Effect of Immediate Versus Gradual Exercises Program on Maximum mouth opening Post Temporomandibular Joint Arthroscopy: A randomized controlled trial

Objective. The purpose of this study was to compare two physiotherapy programs for rehabilitation of patients
after temporomandibular joint (TMJ) arthroscopy. Methods: Sixty patients diagnosed with closed lock and treated
with arthroscopic lysis and lavage participated in this study, patients were divided into two groups: Group
A (immediate program): included thirty patients rehabilitated with immediate full range of motion self‑exercises.
Group B (gradual program): included thirty patients rehabilitated with progressively increasing range of motion
self‑exercises. Outcome Measures. Maximum mouth opening (MMO) by measuring distance between the upper
and lower incisors while the patient actively opens the mouth were assessed by Ruler, Pain assessment was done
by using visual analogue scale. The measurements taken by the end of irst month of treatment, analyzed and
compared between the two groups. Results. Statistical analysis showed signi icant improvement in MMO and pain
outcomes for the immediate group than for the gradual group. Conclusion. Based on the obtained results this
study concluded that, a physiotherapy program consisting of immediate postoperative full range of motion
mobilizations achieves better results (in terms of pain and mouth opening) than a physiotherapy program
consisting of gradual and controlled increases in range of motion of closed lock of the TMJ after arthroscopic
treatment.