Effects of Bowen's Therapy and Post Isometric Relaxation Techniques in Patients of Temporomandibular Joint Disorder

Study Overview
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Brief Summary
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the aim of this study to compare effects of Bowen's therapy and post isometric relaxation techniques on pain, range of motions and function in patients with TMJ disorder.

Detailed Description
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Temporomandibular joint disorder is a very common and serious problem of mouth and face pain related condition that mostly effect in quality of life and compromise the daily functional activities of a patient. It can be caused by any trauma, biomechanical, neuromuscular and psychologically related problems. Patient may come in acute and chronic phase. Patient condition mostly vary and worsen day by day, it thoughts that TMJD going interval throw out the life span of patient. Medicine, physical therapy interventions and surgical procedures are use in treatment of TMJ disorder. This study will conducted the comparative effects of Bowen's and post-isometric relaxation techniques on pain, ROM and functions in TMJ patients. The study would be randomized clinical trial. Total 24 subjects will be assigned randomly into two groups by using lottery methods. Baseline treatment will be same (ultrasound, tapping) in both groups. Group A will be treated by Bowen's therapy and Group B will be treated by post-isometric relaxation technique for 30 min session (2 sessions/week and total 4 weeks). Numeric Pain Rating Scale, maximum mouth opening inter-incisal rural and jaw functional limitation scale-20 would be used as an outcome measurement tool for pain, range of motion and function respectively. Measurement will be taken at Baseline and at the end of the 4th week's treatment session. After assessing the normality data will be analyzed by using parametric / nonparametric test.

Official Title
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Comparative Effects of Bowen's and Post Isometric Relaxation Techniques on Pain, Range of Motion and Function in Patients With Temporomandibular Joint Disorder

Conditions
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Temporomandibular Joint Disorders

Intervention / Treatment
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* Other: Bowen's therapy
* Other: Post isometric relaxation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Male and Female Participant aged 20-50. Pain on function. Restricted jaw movement. Clicking, popping sound. Tenderness in muscle of mastication. Joint tenderness. With a restricted mandibular range of motion 40mmor less measured interincisal. Exclusion Criteria: Systematic arthropathy such as. Rheumatoid arthritis Fracture of jaw or TMJ. Malignant history of face and jaw. Prevent history of jaw or TMJ surgery. Subject has/ had dental/ orthodontic treatment within the past 14 days

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 50 Years

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: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Bowen's therapy<br>Bowens therapy will be given to 12 patients of temporomandibular joint disorder . | Other: Bowen's therapy<br>* Bowens technique will be apply on patients of TMJ for 2 repetitions in 1 set, 4 sets in each session for 4 weeks.<br>|
| Experimental: Post isometric relaxation<br>post isometric relaxation technique will be given to12 patients of temporomandibular joint disorder. | Other: Post isometric relaxation<br>* post isometric relaxation technique and jaw exercises (strengthen the weakened muscles, stretch the shortened muscles) with dosage 5 times/session, 5 sec rest and 2times/week for 4 weeks will apply on patients.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| NPRS for pain | The Numerical Pain Rating Scale (NPRS) is a subjective measure in which individuals rate their pain on an eleven-point numerical scale. The scale is composed of 0 (no pain at all) to 10 (worst imaginable pain). | 4th week | 
| Maximum Mouth opening (Inter- incisal Rural) for rang of motion | Maximum mouth opening is a vital and objective clinical parameter for assessment of stomatognathic region and it represents the range of vertical mandibular range of movement.The distance between the upper central incisor and lower incisor determined by flexible intra-oral ruler ,it is valid and reliable tool for measure TMJ distance. | 4th week | 
| Jaw Functional Limitation Scale for functional activity | Jaw functional limitation is a 20 items,3 level functional scale mastication, vertical jaw mobility, emotional and verbal expression. NO LIMITATION'' score have 0 and SEVER LIMITATION '' have 10 score | 4th week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Temporomandibular disorder, Post isometric relaxation, Temporomandibular joint pain