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[영문] 케이스스터디 턱관절 장애 치료 Case study Temporomandibular joint dysfunction treatment

캐나다에서 도수치료 공부를 하며 썼던 케이스 스터디 졸업논문입니다. 턱관절 장애에 대한 정보, 치료방법, 그리고 결과가 APA 포맷으로 사진과 데이터로 첨부되어있습니다.
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[영문] 케이스스터디 턱관절 장애 치료 Case study Temporomandibular joint dysfunction treatment
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    소개

    캐나다에서 도수치료 공부를 하며 썼던 케이스 스터디 졸업논문입니다.

    턱관절 장애에 대한 정보, 치료방법, 그리고 결과가 APA 포맷으로 사진과 데이터로 첨부되어있습니다.

    목차

    1.Abstract3
    2.Introduction4
    3.Definition and Pathophysiology5
    4.Cause6
    5.Sign and symptoms7
    6.Types of Treatment7
    7.Prognosis9
    8.Massage Research9
    9.Patient’s profile10
    10.Baseline10
    11.Contraindication and precaution12
    12.Management Plan13
    13.Treatment16
    14.Reassessment21
    15.Result22
    16.Pictures of Range of posture25
    17.Factors affecting the research27
    18.Conclusion28
    19.References30
    20.Appendix33

    본문내용

    Abstract
    Background: According to Rattray and Ludwig (2000), there are several synonyms for temporomandibular joint dysfunction, including temporomandibular disorder, temporomandibular joint pain dysfunction syndrome, and temporomandibular joint syndrome. Cady Fox (1995) suggests that TMJ dysfunction is caused by a combination of factors, including a predisposition to TMJ problems, dysfunction of the masticatory muscles and articular disc, and psychosocial factors such as stress, with tooth loss and malocclusion playing a secondary role. This case study aims to demonstrate the effectiveness of massage therapy for a 33-year-old female with temporomandibular joint dysfunction, whose primary symptoms include jaw pain, decreased range of motion, stiffness, and clicking. The patient reported that the symptoms were caused by bruxism, emotional stress, and enjoying tough steaks.

    <중 략>

    Conclusion: Temporomandibular joint dysfunction, or TMJ dysfunction, is a condition that can be effectively treated through manual therapies such as massage and physiotherapy. Despite the absence of a definitive cure for TMJ dysfunction, massage therapy has been shown to have a positive impact on the relief of symptoms. In the present case study, the treatment goals were accomplished by relying on outcome markers and the patient's feedback. While the patient reported a high degree of satisfaction with the treatment, including a reduction in symptoms and improved range of motion, more comprehensive studies that incorporate additional variables are needed to fully assess the effects of massage therapy.

    Keywords: temporomandibular joint, intraoral, TMJ dysfunction, stress, jaw pain, bruxism, Myofascial Release (MFR), Massage Therapy, Homecare, McGill Pain Questionnaire, Numeric Pain Scale.

    참고자료

    · Tanaka, E., Detamore, M. S., &amp; Mercuri, L. G. (2008). Degenerative disorders of the temporomandibular joint: Etiology, diagnosis, and treatment. Journal of Dental Research, 87(4), 296–307. https://doi.org/10.1177/154*************06
    · Wieckiewicz, M., Boening, K., Wiland, P., Shiau, Y.-Y., &amp; Paradowska-Stolarz, A. (2015). Reported concepts for the treatment modalities and pain management of temporomandibular disorders. The Journal of Headache and Pain, 16(1). https://doi.org/10.1186/s10194-015-0586-5
    · Pierson, MT, M. J. (2011). Changes in temporomandibular joint dysfunction symptoms following massage therapy: A case report. International Journal of Therapeutic Massage &amp; Bodywork: Research, Education, &amp; Practice, 4(4). https://doi.org/10.3822/ijtmb.v4i4.110
    · Ingawalé, S., &amp; Goswami, T. (2009). Temporomandibular joint: Disorders, treatments, and Biomechanics. Annals of Biomedical Engineering, 37(5), 976–996. https://doi.org/10.1007/s10439-009-9659-4
    · Rattray, F. S., &amp; Ludwig, L. (2000). Clinical massage therapy: Understanding, assessing and treating over 70 conditions. W. Ross MacDonald School Resource Services Library.
    · Lewis M, Prashar A, Toms A, Armon M, Malcolm P. The diagnosis of thoracic outlet syndrome. Journal of Vascular Diagnostics and Interventions. 2014;2:113-120 https://doi.org/10.2147/JVD.S47387
    · Magee, D. J. (2008). Musculoskeletal Rehabilitation Series: Orthopedic physical Assessment. Fifth Edition. St. Louis, Missouri: Saunders Elsevier
    · Rattray, F. S., Ludwig, L. M. (2000). Clinical Massage Therapy: Understanding, Assessment and Treating over 70 Conditions. Elora, Ontario: Talus Incorporated
    · Wakefield M. L. (2014). Case report: the effects of massage therapy on a woman with thoracic outlet syndrome. International journal of therapeutic massage & bodywork, 7(4), 7–14. https://doi.org/10.3822/ijtmb.v7i4.221
    · Weinberg, S., & Lapointe, H. (1987). Cervical extension-flexion injury (whiplash) and internal derangement of the temporomandibular joint. Journal of oral and maxillofacial surgery, 45(8), 653-656.
    · Köhler, A. A., Nydell Helkimo, A., Magnusson, T., & Hugoson, A. (2009). Prevalence of symptoms and signs indicative of temporomandibular disorders in children and adolescents. A cross-sectional epidemiological investigation covering two decades. European archives of paediatric dentistry, 10(1), 16-25.
    · Feteih, R. M. (2006). Signs and symptoms of temporomandibular disorders and oral parafunctions in urban Saudi Arabian adolescents: a research report. Head & face medicine, 2(1), 1-7.
    · Dionne RA (2006). Pharmacologic approaches. In: TMDs, an evidencebased approach to diagnosis and treatment. Laskin DM, Greene CS, Hylander WL, editors. Chicago: Quintessence, pp. 347-357.
    · Clark GT (1984). A critical evaluation of orthopedic interocclusal appliance therapy: design, therapy, and overall effectiveness. J Am Dent Assoc 108:359-364.
    · De Laat A, Stappaerts K, Papy S (2003). Counseling and physical therapy as treatment for myofascial pain of the masticatory system. J Orofac Pain 17:42-49.
    · Bhat, S. (2010). Etiology of temporomandibular disorders: the journey so far. Int Dent SA, 12(4), 88-92.
    · Cady, Roger K., and Anthony W Fox. 1995. Treating the Headache Patient. New York: Marcel Dekker
    ·  
  • AI와 토픽 톺아보기

    • 1. Temporomandibular joint dysfunction
      Temporomandibular joint (TMJ) dysfunction is a complex condition that affects the jaw joint and surrounding muscles. It can cause a range of symptoms, including pain, clicking or popping sounds, limited jaw movement, and headaches. The causes of TMJ dysfunction are multifactorial, often involving a combination of factors such as stress, injury, teeth grinding, and structural abnormalities. Effective management of TMJ dysfunction requires a comprehensive approach that addresses the underlying causes and provides relief for the symptoms. Treatment options may include physical therapy, medication, splint therapy, and in some cases, surgical intervention. Understanding the complexities of TMJ dysfunction and the various treatment approaches is crucial for healthcare professionals to provide effective care for patients suffering from this condition.
    • 2. Massage therapy for TMJ dysfunction
      Massage therapy can be a valuable component of a comprehensive treatment plan for TMJ dysfunction. By targeting the muscles and soft tissues surrounding the temporomandibular joint, massage can help to reduce muscle tension, improve range of motion, and alleviate pain. Specific massage techniques, such as trigger point therapy, myofascial release, and deep tissue massage, have been shown to be effective in managing TMJ symptoms. Additionally, massage can help to reduce stress and promote relaxation, which can further contribute to the management of TMJ dysfunction. However, it is important to note that massage therapy should be used in conjunction with other treatment modalities, such as physical therapy, dental interventions, and stress management, to achieve optimal outcomes. The effectiveness of massage therapy for TMJ dysfunction may also depend on the severity of the condition, the individual's response to treatment, and the skill and expertise of the massage therapist.
    • 3. Case study on massage therapy for TMJ dysfunction
      Case studies can provide valuable insights into the potential benefits of massage therapy for individuals with TMJ dysfunction. These studies often involve a detailed examination of a patient's history, symptoms, and response to treatment, allowing healthcare professionals to better understand the specific factors that contribute to the effectiveness of massage therapy in managing TMJ dysfunction. Case studies may explore the use of various massage techniques, the frequency and duration of treatment, and the integration of massage with other interventions, such as physical therapy or dental treatments. By analyzing the outcomes of these case studies, healthcare providers can gain a deeper understanding of the role of massage therapy in the management of TMJ dysfunction and identify best practices for incorporating it into a comprehensive treatment plan. While case studies may not provide definitive evidence, they can serve as a valuable complement to larger-scale research and help to inform clinical decision-making for healthcare professionals working with patients with TMJ dysfunction.
    • 4. Causes of TMJ dysfunction
      The causes of temporomandibular joint (TMJ) dysfunction are multifactorial and can involve a combination of physical, psychological, and environmental factors. Some of the primary causes of TMJ dysfunction include: 1. Trauma or injury to the jaw, such as from a car accident, sports injury, or dental procedure. 2. Teeth grinding (bruxism) and clenching, which can put excessive stress on the TMJ. 3. Stress and anxiety, which can lead to muscle tension and increased jaw clenching. 4. Structural abnormalities in the TMJ, such as misalignment or arthritis. 5. Certain medical conditions, such as rheumatoid arthritis or fibromyalgia, that can affect the TMJ. 6. Poor posture and muscle imbalances in the neck and shoulder region, which can contribute to TMJ dysfunction. Understanding the underlying causes of TMJ dysfunction is crucial for developing an effective treatment plan. Healthcare professionals must carefully assess each patient's unique circumstances and tailor the treatment approach accordingly, which may involve a combination of physical therapy, dental interventions, stress management, and other modalities.
    • 5. Symptoms of TMJ dysfunction
      Temporomandibular joint (TMJ) dysfunction can manifest a wide range of symptoms, which can vary in severity and impact on an individual's quality of life. Some of the most common symptoms of TMJ dysfunction include: 1. Pain or discomfort in the jaw, face, neck, or shoulders, especially when chewing, yawning, or speaking. 2. Clicking, popping, or grinding sounds in the TMJ. 3. Limited range of motion or locking of the jaw. 4. Headaches, migraines, or earaches. 5. Dizziness or vertigo. 6. Tinnitus (ringing in the ears). 7. Difficulty swallowing or opening the mouth wide. 8. Tooth sensitivity or pain. 9. Facial muscle spasms or tension. 10. Sleep disturbances, such as sleep apnea or bruxism (teeth grinding). The severity and combination of these symptoms can significantly impact an individual's daily activities, social interactions, and overall quality of life. Accurate diagnosis and comprehensive management of TMJ dysfunction are essential to provide effective relief and improve the patient's well-being.
    • 6. Treatment approaches for TMJ dysfunction
      The treatment of temporomandibular joint (TMJ) dysfunction typically involves a multidisciplinary approach that addresses the underlying causes and provides relief for the symptoms. Some of the common treatment approaches for TMJ dysfunction include: 1. Conservative, non-invasive treatments: - Oral splint or bite guard therapy to reduce teeth grinding and clenching - Physical therapy, including massage, stretching, and exercises to improve joint mobility and muscle function - Stress management techniques, such as relaxation exercises, biofeedback, and cognitive-behavioral therapy - Medication, such as anti-inflammatory drugs, muscle relaxants, or pain relievers, to manage pain and inflammation 2. Dental interventions: - Occlusal adjustments or bite corrections to improve the alignment of the jaw - Orthodontic treatment to address structural abnormalities or malocclusion - Restorative dental work, such as crowns or fillings, to correct uneven bite patterns 3. Surgical treatments (in severe or refractory cases): - Arthrocentesis or arthroscopy to remove debris or adhesions within the TMJ - Joint replacement or reconstruction surgery to address structural abnormalities or degenerative changes The choice of treatment approach depends on the individual's specific needs, the severity of the condition, and the healthcare provider's expertise. A comprehensive evaluation and a collaborative, multidisciplinary approach are essential for effectively managing TMJ dysfunction and improving the patient's quality of life.
    • 7. Prognosis for TMJ dysfunction
      The prognosis for temporomandibular joint (TMJ) dysfunction can vary depending on several factors, including the underlying cause, the severity of the condition, and the effectiveness of the treatment approach. In general, the prognosis for TMJ dysfunction is favorable, especially when the condition is identified and treated early. With appropriate and comprehensive management, many individuals with TMJ dysfunction can experience significant improvement in their symptoms and a return to normal function. Factors that can influence the prognosis for TMJ dysfunction include: 1. Cause of the condition: Conditions with a clear, identifiable cause, such as trauma or structural abnormalities, may have a better prognosis than those with more complex, multifactorial causes. 2. Severity of symptoms: Individuals with mild to moderate symptoms tend to have a better prognosis than those with severe, debilitating pain and dysfunction. 3. Adherence to treatment: Patients who actively engage in and adhere to their prescribed treatment plan, including physical therapy, dental interventions, and lifestyle modifications, often experience more favorable outcomes. 4. Comorbidities: Underlying medical conditions, such as arthritis or fibromyalgia, can complicate the management of TMJ dysfunction and may negatively impact the prognosis. 5. Psychological factors: Stress, anxiety, and depression can influence the perception of pain and the overall management of TMJ dysfunction. With a comprehensive, multidisciplinary approach and ongoing monitoring, many individuals with TMJ dysfunction can achieve significant improvement in their symptoms and quality of life. However, in some cases, the condition may become chronic or recurrent, requiring long-term management and adaptations to the individual's lifestyle and daily activities.
    • 8. Homecare recommendations for TMJ dysfunction
      Effective management of temporomandibular joint (TMJ) dysfunction often requires a combination of professional treatment and self-care strategies. Homecare recommendations for individuals with TMJ dysfunction may include: 1. Jaw exercises and stretches: Performing gentle jaw exercises and stretches can help improve range of motion, reduce muscle tension, and promote joint mobility. These exercises should be tailored to the individual's needs and performed under the guidance of a healthcare professional. 2. Applying heat or cold therapy: Applying a warm compress or ice pack to the jaw area can help alleviate pain and reduce inflammation. 3. Stress management techniques: Practicing relaxation techniques, such as deep breathing, meditation, or yoga, can help reduce muscle tension and stress, which can contribute to TMJ dysfunction. 4. Dietary modifications: Avoiding hard, crunchy, or chewy foods that require extensive chewing can help reduce strain on the TMJ. Opting for softer, easier-to-chew foods may provide relief. 5. Proper posture and body mechanics: Maintaining good posture, especially when sitting or using electronic devices, can help reduce strain on the neck and jaw muscles. 6. Nightguard or splint use: Wearing a custom-fitted nightguard or splint can help prevent teeth grinding and clenching, which can contribute to TMJ dysfunction. 7. Massage and self-care techniques: Gently massaging the jaw, neck, and shoulder muscles can help alleviate tension and discomfort. 8. Avoiding habits that may exacerbate symptoms: This may include limiting yawning, chewing gum, or clenching the teeth. Incorporating these homecare strategies, in conjunction with professional treatment, can empower individuals with TMJ dysfunction to actively participate in their own recovery and management of the condition. Regular communication with healthcare providers is essential to ensure the effectiveness of the homecare plan and make any necessary adjustments.
    • 9. Factors affecting the effectiveness of massage therapy for TMJ dysfunction
      The effectiveness of massage therapy for temporomandibular joint (TMJ) dysfunction can be influenced by several factors, including: 1. Massage technique and expertise: The specific massage techniques used, as well as the skill and experience of the massage therapist, can significantly impact the effectiveness of the treatment. Techniques such as trigger point therapy, myofascial release, and deep tissue massage have been shown to be particularly beneficial for TMJ dysfunction. 2. Frequency and duration of treatment: Regular, consistent massage therapy sessions over an extended period are often necessary to achieve optimal results. The frequency and duration of treatment may need to be adjusted based on the individual's response and the severity of their condition. 3. Underlying causes and comorbidities: The effectiveness of massage therapy may be influenced by the underlying causes of TMJ dysfunction, such as trauma, structural abnormalities, or associated medical conditions. Addressing these underlying factors in conjunction with massage therapy can enhance the overall treatment outcomes. 4. Patient compliance and engagement: The patient's willingness to actively participate in the treatment plan, including following any recommended home exercises or self-care strategies, can significantly impact the effectiveness of massage therapy. 5. Integration with other treatment modalities: Massage therapy is often most effective when used as part of a comprehensive, multidisciplinary approach that includes other interventions, such as physical therapy, dental treatments, and stress management techniques. 6. Individual response and pain perception: Individuals may respond differently to massage therapy, and their perception of pain and discomfort can influence the perceived effectiveness of the treatment. By considering these factors and tailoring the massage therapy approach to the individual's needs, healthcare professionals can optimize the effectiveness of this modality in the management of TMJ dysfunction. Regular communication with the patient and ongoing evaluation of the treatment plan are essential to ensure the best possible outcomes.
    • 10. Conclusion on the effectiveness of massage therapy for TMJ dysfunction
      In conclusion, massage therapy can be a valuable component of a comprehensive treatment plan for temporomandibular joint (TMJ) dysfunction. When used in conjunction with other interventions, such as physical therapy, dental treatments, and stress management techniques, massage therapy has been shown to be effective in reducing pain, improving range of motion, and enhancing overall function in individuals with TMJ dysfunction. The effectiveness of massage therapy for TMJ dysfunction can be influenced by several factors, including the specific massage techniques used, the frequency and duration of treatment, the underlying causes and comorbidities, the patient's compliance and engagement, and the integration of massage therapy with other modalities. Healthcare professionals should carefully assess each patient's unique circumstances and tailor the treatment approach accordingly. Regular communication with the patient, ongoing evaluation of the treatment plan, and a multidisciplinary approach are essential to ensure the best possible outcomes for individuals with TMJ dysfunction. While more research is needed to fully understand the long-term benefits and optimal treatment protocols for massage therapy in the management of TMJ dysfunction, the available evidence suggests that it can be a valuable tool in improving the quality of life for those affected by this complex and often debilitating condition.
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