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Postoperative physiotherapy30712Table 3. Physiotherapy protocol, start and stop, and evaluation.Study (year) Physiotherapy protocol Start of physiotherapy Stop of physiotherapy EvaluationAustin & Shupe(1993) (12) Control group: No protocol was used ROM measured at 1 and 8 weeks after surgeryTreatment group: 3 phases 5 - 7 days after surgery 8 weeks after surgery As abovePhase 1 (days 7-14 after surgery): mobilization–gentle distraction; forced opening 3 times/day with scissor exercises (3×5 reps with 10-sec holding); oral educationROM, pain relief, swellingPhase 2 (days 14-21 after surgery): previous exercises; mobilization–distraction and (pain-free) translation; forced lateral movement exercises (1×5 reps with 10-sec holding, 3 times/day); isometric exercises–passive stretch (1×5 reps with lateral and opening contractions with 10-sec holding, 3 times/day); oral educationROM, pain relief, swellingPhase 3 (days 21-28 after surgery): previous exercises; mobilization–distraction, lateral, and anterior; forced opening exercises (2-3 min, 3 times/day); jetting exercise (1×15 reps, 3 times/day); oral educationROMBraun (1987) (13) Control group: No protocol was used MIO and pain measured within 1 month after surgery and during the last follow-up appointment, within 1 year after surgeryTreatment group: superficial heat; ultrasound; ROM and mobilization techniques1 week after surgery (Minimum of 6 months of home therapy) ROM of at least 35 mm; significant reduction in pain; no change in pain and ROM for 4 treatmentsMIO and pain measured at first physical therapy appointment and last follow-up appointment, within 1 year after surgeryCapan et al. (2017) (14) Control group: 30-min sessions at home, 7 days/week for 8 weeksWithin 24 hours after surgery 8 weeks after surgery MMO, protrusion, and right and left lateral movement were measured before surgery and 2 m after surgery; pain was evaluated using a VAS score (1-10) and QoL was measured using several parameters, such as feelings of depression and quality of sleepTreatment group: 4 phases with 30-min session, 3 days/week for 8 weeks, supervised by a physiotherapist + 30-min session at home 4 days/week Within 24 hours after surgery 8 weeks after surgery As abovePhase 1 (days 1-7 after surgery): posture exercises; active rotation exercises (1×20 reps, 3 times/day); mouth-opening exercises (1×20 reps, 3 times/day); oral education, liquid diet, cold applicationPhase 2 (days 7-30 after surgery): posture exercises; controlled rotational movement exercises; opening and closing exercises; active assistive self-stretching (stimulating MMO); self,mobilization; soft diet, heat application, massagePhase 3 (weeks 4-6 after surgery): forced, fully active exercise (MMO stimulation with spatula); strengthening and endurance exercise; active resistance exercise to opposite side; soft diet, massagePhase 4 (weeks 6-8 after surgery): coordination exercises by opening and closing in front of mirror; all of the aboveNikolas de Meurechy NW.indd 307 05-06-2024 10:15