Efficacy of Proprioceptive Neuromuscular Facilitation on Jaw Function in Bruxism Among Post Stroke Survivor: A Case Study

Abstract

A 49-year-old male who was a known case of Type 2 diabetes mellitus and hypertensive had a history of an acute infarct in the left ganglia capsular region and a chronic infarct in the left parieto-occipital lobe, which was conservatively managed and was referred for physiotherapy rehabilitation for strengthening the right upper and lower limb. During the physiotherapy intervention, abnormal teeth grinding was observed, and the patient was asked about parafunctional behaviour.  Upon examination, there was a restriction in the jaw range of motion assessed by measuring the jaw range using the vernier caliper and tightness in the masticatory muscle, as evidenced by palpating the masseter muscle. Proprioceptive neuromuscular facilitation and ultrasound therapy were given for 1 session per week for 2 weeks to treat bruxism along with standardized stroke protocol. At the end of 2 weeks after the intervention, there was an increase in jaw opening and reduced masticatory muscle activity. Jaw opening was measured using a vernier caliper, and masticatory activity was measured using electromyography of the masseter and temporalis muscles. This study suggests the importance of treating bruxism to prevent complications related to it. It concludes that proprioceptive neuromuscular facilitation and ultrasound therapy were effective in improving mouth opening and reducing the masticatory activity in bruxism among stroke patients with ganglia capsular involvement.