BACKGROUND - Cranio-cervical mandibular disorders constitute a multifactorial pathological process that affects the region of the skull, the TMJ and the cervical spine. The assessment of these disorders is based on the Diagnostic Criteria for Temporomandibular Disorders (DC / TMD), published in literature and internationally recognized, which foresees two evaluation axes, one concerning physical evaluation and the other pain evaluation, parafunctions and psychological state. OBJECTIVE - Outline the main features of an assessment protocol for cranial-mandibular and cervical disorders that is simple and easy to use even by those approaching the subject for the first time, but that also leads to specific physiotherapic diagnoses of TMD. MATERIALS AND METHODS - Two assessment forms edited by dr. Bizzarri and dr. Palmerini respectively, were analised. The protocol edited by dr. Bizzarri was used to assess patients referred to the TMD outpatient clinic of the Maxillofacial Surgery ward of Ospedale Riuniti in Torrette. Information and official material on narrative based medicine that presented the patient's agenda tool was researched to understand how this tool could and should be used to benefit the therapist-patient relationship, essential for a successful rehabilitation and therapeutic process. RESULTS - Both the assessment forms edited by dr. Bizzarri and dr. Palmerini are in accordance with the international DC/TMD, but differ from one another on the graphic layout and choices that determine a different affordance level between the different sections of the form. CONCLUSIONS - The best graphic choices that lead to a good understanding of the assessment process and techniques, even by the neophyte, have been identified and the need for patient’s agenda tool to be used for a correct assessment and an effective treatment path for the patient with TMD has been demonstrated.
BACKGROUND - I disordini cranio cervico mandibolari costituiscono un processo patologico multifattoriale che colpisce la regione del cranio, dell’ATM e del rachide cervicale. La valutazione di questi disordini si basa sui Criteri Diagnostici per i Disordini Temporomandibolari (DC/TMD), pubblicati in letteratura e riconosciuti a livello internazionale, che prevedono due assi di valutazione, uno di valutazione fisica e l’altro di valutazione del dolore, delle parafunzioni e dello stato psicologico. OBIETTIVO - Delineare le caratteristiche principali di una scheda di valutazione per i disordini cranio cervico mandibolari che sia semplice e facilmente fruibile anche da chi approccia l’argomento per la prima volta, ma che conduca a fare specifiche diagnosi fisioterapiche dei DTM. MATERIALI E METODI - Sono state analizzate due schede di valutazione redatte dai dottori Bizzarri e Palmerini. Il protocollo del dotto Bizzarri è stato utilizzato per la valutazione dei pazienti afferiti all’ambulatorio dei DTM della S.O.D. Chirurgia Maxillo Facciale di Ospedale Riuniti di Torrette. Si è ricercato materiale informativo e ufficiale sulla medicina narrativa che potesse presentare lo strumento dell’agenda del paziente da utilizzare a beneficio del rapporto terapista-paziente, fondamentale per una buona riuscita del percorso riabilitativo e terapeutico. RISULTATI - Entrambe le schede valutative redatte dai dottori Bizzarri e Palmerini sono in concordanza con i criteri internazionali DC/TMD, ma presentano differenze sull’impostazione grafica che delineano un livello di affordance differente tra le diverse sezioni. CONCLUSIONI - Sono state individuate le impostazioni grafiche migliori per una buona comprensione del processo e delle tecniche valutative anche da parte del neofita, ed è stata sperimentata la necessità dell’utilizzo dello strumento agenda del paziente per una corretta valutazione e un efficace percorso di cura del paziente affetto da DTM.
La valutazione dei disordini cranio cervico mandibolari Appropriatezza diagnostica in fisioterapia Studio OSSERVAZIONALE descrittivo
BALEANI, LUCA
2020/2021
Abstract
BACKGROUND - Cranio-cervical mandibular disorders constitute a multifactorial pathological process that affects the region of the skull, the TMJ and the cervical spine. The assessment of these disorders is based on the Diagnostic Criteria for Temporomandibular Disorders (DC / TMD), published in literature and internationally recognized, which foresees two evaluation axes, one concerning physical evaluation and the other pain evaluation, parafunctions and psychological state. OBJECTIVE - Outline the main features of an assessment protocol for cranial-mandibular and cervical disorders that is simple and easy to use even by those approaching the subject for the first time, but that also leads to specific physiotherapic diagnoses of TMD. MATERIALS AND METHODS - Two assessment forms edited by dr. Bizzarri and dr. Palmerini respectively, were analised. The protocol edited by dr. Bizzarri was used to assess patients referred to the TMD outpatient clinic of the Maxillofacial Surgery ward of Ospedale Riuniti in Torrette. Information and official material on narrative based medicine that presented the patient's agenda tool was researched to understand how this tool could and should be used to benefit the therapist-patient relationship, essential for a successful rehabilitation and therapeutic process. RESULTS - Both the assessment forms edited by dr. Bizzarri and dr. Palmerini are in accordance with the international DC/TMD, but differ from one another on the graphic layout and choices that determine a different affordance level between the different sections of the form. CONCLUSIONS - The best graphic choices that lead to a good understanding of the assessment process and techniques, even by the neophyte, have been identified and the need for patient’s agenda tool to be used for a correct assessment and an effective treatment path for the patient with TMD has been demonstrated.File | Dimensione | Formato | |
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Open Access dal 17/11/2024
Descrizione: studio osservazionale descrittivo sulla valutazione dei DTM per giungere alla diagnosi fisioterapica corretta
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https://hdl.handle.net/20.500.12075/627