Influence of Symptom Longevity on Outcomes Following a Customized Rehabilitation Program for Painful Temporomandibular Disorders

Purpose: To assess the impact of symptom longevity on functional outcomes, pain and patient perception of recovery following a rehabilitation program for temporomandibular disorders (TMDs) and to determine which variables were associated with improved function. Methods: Forty-eight patients who received TMD rehabilitation in an outpatient setting at a tertiary care facility were divided into acute, subacute and chronic groups based on symptom duration. A customized intervention program was developed for each patient according to assessment results and included the following interventions: manual therapy, neuromuscular re-education, orthotic and other modalities and self-management training. Functional indices, perceived pain and perceived improvement in the CareConnections Outcomes System were measured using a self-report questionnaire at initiation and completion of the therapy program. Results: Within each group, the average functional improvement score and pain score improved significantly from pre-treatment to post-treatment (p ≤ .05). Among the groups, no differences were noted for functional improvement, per cent decrease in pain and patient perception of improvement. In regression analyses, a model with initial pain intensity score (p = .002) and symptom longevity (p = .05) fit the data well and explained 25 per cent of the variance in functional outcome score. Conclusions: Patients with TMD showed improvements in function and pain after a customized rehabilitation program. Baseline pain scores and symptom longevity were highly associated with functional outcomes.