Effects of Manual Therapy and Home Exercise Treatment on Pain, Stress, Sleep, and Life Quality in Patients with Bruxism: A Randomized Clinical Trial

Abstract

Background and Objectives: This study aimed to examine the effects of manual therapy (MT) and home exercise (HE) treatments on pain, sleep quality, stress level, and quality of life in patients with bruxism. Materials and Methods: The study included 30 bruxism patients ages 18-25 years who were randomly divided into the manual therapy group (MTG) and home exercise group (HEG). Before treatment (T1), all patients were asked to fill out the Pittsburgh Sleep Quality Index (PSQI), Perceived Stress Scale (PSS), Fonseca Anamnestic Index (FAI), and Quality of Life Scale/Short Form-36 (SF-36), and additionally, the number of trigger points (NTP) and pain levels were determined. MT and HE were applied for 8 weeks, and all tests were repeated at the end of treatment (T2). A paired-samples t test was used for intra-group comparisons at T1 and T2, and an independent t test was used for inter-group comparisons. The statistical significance level was accepted as p < 0.05. Results: When the results obtained with MT and HE were examined after 8 weeks of treatment, a significant difference was found for all parameters (FAI, PSQI, PSS, SF-36, NTP, activity pain, and night pain levels, p < 0.05) except rest pain in HEG. According to the inter-group comparison, a significant difference was found in PSQI, FAI, and NTP (p < 0.05). However, it was determined that both groups showed statistically similar effects in terms of pain, perceived stress, and quality of life (p > 0.05). Conclusions: MT and HE reduce perceived stress and pain intensity and also improve quality of life and sleep in patients with bruxism. HE is as effective as MT in terms of pain, stress quality of life. MT is more effective than HE in improving sleep quality and TMD symptoms. Both manual therapy and home exercise applications can be applied as alternative treatment methods in the treatment of bruxism.