Exercise therapy for craniomandibular disorders

Nicolakis P, Erdogmus B, Kopf A, Djaber-Ansari A, Piehslinger E, Fialka-Moser V. Exercise therapy for craniomandibular disorders. Arch Phys Med Rehabil 2000;81:1137-42. Objective: To evaluate the use of exercise therapy for the treatment of craniomandibular disorders (CMDs). Design: Before-after trial. All patients were assigned to a waiting list, serving as a no-treatment control period. Setting: Outpatient clinic for physical medicine and rehabilitation of the University of Vienna. Patients: Thirty consecutive patients suffering from CMD with anterior disc displacement with reduction who were consulting a CMD service. Inclusion criteria: (1) symptoms lasting at least 3 months, (2) pain in the temporomandibular region, (3) a positive axiography, and (4) evidence of postural dysfunction. Twenty-six patients completed the study; no adverse effects occurred. Interventions: Active and passive jaw movement exercises, correction of body posture, and relaxation techniques. Main Outcome Measures: (1) Pain at rest, (2) pain at stress, (3) impairment, and (4) mouth opening at baseline, before and after treatment, and at 6-month follow-up. Results: During the control period, no changes occurred. After the treatment, pain and impairment were significantly reduced (Wilcoxon test, p