Kronik Boyun Ağrısı Tedavisinde Çene Kasları Egzersizleri İle Boyun İzometrik Egzersizlerinin Etkinliklerinin Karşılaştırılması: Randomize, Kontrollü Çalışma

Amaç: Çalışmamızın amacı, kronik boyun ağrılı bireylerde, boyun izometrik egzersizleri ile çene kasları egzersizlerinin; ağrı şiddeti, boyun ve temporomandibular eklem hareketleri, yaşam kalitesi ve özürlülük durumu üzerindeki etkilerini karşılaştırmaktır.Gereç ve Yöntemler: Kırk kronik boyun ağrılı birey 2 gruba randomize edildi (Grup A, ortalama yaş: 39,6±10,4; Grup B, ortalama yaş: 41,4±12,2). Servikal ve temporomandibular eklem hareket açıklıkları (EHA), ağrı şiddetleri, özürlülük durumu ve yaşam kaliteleri değerlendirildi. Grup A’daki olgular 5 adet servikal izometrik egzersizini, Grup B’deki olgular ise 5 adet çene egzersizini içeren ev programlarına dâhil edildi. Her grup için tedavi programları 3 hafta boyunca sürdürüldü. Tedavi sonunda değerlendirmeler tekrarlandı.Bulgular: Grup A’da; ağrı şiddeti azaldı, servikal fleksiyon, ekstansiyon, sol lateral fleksiyon, sağ ve sol rotasyon EHA ve maksimum ağız açıklığı arttı, yaşam kalitesi ve özürlülük durumu iyileşti (p<0,05). Grup B’de; ağrı şiddeti azaldı, servikal fleksiyon, ekstansiyon, sağ ve sol lateral fleksiyon, sağ ve sol rotasyon EHA, maksimum ağız açıklığı ve mandibula hareketleri arttı, yaşam kalitesi ve özürlülük durumunda iyileşme gözlendi (p<0,05). Mandibula protrüzyonu (p=0,009) ve mandibula sağ lateral deviasyonu’nda (p=0,032) elde edilen değişim Grup B’de, Grup A’ya göre daha iyiydi. Sonuç: Sonuçlarımız, kronik boyun ağrılı bireylerde, çene kasları ve izometrik boyun egzersizlerinin; ağrı, servikal EHA, maksimum ağız açıklığı, yaşam kalitesi ve özürlülük üzerinde benzer etkileri olduğunu ve çene kasları egzersizlerinin mandibula hareketlerinde daha çok artış sağlayabileceğini göstermektedir.

Anahtar Kelimeler:

Boyun ağrısı, rehabilitasyon, egzersiz, temporomandibular eklem

The Comparison of Jaw Muscle Exercises and Neck Isometric Exercises in the Treatment of Chronic Neck Pain: A Randomised, Controlled Trial

Aim: The aim of our study is to compare the effects of neck isometric exercises and jaw muscles exercises on pain severity, neck and temporomandibular joint motions, quality of life (QoL) and disability status in patients with chronic neck pain.Material and Methods: Forty subjects were randomized into 2 groups (Group A, mean age: 39.6±10.4; Group B, mean age: 41.4±12.2). The cervical and temporomandibular joint range of motions (ROMs), pain severity, disability status and QoL were evaluated. The patients in Group A were included in the home programs that included 5 cervical isometric exercises and the patients in Group B included 5 chin exercises. Both groups continued their own programs for three-weeks. All evaluations were repeated at the end of the treatment. Results: In Group A; pain severity was decreased, cervical flexion, extention, left lateral flexion, right and left rotation ROMs and maximum mouth opening were increased, QoL and disability were improved (p<0.05). In Group B; pain severity was decreased, cervical flexion, extention, right and left lateral flexion, right and left rotation ROMs and maximum mouth opening, mandibular movements were increased, improvements in QoL and disability were observed (p<0.05). The obtained change in mandibular protrusion (p=0.009) and right lateral deviation (p=0.032) were better in Group B compared with Group A. Conclusion: Our results showed that jaw muscles and isometric neck exercises had similar effects on pain, cervical ROMs, maximum mouth opening, QoL and disability, and jaw muscles exercises may provide more increase in mandibular movements in subjects with chronic neck pain.

Keywords:

Neck pain, rehabilitation, exercise, temporomandibular joint,

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