A preliminary report on the efficacy of a dynamic jaw opening device (dynasplint trismus system) as part of the multimodal treatment of trismus in patients with head and neck cancer Journal Article


Authors: Stubblefield, M. D.; Manfield, L.; Riedel, E. R.
Article Title: A preliminary report on the efficacy of a dynamic jaw opening device (dynasplint trismus system) as part of the multimodal treatment of trismus in patients with head and neck cancer
Abstract: Objective: To examine the effectiveness of a dynamic jaw opening device as part of a multimodal treatment strategy for trismus in patients with head and neck cancer. Design: Retrospective cohort study. Setting: Tertiary care cancer center. Participants: Patients with head and neck cancer and trismus (N=20). Intervention: All patients underwent assessment by a board-certified physiatrist and were referred to physical therapy for delivery of the DTS and instructed to progress use of the DTS to 30 minutes 3 times a day. Additional modalities for the treatment of trismus including pain medications and botulinum toxin injections were prescribed as clinically indicated. Main Outcome Measures: Change in maximal interincisal distance (MID) as documented in the medical record. Results: The use of the DTS as part of multimodal therapy including physical therapy, pain medications, and botulinum toxin injections as deemed clinically appropriate resulted in an overall improvement of the MID from 16.5mm to 23.5mm (P<.001). Patients who could comply with the treatment recommendations for DTS treatment did better than those who could not, with an improvement of the MID from 16mm to 27mm (P<.001) versus 17mm to 22mm (P=.88). Conclusions: The DTS is a safe and effective component of a multimodal strategy for improving trismus associated with head and neck cancer and its treatment. Further investigation is needed to determine the relative efficacy of the treatment modalities available for trismus including physical therapy and other jaw stretching devices. © 2010 American Congress of Rehabilitation Medicine.
Keywords: adult; clinical article; aged; middle aged; retrospective studies; combined modality therapy; quality of life; cohort studies; radiation; opiate; chronic disease; head and neck cancer; head and neck neoplasms; nonsteroid antiinflammatory agent; analgesics; rehabilitation; physiotherapy; trismus; acute disease; analgesic agent; muscle relaxant agent; physical therapy modalities; botulinum toxin; dynamic jaw opening device; orthopedic equipment; botulinum toxins; splints
Journal Title: Archives of Physical Medicine and Rehabilitation
Volume: 91
Issue: 8
ISSN: 0003-9993
Publisher: W.B. Saunders Co.  
Date Published: 2010-08-01
Start Page: 1278
End Page: 1282
Language: English
DOI: 10.1016/j.apmr.2010.05.010
PUBMED: 20684911
PROVIDER: scopus
DOI/URL:
Notes: --- - "Export Date: 20 April 2011" - "CODEN: APMHA" - "Source: Scopus"
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