Physiotherapeutic methods of treatment of mandibular distal occlusion and the progress of therapy: A case report.

BACKGROUND: Studies have demonstrated a relationship between dental malocclusion and posture defects. The aims of the study were to present (1) the effect of a physiotherapeutic approach to a patient with a distal occlusion defect with the use of a set of exercises to strengthen the muscles responsible for mandibular protrusion, and (2) a non-invasive and easy-to-use method to monitor the effects of therapy. METHODS: Five year old girl with a distal occlusion and with a low basic postural tone was referred to physiotherapy. A therapeutic program i.a. concerning a strengthening of the temporomandibular joint muscles with the use of a flexible tape was proposed. To assess the functional changes of the masticatory apparatus a photoanthropometric method was used. In side-face photos, proportions of 2 linear measurements and values of two angles on the first day of therapy, after 2 and after 4 months of exercises, with the mandible located freely and in the maximum protrusion were compared. RESULTS: A comparison of indices and angles showed a marked improvement in mandibular mobility already after two and four months of the exercises. Using the elastic resistance tape in addition to general developmental exercises allowed for increasing the mobility in the temporomandibular joint. CONCLUSION: Malocclusion should not be considered separately, without taking into account the body posture. The work of the physiotherapist can benefit the orthodontist, correcting postural defects and consequently affecting malocclusion. A comparison of linear measurements and angles can be used to assess the progress of the therapy.

Influence of neurophysiological hippotherapy on the transference of the centre of gravity among children with cerebral palsy.

BACKGROUND: The aim of the study was to present the influence of neurophysiological hippotherapy on the transference of the centre of gravity (COG) among children with cerebral palsy (CP). MATERIAL AND METHODS: The study involved 19 children aged 4-13 years suffering from CP who demonstrated an asymmetric (A/P) model of compensation. Body balance was studied with the Cosmogamma Balance Platform. An examination on this platform was performed before and after a session of neurophysiological hippotherapy. In order to compare the correlations and differences between the examinations, the results were analysed using Student's T-test for dependent samples at p ≤ 0.05 as the level of statistical significance and descriptive statistics were calculated. RESULTS: The mean value of the body's centre of gravity in the frontal plane (COG X) was 18.33 (mm) during the first examination, changing by 21.84 (mm) after neurophysiological hippotherapy towards deloading of the antigravity lower limb (p ≤ 0.0001). The other stabilographic parameters increased; however, only the change in average speed of antero - posterior COG oscillation was statistically significant (p = 0.0354). CONCLUSION: 1. One session of neurophysiological hippotherapy induced statistically significant changes in the position of the centre of gravity in the body in the frontal plane and the average speed of COG oscillation in the sagittal plane among CP children demonstrating an asymmetric model of compensation (A/P).