PO:38:281 | Therapeutic exercise in temporomandibular disorders: a scoping review of the literature

Federico Amateis¹, Gabriele Aimini¹, Paolo Mastromarchi¹, Lorenzo Lo Russo¹, Marco Chiodini¹, Roberta Giova Bazzacchi¹, Noemi Corbetta¹, Stefano Salvioli¹.   | <i> ¹Department of Neurosciences, Rehabilitation, Opthalmology, Genetics, Maternal and Child Health, University of Genoa Italy; ³Scuola Universitaria per la Svizzera Italiana, DEASS Manno Switzerland; ⁶Department of Maxillo-Facial Surgery, Santi Paolo e Carlo Hospital, University of Milan Italy; ⁷Department of Neurosciences, Rehabilitation, Opthalmology , Genetics, Maternal and Child Health, University of Genoa Italy; ⁸Department of Neurosciences, Rehabilitation, Opthalmology , Genetics, Maternal and Child Health, University of Genoa Italy. </i>

Background. Temporomandibular disorders (TMD) are musculoskeletal dysfunctions affecting the temporomandibular joint and related structures, leading to pain and functional limitations. The aim of this review is to map the available studies on therapeutic exercise for temporomandibular disorders in the adult population, analyzing rehabilitation strategies, their dosage, and clinical implications.

Materials and Methods. A scoping review was conducted through a literature search in five databases: MEDLINE, EMBASE, CINAHL, PEDro and Cochrane. Primary studies (RCTs, prospective and retrospective studies, case series and case reports) conducted on adults diagnosed with TMD of non-traumatic, non-infectious, non-neoplastic or non-post-surgical origin who underwent therapeutic exercise interventions were included. Study selection and data extraction processes were carried out independently by two reviewers.

Results. A total of 57 studies were included in the review, from which 267 exercises were extracted and organized into functionally homogeneous categories. 76% (204/267) of the identified exercises targeted the orofacial region, particularly mouth opening (50%), lateral movements (13%), and protrusion movements (7%). Motor-control strategies accounted for 20% of the interventions analyzed. Only 19% of the studies provided explicit instructions for pain management during exercise execution. The overall duration of rehabilitation protocols varied across studies, with 68% recommending daily exercises and 89% adopting a multi-session frequency.

Conclusions. The analyzed data indicate that mouth-opening exercises and motor-control exercises are the most commonly used strategies for the rehabilitation of TMD. However, the lack of standardization in terminology and exercise prescription limits the clinical applicability of the findings, particularly regarding their impact on pain management. Future research should focus on developing shared therapeutic strategies to optimize rehabilitation protocols and improve their clinical effectiveness.