Background A 60‐year‐old female patient reported with a chief complaint of pain in bilateral temporomandibular joints (TMJ) region since 11/2 years. The pain was initially reported to be insidious in onset, moderate in intensity, aggravated on chewing food and during excessive mouth opening. On examination her mouth opening was found to be less than 8 mm and standard head and neck examination showed grade 2 tenderness with swelling on bilateral TMJ and forward neck posture with rounded shoulders. The patient reported her pain to be 6 at rest in NPRS (with 0 being no pain and 10 being maximum) and 8 out of 10 on mouth opening. Methodology/Management A 4‐week Physiotherapy Intervention program, which consisted of Ultrasound Therapy at varying intensity, TMJ manipulation, Cervical Range of Motion Exercises and Manual Cervical traction was administered. Repeated evaluation of pain and other functional outcomes were done on a weekly basis. Results There was significant improvement in her mouth opening (41 mm), restoration of masticatory functions, complete resolution of pain and overall improvement in quality of life after the 4 weeks intervention program. Conclusion A structured Physiotherapy intervention program consisting of Non‐thermal Ultrasound, Manipulation and exercise targeting TMJ and Upper quarter, proved to be highly effective in increasing functions and reducing signs and symptoms in Chronic TMJ Dysfunction which can be highly disabling. The recovery observed in this patient, who was not on any standard treatment for almost 18 months, hence the severe limitations she encountered, is a testament to the need of designing individualized treatment protocols addressing the many facets of impairment in TMJ Disorders.

No abstract

Background: Physical Inactivity (PI) and sedentary behaviour are the most important and modifiable risk factors to prevent cardiovascular diseases (CVD). Cardiac rehabilitation (CR) is a multidisciplinary program for patients who have undergone cardiac surgeries. Through CR, monitoring physical activity (PA) is possible and may reduce the rate of rehospitalization. The pedometer is a device that is useful to track the step count of the person day to day. It helps in self-monitoring of PA. The purpose of this review was to summarise the evidence about the effect of pedometer-based exercise program in phase 1 and phase 2 CR. Methods: Databases such as MEDLINE, Cochrane, Scopus, Embase, and Web of Science were searched. This search is limited to randomized controlled trials (RCTs), human trials, a 10-year period, and English language journals. Based on inclusion criteria of pedometer-based exercise programs in phase 1 (inpatient phase) and phase 2 (outpatient phase) of CR and exclusion criteria of studies using pedometer in maintenance phase CR. The primary outcome of the study is step count, while secondary is PA (in terms of time), heart rate, sedentary behaviour, and quality of life. This study quality was assessed by the Downs and Black’s checklist. Results: The study includes 6 RCTs based on the inclusion and exclusion criteria. Most studies show a considerable increase in step count associated with increased patient PA. Few studies have explained a significant increase of PA in the study group and maintained for longer terms. More research is needed to determine the impact of cardiovascular risk factors.