Temporomandibular Disorders, Bruxism
Conditions
Keywords
Telerehabilitation, Temporomandibular disorders, Bruxism, Rocabado exercises, Myofascial pain, Exercise therapy, Telemedicine, Physiotherap
Brief summary
This study looked at whether jaw exercises (the Rocabado exercise programme) work better when delivered through supervised online video sessions than when done at home with written instructions alone, in adults who have jaw-joint pain (temporomandibular disorder) together with teeth grinding (bruxism). Thirty adults were randomly placed into one of two groups. Both groups were taught the same exercises and asked to do them twice a day for four weeks. One group also took part in supervised video sessions three times a week, where a physiotherapist watched their exercises and gave feedback; the other group used printed exercise leaflets with weekly text-message reminders. The researchers measured jaw pain, how wide participants could open their mouth, jaw movement, stress, sleep quality and oral habits before treatment, after two weeks and after four weeks, to see which approach gave better results.
Detailed description
This single-centre, parallel-group, randomised controlled trial was conducted at the Faculty of Dentistry, Nevşehir Hacı Bektaş Veli University. Participants who met the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for myofascial temporomandibular disorder with concurrent bruxism were randomly allocated in a 1:1 ratio using a computer-generated simple randomisation sequence. Allocation was concealed using sequentially numbered, opaque, sealed envelopes that were opened only after enrolment. The outcome assessor was blinded to group allocation; participants were not blinded owing to the nature of the intervention. Both groups received identical initial face-to-face training in the Rocabado 6×6 exercise programme and were instructed to perform the exercises twice daily for four weeks. The telerehabilitation group additionally received supervised video sessions, whereas the comparator group followed the programme at home with printed materials and reminders only. Assessments were performed in person at baseline, at week 2 (mid-treatment) and at week 4 (post-treatment). The sample size was estimated using G\*Power, and data were analysed with within-group and between-group statistical comparisons.
Interventions
BEHAVIORALTelerehabilitation-based Rocabado exercises
Supervised Rocabado 6×6 exercise programme delivered through video sessions via WhatsApp three times per week, with real-time physiotherapist feedback on exercise performance and technique, performed in addition to twice-daily home Rocabado exercises for four weeks.
BEHAVIORALHome-based Rocabado exercises
Rocabado 6×6 exercise programme performed at home twice daily for four weeks, supported by printed exercise brochures and weekly SMS reminders, without supervised video sessions or physiotherapist feedback.
Sponsors
Mehmet Turgut
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
The outcome assessor was blinded to group allocation. Participants and the treating physiotherapist were not blinded owing to the nature of the intervention.
Intervention model description
Two-arm parallel-group randomised controlled trial; participants were allocated 1:1 to a telerehabilitation group or a home exercise group.
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Adults aged 18-60 years * Diagnosis of myofascial temporomandibular disorder (TMD) with bruxism according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) * Visual Analogue Scale (VAS) pain score ≥ 3 * No medical treatment for TMD in the preceding 6 months * Access to a smartphone with internet connectivity * Turkish literacy and communication ability
Exclusion criteria
* Active orthodontic or splint treatment * History of temporomandibular joint surgery * Systemic inflammatory disease * Pregnancy * Major psychiatric disorders * Neurological deficits in the cervical region
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Maximum mouth opening | Baseline, week 2 (mid-treatment) and week 4 (post-treatment) | Maximum mouth opening measured in millimetres using a digital calliper (Mitutoyo, Japan); the mean of three consecutive measurements was recorded. |
| Pain intensity (Visual Analogue Scale) | Baseline, week 2 (mid-treatment) and week 4 (post-treatment) | Pain intensity assessed using the Visual Analogue Scale (VAS), scored from 0 to 10 cm, for morning pain, pain during chewing (mastication) and night pain. Higher scores indicate greater pain. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Perceived stress (Perceived Stress Scale) | Baseline and week 4 (post-treatment) | Perceived stress assessed using the Perceived Stress Scale (PSS-14), scored from 0 to 40; higher scores indicate greater perceived stress. |
| Oral parafunctional habits (Oral Behaviours Checklist) | Baseline and week 4 (post-treatment) | Oral parafunctional habits assessed using the Oral Behaviours Checklist (OBC), scored from 0 to 40; higher scores indicate more frequent oral parafunctional behaviours. |
| Temporomandibular joint range of motion | Baseline, week 2 (mid-treatment) and week 4 (post-treatment) | Active and passive maximum mouth opening, right and left lateral movements, and protrusion measured in millimetres using a digital calliper (Mitutoyo, Japan). |
| TMD severity (Fonseca Anamnestic Index) | Baseline and week 4 (post-treatment) | Severity of temporomandibular disorder assessed using the Fonseca Anamnestic Index (0-100 points); higher scores indicate greater severity. |
| Sleep quality (Jenkins Sleep Scale) | Baseline and week 4 (post-treatment) | Sleep quality assessed using the Jenkins Sleep Scale, scored from 0 to 20; higher scores indicate poorer sleep quality. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORTaha Turgut, Msc. PT.
Nevşehir Hacı Bektaş Veli University
PRINCIPAL_INVESTIGATORMehmet Turgut
Nevsehir Haci Bektas Veli University
STUDY_DIRECTORNevin Ergun
Sanko University
Outcome results
None listed