Abstract | OBJECTIVE: CASE REPORT: A 78-year-old woman with bilateral spasticity of the masseteric regions for 2 years was referred for physiotherapy. She had trismus and bruxism, and could neither close nor open her mouth normally; thus, she was unable to be fed orally in a normal manner. INTERVENTION AND OUTCOME: The patient underwent combined treatment with BoNT-A and cervical spine manual therapy. A medical physician (neurologist) performed the BoNT-A injections into 2 points at the center of the lower third of the masseter muscle. A physical therapist performed manual therapy interventions targeted at the cervical spine. Manual therapy started the day after the BoNT-A injection and continued for 5 sessions per week for a total period of 2 weeks. Clinical outcomes were measured including spasticity (Modified Ashworth Scale), functionality (Barthel Index), and jaw opening. Outcomes were conducted at baseline, 2 weeks after treatment, and at 2-month follow-up session after finishing the treatment. The patient improved in all of the outcomes at the end of treatment, and these results were maintained during the follow-up. After treatment, the patient was able to feed with minimal caregiver dependency because oral feeding was possible. CONCLUSION: The patient in this study responded positively to a combination of BoNT-A and manual therapy, resulting in decreased masseter muscles spasticity and improved trismus and bruxism.
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Authors | Jorge H Villafañe, Cesar Fernandez-de-Las-Peñas, Paolo Pillastrini |
Journal | Journal of chiropractic medicine
(J Chiropr Med)
Vol. 11
Issue 4
Pg. 280-5
(Dec 2012)
ISSN: 1556-3707 [Print] United States |
PMID | 23843761
(Publication Type: Journal Article)
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