Revista Brasileira em Promoção da Saúde (Dec 2011)
Functional profile of patients with temporomandibular joint dysfunction under physiotherapy treatment
Abstract
Objectives: To assess the functional profile of patients with temporomandibular joint dysfunction (TMJD) receiving physical therapy. Methods: A cross-sectional study carried with 21 patients receiving physiotherapy care during the year of 2007 at the Center for Integrated Medical Care (Núcleo de Atenção Médica Integrada - NAMI), in Fortaleza-CE, Brazil. Those were submitted to anamnesis (age, presence of pain, affected sites and parafunctional habits) and functional assessment (presence of trigger points, movement amplitude and postural evaluation). Results: The age varied from 16 to 56 years, with an average of 31.3 ± 14.85 and female gender was the most affected with 17 (81.0%) patients. Of the assessed patients, 13 (61.9%) presented pain of moderate intensity, with an average of 5.4 ± 0.50. The most common sites of pain were the temporomandibular joint (TMJ), reported by 15 (71.4%),and cervical region, reported by 13 (61.9%) patients. We found that 13 (61.9%) assessed patients reported clenching as parafunctional habit. Significant limitation of mouth opening and movements of the cervical region were observed when compared to normal values (p <0.05). The most painful muscles on palpation were upper trapezius (n=19), medial pterygoid (n=15) and the masseter (n=15). The TMJ presented strong pain (degree 3) on palpation in 3 (14.3%) patients. In postural assessment, 10 (47.6%) had cervical hyperlordosis, 7 (33%) had forward head posture and 7 (33%) had raised shoulders. Conclusion: Patients with TMJD receiving physical therapy present limitations in TMJ and cervical movement, pain, presence of trigger points and postural changes at a more compromised and symptomatic stage of this dysfunction. In view of this, it becomes necessary to provide early evaluation and treatment with physical therapy.
