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Treating trismus with dynamic splinting: a cohort, case series
David H Shulman1, Barry Shipman, F Buck Willis
1Shulman & Associates Physical Therapy, Towson, Maryland, USA.
Introduction:
The purpose of this study was to retrospectively evaluate the effect of the Dynasplint Trismus System (DTS; Dynasplint Systems Inc, Severna Park, Md, USA) for patients who were recently diagnosed with trismus following radiation therapy, dental treatment, oral surgery, or following a neural pathology such as a stroke.
Methods:
We reviewed 48 patient histories (treated in 2006--2007), and divided into 4 cohort groups (radiation therapy for head/neck cancer, dental treatment, oral surgery, or stroke), to measure the efficacy of this treatment's modality. Patients were prescribed the DTS after diagnosis of trismus based on examination that showed < 40 mm maximal interincisal distance. The DTS uses low-load, prolonged-duration stretch with replicable, dynamic tension to achieve longer time at end range (of motion). Each patient used this device for 20-30 min, 3 times per d.
Results:
This cohort case series showed that there was a statistically significant difference within all patient groups (P < 0.0001; t = 10.3289), but there was not a significant difference between groups (P = 0.374).
Conclusion:
The biomechanical modality of DTS with a low-load, prolonged-duration stretch was attributed to the success in reducing contracture in this study. This improved range of motion, allowing patients to regain the eating, hygiene and speaking patterns they had before developing trismus.
