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Physical therapy in cancer related vs non-cancer trismus
Demirhan Dıraçoğlu1, Ekin İlke Şen, Sezai Vatansever
1Istanbul Universitesi, Istanbul Tip Fakultesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dali, 34093 Capa, Istanbul, Turkey. demirhan1@yahoo.com.
Objective:
Trismus may be caused by several factors including those related with cancer and non-cancer disorders. The purpose of our study was to explore the effectiveness of physical therapy in cancer related vs non-cancer trismus.
Material And Methods:
Thirty trismus patients who had undergone radiotherapy due to a tumor at the maxillary or nasopharyngeal region (cancer group) and 65 trismus patients with various underlying causes (non-cancer group) were enrolled. Fifteen sessions of physical therapy have been applied to both TMJ regions of the patients. Patients performed active manual stretching and relaxation exercises with the company of a physiotherapist after each physical therapy session.
Results:
Although maximal mouth opening (changing from 17.7±5.4 to 27.4±6.9 mm in non-cancer group and from 10.5±5.6 to 12.8±6.9 mm in cancer group) and VAS values (changing from 58.4±21.5 to 41.8±22.4 mm in non-cancer group and from 68.3±25.7 to 60.3±25.7 mm in cancer group) showed significant improvements in both groups at the end of the physical therapy program (p=0.00); the difference was significantly higher in the non-cancer group (p=0.00). Post-treatment patient global self-assessment was found to be significantly higher in the non-cancer group when compared with the cancer group (p=0.005).
Conclusions:
In summary, combined physical therapy and exercise program appears to be effective in the treatment in both cancer related and non-cancer trismus. But clinical relevance of the results is doubtful and far from satisfying in the patients with cancer related trismus.
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