Application effect of home-based rehabilitation program led by self-efficacy theory after temporomandibular joint disk repositioning

doi:10.3969/j.issn.1674-8115.2023.05.003

Abstract

Abstract:

Objective ·To explore the effects of home-based rehabilitation program led by self-efficacy theory after temporomandibular joint disk repositioning. Methods ·Convenient sampling method was used. Patients with temporomandibular joint disk displacement who received temporomandibular joint disk repositioning in Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine from August 2020 to January 2021 were selected as the control group, and patients admitted from February 2021 to July 2021 were selected as the intervention group. The control group received the conventional home-based rehabilitation care, while the intervention group were given home-based rehabilitation program led by self-efficacy theory. The general information questionnaire was used to collect the general information about patients. The joint range of motion measuring, rehabilitation exercise compliance questionnaire, General Self-efficacy Scale (GSES), and Mishel's Uncertainty in Illness Scale (MUIS) were used to investigate the joint range of motion, the rehabilitation exercise compliance score, the self-efficacy score and the uncertainty in illness score in the two groups at baseline and at 1, 3 and 6 months after surgery. Results ·A total of 167 patients with temporomandibular joint disk displacement who received temporomandibular joint disk repositioning surgery were enrolled, including 96 cases in the control group and 71 cases in the intervention group. There was no difference in the general information between the two groups (P>0.05). There were no differences in the maximal mouth opening, maximum rightward lateral movement, maximum leftward lateral movement, self-efficacy score and uncertainty in illness score between the two groups at baseline (all P>0.05). The maximal forward extension in the intervention group was significantly less than that in the control group (P=0.008). Repeated measurement variance analysis showed that the self-efficacy scores in the intervention group were higher than those in the control group at 1, 3 and 6 months after surgery, and the differences were statistically significant (P=0.006, P=0.003, P=0.016). At 1 and 3 months after surgery, the scores of complexity dimension of uncertainty in illness in the intervention group were significantly lower than those in the control group (P=0.003, P=0.000). At 1 and 6 months after surgery, the rehabilitation exercise compliance scores in the intervention group were significantly higher than those in the control group (P=0.000, P=0.016). At 6 months after surgery, the maximum forward extension and maximum rightward lateral movement were significantly greater than those in the control group (P=0.024, P=0.008). Conclusion ·The home-based rehabilitation program led by self-efficacy theory has a positive effect on improving the self-efficacy and compliance of rehabilitation exercise, reducing the disease uncertainty, and promoting the joint function recovery in patients receiving temporomandibular joint disk repositioning.

Key words: temporomandibular joint disk repositioning, temporomandibular joint disk displacement, self-efficacy, home-based rehabilitation, uncertainty in illness

CLC Number:

R782.6

YU Leilei, RUAN Hong, XIA Di, HE Meijuan, SUN Mingyuan, ZHENG Jisi. Application effect of home-based rehabilitation program led by self-efficacy theory after temporomandibular joint disk repositioning[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(5): 532-539.

Figures/Tables 4

TrendMD

References 22

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Characteristic variable	Intervention group (n=71)	Control group (n=96)	t/χ² value	P value
Age/year	26.41±9.86	27.36±9.99	0.615	0.539
Gender/n (%)			0.796	0.372
Male	4 (5.6)	9 (9.4)
Female	67 (94.4)	87 (90.6)
Education/n (%)			2.594	0.459
Junior high and below	5 (7.0)	12 (12.5)
Technical secondary school/senior high school	15 (21.1)	20 (20.8)
Junior college	14 (19.7)	12 (12.5)
Tertiary or above	37 (52.1)	52 (54.2)
Marital status/n (%)			0.355	0.551
Married	23 (32.4)	27 (28.1)
Single and others	48 (67.6)	69 (71.9)
Work/n (%)			0.050	0.823
In service	35 (49.3)	49 (51.0)
Not in service	36 (50.7)	47 (49.0)
Monthly household income/n (%)			0.425	0.935
≤3 000 yuan	6 (8.5)	11 (11.5)
3 001~5 000 yuan	24 (33.8)	32 (33.3)
5 001~10 000 yuan	26 (36.6)	33 (34.4)
>10 000 yuan	15 (21.1)	20 (20.8)
Surgery type/n (%)			0.637	0.425
Arthroscope	12 (16.9)	21 (21.9)
Opening anchoring operation	59 (83.1)	75 (78.1)

Characteristic variable	Intervention group (n=71)	Control group (n=96)	t/χ² value	P value
Age/year	26.41±9.86	27.36±9.99	0.615	0.539
Gender/n (%)			0.796	0.372
Male	4 (5.6)	9 (9.4)
Female	67 (94.4)	87 (90.6)
Education/n (%)			2.594	0.459
Junior high and below	5 (7.0)	12 (12.5)
Technical secondary school/senior high school	15 (21.1)	20 (20.8)
Junior college	14 (19.7)	12 (12.5)
Tertiary or above	37 (52.1)	52 (54.2)
Marital status/n (%)			0.355	0.551
Married	23 (32.4)	27 (28.1)
Single and others	48 (67.6)	69 (71.9)
Work/n (%)			0.050	0.823
In service	35 (49.3)	49 (51.0)
Not in service	36 (50.7)	47 (49.0)
Monthly household income/n (%)			0.425	0.935
≤3 000 yuan	6 (8.5)	11 (11.5)
3 001~5 000 yuan	24 (33.8)	32 (33.3)
5 001~10 000 yuan	26 (36.6)	33 (34.4)
>10 000 yuan	15 (21.1)	20 (20.8)
Surgery type/n (%)			0.637	0.425
Arthroscope	12 (16.9)	21 (21.9)
Opening anchoring operation	59 (83.1)	75 (78.1)

Variable	Group	Baseline	Post-operation
Variable	Group	Baseline	1 month	3 months	6 months
Self-efficacy score^①	Intervention group	41.86±9.99	39.56±9.01	42.06±8.99	43.10±12.24
	Control group	39.59±10.06	35.65±8.77	37.78±8.96	39.31±7.82
	F value	2.081	7.886	9.218	5.945
	P value	0.151	0.006	0.003	0.016
Rehabilitation exercise compliance score^②	Intervention group	‒	17.33±2.51	15.90±2.92	17.26±3.07
	Control group	‒	15.55±3.40	16.07±2.80	16.18±2.64
	F value	‒	13.817	0.148	5.888
	P value	‒	0.000	0.701	0.016

Variable	Group	Baseline	Post-operation
Variable	Group	Baseline	1 month	3 months	6 months
Self-efficacy score^①	Intervention group	41.86±9.99	39.56±9.01	42.06±8.99	43.10±12.24
	Control group	39.59±10.06	35.65±8.77	37.78±8.96	39.31±7.82
	F value	2.081	7.886	9.218	5.945
	P value	0.151	0.006	0.003	0.016
Rehabilitation exercise compliance score^②	Intervention group	‒	17.33±2.51	15.90±2.92	17.26±3.07
	Control group	‒	15.55±3.40	16.07±2.80	16.18±2.64
	F value	‒	13.817	0.148	5.888
	P value	‒	0.000	0.701	0.016

Variable	Group	Baseline	Post-operation
Variable	Group	Baseline	1 month	3 months	6 months
Maximal mouth opening^①	Intervention group	32.97±0.98	28.19±0.74	33.16±0.63	36.32±0.73
	Control group	31.69±0.85	27.97±0.63	33.52±0.54	35.25±0.63
	F value	0.984	0.055	0.184	1.048
	P value	0.323	0.815	0.668	0.307
Maximum forward extension^②	Intervention group	4.65±2.15	1.28±1.23	2.61±1.73	3.93±1.92
	Control group	5.78±3.04	1.08±1.23	2.19±1.12	3.30±1.92
	F value	7.205	1.099	3.483	5.191
	P value	0.008	0.296	0.064	0.024
Maximum rightward lateral movement^③	Intervention group	5.76±2.54	3.54±2.28	4.95±2.46	6.20±2.09
	Control group	5.66±3.17	3.26±2.59	4.85±2.06	5.26±2.31
	F value	0.052	0.537	0.081	7.299
	P value	0.820	0.465	0.776	0.008
Maximum leftward lateral movement^④	Intervention group	5.50±3.15	3.07±2.20	4.85±2.18	5.93±2.30
	Control group	5.94±3.32	3.67±3.33	4.94±2.22	5.35±2.20
	F value	0.739	1.739	0.065	2.757
	P value	0.391	0.189	0.799	0.099