徒手療法と自宅での運動療法がブラキシズム患者の痛み、ストレス、睡眠、生活の質に及ぼす影響：無作為臨床試験

Effects of Manual Therapy and Home Exercise Treatment on Pain, Stress, Sleep, and Life Quality in Patients with Bruxism: A Randomized Clinical Trial.

抄録

:本研究は、徒手療法(MT)とホームエクササイズ(HE)の治療が、ブラキシズム患者の痛み、睡眠の質、ストレスレベル、QOLに及ぼす影響を検討することを目的とした。 : 対象は18～25歳のブラキシズム患者30名で、無作為に徒手療法群(MTG)とホームエクササイズ群(HEG)に分けられた。治療前(T1)に、すべての患者にピッツバーグ睡眠の質指数(PSQI)、知覚ストレス尺度(PSS)、フォンセカ・アナムネスティック指数(FAI)、QOL尺度/ショートフォーム-36(SF-36)を記入してもらい、さらにトリガーポイント数(NTP)と痛みのレベルを測定した。MTとHEは8週間適用され、すべての検査は治療終了時（T2）に繰り返された。T1およびT2における群内比較には対の標本検定を用い、群間比較には独立検定を用いた。統計的有意水準は＜0.05とした。MTとHEで得られた結果を治療8週後に検討したところ、HEGの安静時痛を除くすべてのパラメータ（FAI、PSQI、PSS、SF-36、NTP、活動時痛、夜間痛レベル、＜0.05）で有意差が認められた。群間比較では、PSQI、FAI、NTPで有意差が認められた（＜0.05）。MTとHEはブラキシズム患者の知覚ストレスと痛みの強さを軽減し、QOLと睡眠を改善する。HEは痛みやストレスQOLの点でMTと同等の効果がある。MTは睡眠の質と顎関節症の症状の改善においてHEよりも効果的である。徒手療法とホームエクササイズは、どちらもブラキシズム治療の代替治療法として応用できる。

: This study aimed to examine the effects of manual therapy (MT) and home exercise (HE) treatments on pain, sleep quality, stress level, and quality of life in patients with bruxism. : The study included 30 bruxism patients ages 18-25 years who were randomly divided into the manual therapy group (MTG) and home exercise group (HEG). Before treatment (T1), all patients were asked to fill out the Pittsburgh Sleep Quality Index (PSQI), Perceived Stress Scale (PSS), Fonseca Anamnestic Index (FAI), and Quality of Life Scale/Short Form-36 (SF-36), and additionally, the number of trigger points (NTP) and pain levels were determined. MT and HE were applied for 8 weeks, and all tests were repeated at the end of treatment (T2). A paired-samples test was used for intra-group comparisons at T1 and T2, and an independent test was used for inter-group comparisons. The statistical significance level was accepted as < 0.05. : When the results obtained with MT and HE were examined after 8 weeks of treatment, a significant difference was found for all parameters (FAI, PSQI, PSS, SF-36, NTP, activity pain, and night pain levels, < 0.05) except rest pain in HEG. According to the inter-group comparison, a significant difference was found in PSQI, FAI, and NTP ( < 0.05). However, it was determined that both groups showed statistically similar effects in terms of pain, perceived stress, and quality of life ( > 0.05). : MT and HE reduce perceived stress and pain intensity and also improve quality of life and sleep in patients with bruxism. HE is as effective as MT in terms of pain, stress quality of life. MT is more effective than HE in improving sleep quality and TMD symptoms. Both manual therapy and home exercise applications can be applied as alternative treatment methods in the treatment of bruxism.