Assessment of Selected Physiotherapeutic Methods in the Rehabilitation of Temporomandibular Disorders

Arm 1: Manual therapy + occlusal splint Brief name: Manual therapy combined with an occlusal relaxation splint Occlusal splint: A custom-made appliance made of synthetic material. It is most often used at night to reduce abnormal muscle activity, protect teeth from bruxism, and stabilize the temporomandibular joints. Manual therapy techniques: Gentle mobilization and soft tissue techniques (stretching, trigger points pressing) applied to the temporomandibular joints and masticatory muscles to reduce tension, improve joint mobility, and relieve pain. Description: Participants will receive a combination of manual therapy techniques and an individually fitted occlusal relaxation splint. Materials: Custom-made occlusal splint; printed instructions for self-guided home exercises.. Procedures: Manual therapy techniques include temporomandibular joint mobilization, soft tissue techniques, and stretching of masticatory muscles. Support activities: Participants will be instructed to perform daily home exercises targeting jaw stabilization and motor pattern re-education. Providers: Certified physiotherapists with a minimum of 10 years of clinical experience in orofacial physiotherapy. Mode of delivery: Individual, in-person sessions at a physiotherapy clinic. Schedule: 10 treatment sessions over 5 weeks (2 sessions per week, 45 minutes each); daily home exercises. Location: Physiotherapy and Stomatognathic Clinic, Urzednicza Street 26/2, 33-332 Krakow, Poland. Personalisation: Treatment intensity may be adapted based on individual tolerance and progress. Adherence and fidelity: Attendance logs will be maintained; home exercise adherence self-reported; regular patient check-ins used to promote compliance. Arm 2: Post-isometric relaxation (PIR) + occlusal splint Brief name: Post-isometric relaxation (PIR) techniques combined with an occlusal relaxation splint Occlusal splint: A custom-made appliance made of synthetic material. It is most often used at night to reduce abnormal muscle activity, protect teeth from bruxism, and stabilize the temporomandibular joints. Post-isometric relaxation: A muscle energy technique in which the patient performs a gentle isometric contraction against resistance, followed by relaxation and passive stretching of the masticatory muscles to decrease muscle tone and improve flexibility. Description: Participants in this group will receive PIR techniques targeting masticatory muscles, combined with the use of an individually fitted occlusal splint. Materials: Custom-made occlusal splint; printed instructions for self-guided home exercises. Procedures: PIR techniques aim to reduce muscle tension and improve joint mobility. Support activities: Participants will be instructed to perform daily home exercises targeting jaw stabilization and motor pattern re-education. Providers: Certified physiotherapists with a minimum of 10 years of clinical experience in orofacial physiotherapy. Mode of delivery: Individual, in-person sessions at a physiotherapy clinic. Schedule: 10 sessions over 5 weeks (2 per week, 45 minutes each); daily home exercise routine. Location: Physiotherapy and Stomatognathic Clinic, Urzednicza Street 26/2, 33-332 Krakow, Poland . Personalisation: Treatment intensity may be adapted based on individual tolerance and progress. Adherence and fidelity: Attendance logs will be maintained; home exercise adherence self-reported; regular patient check-ins used to promote compliance.