1.9±0.7 vs 2.9±0.8,P<0.001).There were no significant group differences between the improvement of head rotation angle and MMO(P=0.437,P=0.313).Conclusion:Posture training can improve the head posture of myogenic and symptoms in TMD patients.
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