Influence of proprioceptive neuromuscular facilitation therapeutic exercise on woman with temporomandibular joint disorder: a case study

Abstract

The purpose of this study was to determine the effect of therapeutic exercise for a woman with temporomandibular joint disorder. She was 31 year old and had limitation in the opening of mouth. When opening the mouth, she complained pain in the temporomandibular joint and noise. The health status of the patient was classified based on International Classification Functioning, Disability, and Health regarding the activity of the patient. The activity limitation was determined by the ability of opening the mouth, while the impairments in the body structure and body function were determined by the forward-headed posture due to the hypertension and shortening of upper cervical extensors. The proprioceptive neuromuscular facilitation (PNF) program consists of eight types of therapeutic exercises considering the alignment of the cervical spine and the pain in the temporomandibular joint. The application of the PNF program was composed of 12 sessions over 4 weeks and each session continued 30 min. Before and after the application of the PNF program, the up-down length and the left-right width of the bite mark on the apple were measured (activity limitation test). The length of the apple that was bitten was measured using a tape measure (activity limitation test). The test on the abnormal alignment of the cervical spine was conducted using a plastic goniometer to measure the angle to the cervical spine (impairment test). After a 4-week PNF program, patient could open mouth wide without pain. The present results suggest that PNF program can be used to enhance the stability and mobility of the temporomandibular joint. With this, the impairment in the body structure and body function and activity of patient were improved.

Biotensegration of malocclusion and temporomandibular disorders with diseases of the musculoskeletal system and posture defects – a literature review, supported by own observations

“…Studies by Wijer indicate that symptoms from the TMJ and a dysfunctional cervical segment are concomitant. An orthopaedic test for the cervical segment is applied to recognize the source of the pain [303,304]. In her studies, Weber did not find a relationship between the craniocervical position and TMD.…”

Physiotherapists and Osteopaths’ Attitudes: Training in Management of Temporomandibular Disorders

“…Those have an evidence in literature, in particular the posture therapy is considered a good way to reduce the signs and symptoms of TMDs, because there are case where pain and disfunction of the upper area of the spine is caused by the posture of the rest of the body [ 48 ]. The proprioceptive therapy sometimes produces good results, in term of disrupt the muscle pattern and can determine a relief which, in most patients, does not last for a long period [ 49 ]. There are new treatments that can be adopted to reduce the impact of TMDs, but these should be analyzed and assessed to determine where they can be useful.…”