Usefulness of posture training for patients: With temporomandibular disorders

Background. Many practitioners have found that posture training has a positive 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 randomized into two groups: one group received posture training and TMD self-management instructions while the control group received TMD self-management instructions only. Four weeks after the study began, the authors reexamined the subjects for changes in symptoms, pain-free opening and pressure algometer pain thresholds. In addition, pretreatment and posttreatment posture measurements were recorded for subjects in the treatment group. Results. Statistically significant improvement was demonstrated by the modified symptom severity index, maximum pain-free opening and pressure algometer threshold measurements, as well as by the subjects' perceived TMD and neck symptoms. Subjects in the treatment group reported having experienced a mean reduction in TMD and neck symptoms of 41.9 and 38.2 percent, respectively, while subjects in the control group reported a mean reduction in these symptoms of 8.1 and 9.3 percent. Within the treatment group, the authors found significant correlations between improvements in TMD symptoms and improvements in neck symptoms (P < .005) as well as between TMD symptom improvement 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 significantly more effective than TMD self-management instructions alone for patients with TMD who have a primary muscle disorder. Practice Implications. Patients with TMD who hold their heads farther forward relative to the shoulders have a high probability of experiencing symptom improvement as a result of posture training and being provided with selfmanagement instructions.