A Scoping Review of Physiotherapeutic Interventions for Trismus in Head and Neck Cancer: Where Is the Manual Therapy?

Physiotherapy Canada

Nedeljak, J., Armijo-Olivo, S., et al. (2022).

Physiotherapy Canada, 74(2), 173-183.

This systematic review investigates the effects of interventions for preventing or managing trismus (i.e., manual therapy, jaw-mobilizing devices or tools, or a combination of both) in adults with head and neck cancer.

Not stated

January 2006 to March 2020

Prospective randomized controlled trials (RCTs), controlled trials, or single-group before-and-after studies. Excludes retrospective designs, systematic reviews, and studies with combined interventions (e.g., medication with physiotherapy).

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The following findings were noted regarding interventions targeting trismus in adults with head and neck cancer:<br /> <ul> <li><span style="color: #333333;">Two studies investigating the use of jaw-mobilizing devices to prevent trismus found no benefit in the maximal inter-incisal opening (MIO) of the jaw. A negative impact on patient adherence was reported, which was associated with time burden. </span></li> <li><span style="color: #333333;">Three out of five studies investigating the use of jaw-mobilizing devices for the management of trismus after cancer treatment found statistically significant within-group improvements of MIO. </span></li> <li><span style="color: #333333;">One study found no significant benefit from using a TheraBite compare with tongue depressors. </span></li> <li><span style="color: #333333;">One study found significant benefits from the addition of telephone support to standard care with exercises, masseter muscle self-massage, and tongue depressors. </span></li> </ul> <span style="color: #333333;">The authors of this review conclude that "although the findings of this review support the use of jaw-mobilizing devices to manage trismus, the evidence of this benefit was drawn largely from [non-randomized controlled trials] non-RCTs. No studies were found that examined [manual therapy] MT interventions, and no evidence was found to support using devices to prevent trismus" (p. 181). Additional research is warranted.</span>