Temporomandibular Joint Disorders
Conditions
Brief summary
Temporomandibular joint dysfunction (TMJD) is an important health problem that occurs approximately in 22 to 35 percent of adults, different physiotherapy methods are reported as treatment options for management of TMJD. Although that, there is no previous studies about the efficacy of PNF exercises in treatment of TMJD in patients with forward head posture. So, the purpose of the present double-blind, randomized, controlled trial is to investigate the efficacy of PNF exercises in treatment of TMJD in patients with forward head posture.
Interventions
PNF exercises will be done for Masseter, Temporalis, Lateral pterygoid and medial pterygoid muscles. Each contraction will be held for 10 seconds, and each stretch (relaxation phase) will be allowed to continue as long as the muscle tension continued to give away.
* Ultrasound: Continuous ultrasound at 1MHZ to temporomandibular joint at 1.0-1.25 W/CM2 for 5 min over each affected TMJ and masseter area, with the mouth in a slightly open position. * Forward head posture correction exercises including: chin tuck exercise, Strengthening shoulder retractors, stretching of sternocleidomastoid muscle, and Stretching of pectoralis muscle.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* Patients of both genders of age between 20-40 years * having symptoms of TMD for at least six weeks duration established by an expert physician or orthopaedician * having forward head posture with CVA \< 53 * pain over TMJ between 3 to 6 on NPRS * mouth opening \< 25mm.
Exclusion criteria
Patients will be excluded if they exhibited any of the following criteria: * TMJ fracture undergone any surgical procedure for TMJ * Fracture surrounding TMJ * Dislocation or subluxation of TMJ * systemic generalized joint diseases, such as rheumatoid arthritis, and osteoporosis, congenital diseases, or facial paralysis * recently any dental treatment is taken or surgery over TMJ * hematological cervical disorders which may affect the jaw * Neurological deficits e.g. Bells palsy, Trigeminal neuralgia. * Recent infections (within the last six months) affecting the head and neck e.g. bone infections, meningitis, encephalitis, malaria, ear infection * Participants who were using any functional appliances e.g. dentures, braces, bite appliances which had been adjusted or fitted in the last 12 weeks prior to the commencement of this study * DDwR, DDwoR * Patients were excluded from the study if they were receiving any other form of treatment for their TMJ dysfunction.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pressure Pain Threshold | change from base line at 6 weeks. | A pressure algometer will be used for the objective measurement of the PPT. The algometer was pressed on the masseter, temporalis muscles until the patient feel pain. The unit of measurement will be in kg/cm2, and three measurements will be taken every 30 seconds. The average of the three consecutive measurements will be taken as the final value. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| ROM assessment | change from base line at 6 weeks. | A caliper will be used to measure mandibular depression, protrusion and lateral deviation. |
| Temporomandibular Disorder Disability Questionnaire | change from base line at 6 weeks. | This questionnaire consists of the following: * The Temporomandibular Disorder Disability Index. It consists of 10 questions with 5 possible answers, rating a 0 to 4 score level for each of the answers. * The Temporomandibular Disorder symptom intensity scale and the Temporomandibular Disorder symptom frequency scale are two visual analogue scales which address the frequency and intensity of a patient's TMJ symptoms and consist of 7 sections for each scale where the patient must rate his/her intensity and frequency of symptoms on a scale of 0 to 10 score level. * The Pain Drawing sheet is used by the patients to capture pain location and quality. |
| Numerical Rating Scale (NRS) | change from baseline at 6 weeks. | The patient will be asked to indicate a number between 0 and 100 on a horizontal line, that best described his/her perceived level of pain intensity when it is at its worst and when it is at is least. The average of these two totals indicates the average pain experienced by the patient as a percentage. |
Countries
Egypt
Outcome results
None listed