头颈姿势训练改善肌源性颞下颌关节紊乱病患者头前伸姿势的临床研究

关键词：头颈姿势  运动治疗  姿势训练  颞下颌关节

Keywords:head and neck posture  therapeutic exercise  posture training  temporomandibular joint

摘要：

      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。

Abstract:

      Abstract 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.