Page 325 - Demo

Postoperative physiotherapy3231220 minutes before the exercise program to allow the muscles to be as relaxed as possible.(9,14,41) One could also consider the use of cold therapy immediately after the physical exercises; Lin(41) found that the combination of pretreatment heat application and posttreatment cold application yielded better results in total ROM compared with the use of only heat application. It should be noted though that this study evaluated knee motion, so results for the TMJ may be different.Previously performed condylar rotational exercises can be continued because they considerably aid in achieving a symmetrical mouth opening, as was indicated by Oh et al(42) in patients with TMD. Furthermore, performing coordination exercises in front of a mirror can further aid muscle coordination. After drawing a straight vertical line on the mirror, the patient should attempt to keep the midline of the lower jaw on this line when performing exercises with vertical movement. This use of a mirror can also be combined with other exercises, such as active opening and closing or protrusive and retrusive exercises.(43) Fig. 4: Hook-pull exercise: The index finger is hooked in the lower jaw, after which the jaw is opened and gently pulled farther open using the hooked finger.Nikolas de Meurechy NW.indd 323 05-06-2024 10:15