Physical therapy for the correction of autonomic dysfunction in women with sleep bruxism during the postpartum period

Abstract

Background. Physical therapy may improve autonomic regulation and indirectly reduce bruxism-associated symptoms in postpartum women. Aim. To evaluate the effectiveness of physical therapy in women with sleep bruxism during the postpartum period by assessing changes in autonomic dysfunction parameters. Materials and Methods. The study included 36 women ([26.0±1.1] years; up to eight weeks postpartum) with sleep bruxism managed using an individualized occlusal splint. The Control Group (n=17) received general recommendations for postpartum recovery. The Experimental Group (n=19) completed a four-week physical therapy program consisting of daily 60-minute sessions, including aerobic and breathing exercises, manual and orofacial interventions, and self-massage. Outcomes were assessed using the Wayne Autonomic Symptom Questionnaire, Kerdo Index, isometric handgrip test, and 24-hour heart rate variability monitoring. Between-group and within-group comparisons were performed using the independent samples and paired Student's t-tests, respectively, in "SPSS" 26.0 (IBM, USA). The study was conducted as part of the research project "Improvement of Functional Status, Quality of Life, and Correction of Pathological Conditions of Various Origins by Means of Therapy and Rehabilitation" (2023–2026) at Vasyl Stefanyk Carpathian National University, state registration No.0123U101534. Research Ethics. The study complied with the principles of the World Medical Association Declaration of Helsinki (1964–2024). Informed consent was obtained from all participants, and the study protocol was approved by the institutional bioethics committee. Results. The total Wayne Autonomic Symptom Questionnaire score decreased by 55.5% in the Experimental Group compared with 21.2% in the Control Group. The Kerdo Index decreased from [2.27±0.09] to [1.33±0.12] in the Experimental Group and from [2.35±0.11] to [1.83±0.15] in the Control Group. In the Experimental Group, low-frequency power decreased by 34.2%, high-frequency power increased by 25.5%, the ratio decreased by 47.5%, and the Baevsky Stress Index decreased by 53.1%. Conclusions. The physical therapy program resulted in statistically significant improvements in autonomic regulation and reductions in subjective manifestations of autonomic dysfunction compared with the use of an occlusal splint during physiological postpartum recovery. Keywords: rehabilitation, dentistry, obstetrics and gynecology, autonomic dysregulation, autonomic nervous system.