Background. The progressive resistance exercise (PRE) in Parkinson’s disease trial (PRET-PD) showed that PRE improved the motor signs of PD compared to a modified Fitness Counts (mFC) program. It is unclear how long-term exercise affects physical function in these individuals. Objective. To examine the effects of long-term PRE and mFC on physical function outcome measures in individuals with PD. Methods. A preplanned secondary analysis was conducted using data from the 38 patients with idiopathic PD who completed the PRET-PD trial. Participants were randomized into PRE or mFC groups and exercised 2 days/week up to 24 months. Blinded assessors obtained functional outcomes on and off medication at baseline, 6 and 24 months with the Modified Physical Performance Test, 5 times sit to stand test, Functional Reach Test, Timed Up and Go, Berg Balance Scale, 6 minute walk test (6MWT), and 50-ft walking speed (walk speed). Results. The groups did not differ on any physical function measure at 6 or 24 months (Ps > .1). Across time, all physical function measures improved from baseline to 24 months when tested on medication (Ps < .0001), except for 6MWT (P = .068). Off medication results were similar except that the 6MWT was now significant. Conclusions. Twenty-four months of supervised and structured exercise (either PRE or mFC) is effective at improving functional performance outcomes in individuals with moderate PD. Clinicians should strive to include structured and supervised exercise in the long-term plan of care for individuals with PD.

Studies have highlighted variability and deficiencies in temporomandibular disorders (TMD) predoctoral education, with limited student clinical exposure. However, no research has examined changes following CODA inclusion of TMD instruction in predoctoral curricula. We investigated current scope, instructional modalities, and extent of TMD curricula in U.S. predoctoral dental programs. A 17-item REDCap^TM survey was distributed in September-October 2024 to deans/associate deans of academic affairs at 72 CODA-accredited U.S. predoctoral dental schools, investigating TMD curricula, modalities, and extent. All 33 responding programs (53.2% response rate) included TMD instruction. Formal teaching accounted for 70.6±24.9% of instruction, while patient exposure constituted 22.5±21.0%. Programs dedicated 15.7±7.1 h on average (range 4-34) to TMD instruction . About 25.0% of programs had no board-certified orofacial pain (OFP) specialist on faculty. Instruction was mostly provided by OFP (75.8%), oral medicine specialists (36.4%), prosthodontists (30.3%), and oral surgeons (27.3%). Most programs (87.9%) treated TMD patients, yet 9.1% reported no student clinical exposure to these patients. In programs offering clinical exposure, patient interactions included direct evaluation and treatment (60.6%), rotations in OFP clinics (42.4%), observation (36.4%), or elective courses (3.0%). Management of OFP patients expanded to neuropathic pain (54.5%) and primary headache (33.3%), especially among programs with OFP specialists on faculty. TMD instruction varies widely across responding programs, but recent curricula have expanded instructional hours, broadened scope, and increased opportunities for patient interaction compared to previous reports.

The effect of body posture on movement of the jaw and head has not yet been clearly established. The relationship between jaw and head movement has implications for conditions such as temporomandibular joint disorders which can be associated with neck pain. The purpose of this quasi-experimental study was to examine the effect of starting posture on three-dimensional movement of the jaw and head, and to examine the relationship between head and jaw movement during mouth opening.

Purpose: The purpose of this study is to explore the diagnostic accuracy and clinical utility of an examination by a physical therapist using a clinical patient population for diagnosing a specific sub-type of disc displacement (DDWoR wLO) compared to the imaged disc position. Methods: Data from 46 patients with a clinical diagnosis of DDWoR wLO (92 clinical examinations and MRI records) were collected. Clinical diagnosis was made based on predefined diagnostic criteria, and the MRI diagnosis was made based on the MRI radiology report obtained from the dental provider. A McNemar test was used to determine whether the outcomes of the clinical and MRI diagnoses differed significantly, and sensitivity, specificity, likelihood ratios, predicative values, 95% confidence intervals, and the overall diagnostic accuracy were computed. Results: There was high sensitivity (85%), moderate but unacceptable specificity (73%), and acceptable overall diagnostic accuracy (80%) for using predefined criteria in the diagnosis of DDWoR wLO. The likelihood ratios and predictive values supported the clinical utility of the criteria used for diagnosing DDWoR wLO. Conclusion: This is the first study to characterize diagnostic accuracy by a physical therapist of a specific sub-type of TMD in a clinical patient population rather than a research based population. The results suggest that while sensitivity and the overall diagnostic accuracy were acceptable, specificity was lower than acceptable and these findings are discussed in relation to clinical utility of using diagnostic criteria in a clinical setting against a gold standard of MRI.