Physical Therapy for Temporomandibular Joint (TMJ) Closed Lock

Study Overview
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Brief Summary
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The aim of the present study was to investigate the effect of Physical Therapy (PT) on pain and mandibular function in patients with anterior disc displacement without reduction (ADD-R) or closed lock of the TMJ and this in a randomized controlled trial design.

Detailed Description
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The study evaluated the effect of extra, technical PT over the traditional information on the benign nature of the disease and the advice to refrain from overuse or misuse of the masticatory system as in parafunctions.

Official Title
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Randomised Controlled Trial on Physical Therapy PT) for TMJ Closed Lock

Conditions
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Temporomandibular Joint Disorders, Temporomandibular Joint Disc Displacement, Without Reduction

Intervention / Treatment
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* Procedure: physical therapy
* Procedure: control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients were recruited from the Oral Pain and Dysfunction Clinic and strictly satisfied the RDC-TMD criteria for .for disc displacement without reduction with (group IIb) or without (group IIc) limitation of mouth opening, based upon history and clinical examination. Additionally, pain experienced during the first examination had to be ≥ 35mm on a visual analog scale (VAS) of 100mm. Exclusion Criteria: Patients were excluded if their medical history mentioned orofacial traumata (contusion or fracture), systemic disorders (e.g. rheumatoid arthritis, fibromyalgia), cervical disorders (operationalized as complaints, pain or referral patterns of pain provoked during movements of the cervical spine), neurologic disorders (e.g. trigeminal neuralgia, migraine or tension type headache), drug or alcohol abuse, use of antidepressant or hormonal medication. Participants did not receive therapy for symptoms of TMD within the last 2 months.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: control<br>information, avoiding parafunctions | Procedure: control<br>* relaxation<br>* Other names: information;|
| Experimental: physical therapy<br>mobilisation, exercises ,.. | Procedure: physical therapy<br>* mobilisation of the jaw, exercises, boostering information on avoiding parafunctions<br>* Other names: physiotherapy;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pain intensity | using VAS scales | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| mouth opening | interincisal dstance measured by a ruler upon active and passive mouth opening | 1 year | 
| pressure pain threshold | the pressure pain threshold was measured using an algometer at the masseter and temporalis muscles bilaterally | 1 year | 
| mandibular function impairment questionnaire | Using a validated questionnaire the impact of the pain and limitaiton on normal masticatory function is monitored | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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temporomandibular joint, rehabilitation medicine, joint diseases, physical therapy