Defraia, C

Del Rosso, A

Landi, G.

Maddali Bongi, Susanna

Matucci Cerinic, Marco

Passalacqua, M

English

Florence Research

Medical or Research Professionals/CliniciansTopic area: Clinical topics by area of researchSpecific topic: 33. RehabilitationEULAR14-SCIE-4505REHABILITATION OF TEMPOROMANDIBULAR JOINT (TMJ) IN PATIENTS WITH SYSTEMIC SCLEROSIS (SSC). ACOMPARISON BETWEEN TWO PROTOCOLS: PRELIMINARY RESULTSSusanna  Maddali Bongi  1Angela Del Rosso 1,*Mauro  Passalacqua  1Giovanna  Landi  1Cecilia  Defraia  1Marco  MatucciCerinic  11Department of Experimental and Clinical Medicine, University of Florence, Florence, ItalyMy abstract has been or will be presented at a scientific meeting during a 12 months period prior to EULAR 2014: NoIs the first author applying for a travel bursary?: NoBackground: In SSc patients, microstomia is frequent and impairs mouth function. It may be due to fibrosis of skin face and tochanges in TMJ, scarcely evaluated and treated with rehabilitation  in SSc.Objectives: To evaluate, in SSc patients (pts)  with microstomia due to TMJ dysfunction, the efficacy of 2 rehabilitation protocol.Methods: We enrolled 26 SSc pts (22 women, 4 men; age and disease duration: 59.08 ± 10.31 and 13.65 ± 5.71 years) withmicrostomia and TMJ dysfunction. Group 1 (13 pts) was treated by Protocol 1 (P1) (home exercises for mimic, masticatory and neckmuscles; 20 minutes/day, 3 days/week) and group 2 (13 pts) was treated by Protocol 2 (exercises plus face and neck,connective tissuemassage, Kabat technique for mimic muscles, manual techniques -intra- and extra-oral manipulation of TMJ, stretching andmobilization of cranio-cervical muscles-; 1 hour/week). Pts were evaluated at T0, at T1 (end of treatment; week 12) and at T2 (at 8weeks of follow-up) by: Helkimo Index (Anamnestic -A-dysfunction -D- and occlusal-O- index), for TMJ dysfunction; mobility ofcervical rachis (cm) and mouth (ROM) (mm); SSc face involvement (facial skin score; Mouth Handicap in SSc scale–MHISS-).Results: At T1, both protocols improved Helkimo A index and Helkimo O Score, while only protocol 2 improved Helkimo D(p<0.05).Mouth left lateralization and protrusion were improved by both protocols while mouth opening and right lateralization wereincreased only by P2 (p<0.05). At T1, P1 improved cervical anterior flexion and left rotation (p<0.05), with the latter result confirmedat T2 versus (vs) T0 (p<0.01), P2 ameliorated cervical right lateralization, while both protocols improved cervical left lateralization,right rotation and extension (p<0.05), with the latter result confirmed at T2 vs T0 for P1 and P2 (p<0.05). Both protocols reducedfacial skin score at T1 (p<0.01), with the results confirmed at T2 vs T0 for both treatments (p=NS). P2 also improves at T1 vs T0values of MHISS.(p<0.05).                   T0 T1 T2 PT0/T1 P T0/T2 PT1/T2Helkimo A P11.42±0.51 1.08±0.67 1.25±0.62 <0.05 NS NSP210.57±4,585.64±2,17 9.28±5,73 <0.05 NS NSHelkimo D P111.17±4.639.08±5.64 10.42±5.35NS NS NSP210.57±4,585.64±2,17 9.28±5,73 <0.05 NS NSHelkimo score O P12.68±0.49 2.33±0.78 2.50±0.67 <0.05 NS NSP22.50±0.65 1.78±0.42 2.36±0.63 <0.01 NS <0.05Mouth opening P142.83±9.5144.42±13.8345.08±9.18NS NS NSP244.79±9.1751.57±8.8 50.57±9.06<0.001 <0.01 NSMouth protrusion P17.5±2.47 10.63±2.429.08±2.61 <0.001 <0.05 <0.05P27.21±2.63 8.71±2.16 8.5±1.74 <0.05 NS NSCervical  anteriorflexionP13.92±1.16 3.00±0.47 3.54±0.78 <0.05 NS NSP23.03±1.47 2.18±1.25 2.5±1.27 NS NS NSCervicalextensionP118.50±2.8121.58±2.9422.46±1.96<0.001 <0.001 NSP217.64±2.5 19.79±1.8019.86±2.98<0.05 <0.05 NSFacial Skin Score P16.33±2.74 3.83±1,90 4.33±2.01 <0.001 <0.01 NSP26.43±2.44 2.93±1.94 3.0±2.07 <0.001 P<0.001 NSMHISS          P122.92±10.7321.58±9.2418.42±9.43NS NS NSP222.43±10.4313.64±7.8116.50±9.53<0.05 NS NS Conclusions: In SSc patients, both protocols improve TMJ and cervical mobilization, TMJ disability, and skin score. with some ofthe results confirmed at follow-up. P2, also improving SSc face disability, seems to ameliorate  more items than P1 and to be moreefficacious than P1.Disclosure of Interest: None declared

Rehabilitation Of Temporomandibular Joint (TMJ) In Patients With Systemic Sclerosis (SSc). A Comparison Between Two Protocols: Preliminary Results

https://flore.unifi.it/bitstream/2158/1060467/1/EULAR14-SCIE-4505-preview-2.pdf

Rehabilitation Of Temporomandibular Joint (TMJ) In Patients With Systemic Sclerosis (SSc). A Comparison Between Two Protocols: Preliminary Results

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