Investigation of the effectiveness of telerehabilitation in patients with bruksizm- İnduced temporomandibular joint dysfunction.

This study was conducted to investigate the effectiveness of telerehabilitation on pain and oral behaviors in individuals with temporomandibular joint dysfunction (TMD) with bruxism. 40 individuals between the ages of 18-65 who were diagnosed with TMD and accompanied by bruxism were included in our study. Individuals were randomly divided into two groups telerehabilitation (n=20) and home exercise (n=20). Demographic information, posture, and cervical and temporomandibular joint range of motion were evaluated. In addition, pain severity was determined by the Visual Analogue Scale (VAS) and McGill Pain Questionnaire, neck disability by the Neck Disability Index (BDI), headache by the Headache Impact Test (HIT-6), fatigue by the Fatigue Severity Scale (FSS), sleep quality by the Pittsburgh Sleep Quality Index (PUKI), TMD severity by the Fonseca Questionnaire, oral habits by the Oral Habits Questionnaire (OBC), quality of life by the Oral Health Impact Profile (OHIP-14), and anxiety status by the Trait-State Anxiety Inventory (STAI). Patient education and exercises were taught to both groups after the initial assessment. Both groups were asked to do the exercises every day, three times a day for 8 weeks, and a reminder message was sent to the groups once a week. Individuals in the telerehabilitation group were also given exercises over WhatsApp video once a week for 8 weeks. Measurements were repeated three times, at the beginning of the treatment, in the middle of the treatment (4th week), and after the treatment (8th week). When the in-group activity was examined, it was observed that there was a significant improvement in all periods in all parameters in both groups (p<0.05), and the values in the telerehabilitation group made a significant difference compared to the home exercise program (p<0.05). As a result of the study, it was found that the telerehabilitation group made a significant difference in the treatment of TMD individuals with bruxism compared to the home exercise group on pain, range of motion, fatigue, sleep quality, headache, oral behaviors, anxiety and quality of life (p<0.05). It was concluded that exercise therapy applied with the telerehabilitation model is an alternative for patients with TMD who may not have access to direct care to the clinics for treatment in cases such as the COVID-19 pandemic process. In the future, we may suggest that conducting comparative studies of face-to-face treatment with telerehabilitation methods and investigating the results of longer-term follow-up may increase the value of the study. Key Words: Temporomandibular Joint Dysfunction, Bruxism, Telerehabilitation, Exercise, Education