Usefulness of posture training for patients with temporomandibular disorders

Background. Many practitioners have found that posture training has a posit ive impact on temporomandibular, or TMD, symptoms. The authors conducted a study to evaluate its effectiveness. Methods. Sixty patients with TMD and a primary muscle disorder were randomi zed into two groups: one group received posture training and TMD self-manag ement instructions while the control group received TMD self-management ins tructions only. Four weeks after the study began, the authors reexamined th e subjects for changes in symptoms, pain-free opening and pressure algomete r pain thresholds. In addition, pretreatment and posttreatment posture meas urements were recorded for subjects in the treatment group. Results. Statistically significant improvement was demonstrated by the modi fied symptom severity index, maximum pain-free opening and pressure algomet er threshold measurements, as well as by the subjects' perceived TMD and ne ck symptoms. Subjects in the treatment group reported having experienced a mean reduction in TR;ID and neck symptoms of 41.9 and 38.2 percent, respect ively, while subjects in the control group reported a mean reduction in the se symptoms of 8.1 and 9.3 percent. Within the treatment group, the authors found significant correlations between improvements in TMD symptoms and im provements in neck symptoms (P <.005) as well as between TMD symptom improv ement and the difference between head and shoulder posture measurements at the outset of treatment (P <.05). Conclusions. Posture training and TMD self-management instructions are sign ificantly more effective than TMD self-management instructions alone for pa tients with TMD who have a primary muscle disorder. Practice Implications. Patients with TMD who hold their heads farther forwa rd relative to the shoulders have a high probability of experiencing sympto m improvement as a result of posture training and being provided with selfm anagement instructions.