Effect of Progressive Neck Motor Control Exercises on Temporomandibular Joint Dysfunction

Study Overview
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Brief Summary
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The primary aim of this study was to investigate the effects of progressive neck motor control exercises on craniocervical pain, posture, function and kinesiophobia in different types of temporomandibular dysfunction. The secondary aim of the study was to examine the differences between the effects of progressive neck motor control exercises on different types of temporomandibular dysfunction.

Detailed Description
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In this randomised controlled study, the effects of progressive neck motor control exercise therapy on craniocervical pain, posture, function and kinesiophobia in individuals with different types of temporomandibular dysfunction (myofascial, disc displacement with reduction, disc displacement without reduction) and their differences with the control group will be compared. Participants diagnosed by a dentist according to three different types of temporomandibular dysfunction will be included in the study. Participants will be divided into groups by block randomisation method. A total of 6 groups will be included in the study, including participants with three different types of temporomandibular dysfunction who voluntarily agree to participate in the study and meet the inclusion criteria, and the control group of each group. The study groups will receive the same treatment and patient education for 6 weeks, while the control groups will receive only patient education.

Official Title
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Investigation of the Effect of Progressive Neck Motor Control Exercises on Craniocervical Pain, Posture, Function and Kinesiophobia in Different Types of Temporomandibular Joint Dysfunction

Conditions
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Temporomandibular Joint Dysfunction Syndrome

Intervention / Treatment
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* Other: Progressive neck motor control exercise therapy
* Other: Patient education


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 to 55 years old, Temporomandibular joint-related complaints for at least 3 months, Temporomandibular dysfunction is diagnosed as a result of clinical and radiological evaluation by the dentist, Neck pain of 3 or more according to the numeric pain scale Exclusion Criteria: Cognitive problems, The one with the splint, Those who have used painkillers or muscle relaxants for temporomandibular dysfunction complaints in the last 1 week, With any systematic joint or muscle disease (e.g. fibromyalgia, rheumatoid arthritis), Those with serious systemic diseases, Any neurological disorder (e.g. trigeminal neuralgia), Pregnancy or breastfeeding, Treated for Temporomandibular joint or orofacial muscle pain in the last 3 months, Has undergone an operation/trauma to the cervical region and/or temporomandibular joint, Positive vertebrobasilar artery test

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 55 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

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: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Myofascial<br>Myofascial Temporomandibular Dysfunction | Other: Progressive neck motor control exercise therapy<br>* The exercise programme will be conducted as a single session two days a week for 6 weeks. The sessions will always be conducted by the same physiotherapist. Each exercise session will consist of 10 minutes of warm-up exercises, 40 minutes of neck motor control exercises and 10 minutes of cool down exercises. Each exercise will be performed as 2 sets of 10 repetitions.<br>Other: Patient education<br>* The content of this education consists of information about the disease and symptoms, chewing recommendations, dietary changes, parafunctional habits, activities to be avoided, posture recommendations.<br>|
| Experimental: disc displacement with reduction<br>Temporomandibular joint disc displacement with reduction | Other: Progressive neck motor control exercise therapy<br>* The exercise programme will be conducted as a single session two days a week for 6 weeks. The sessions will always be conducted by the same physiotherapist. Each exercise session will consist of 10 minutes of warm-up exercises, 40 minutes of neck motor control exercises and 10 minutes of cool down exercises. Each exercise will be performed as 2 sets of 10 repetitions.<br>Other: Patient education<br>* The content of this education consists of information about the disease and symptoms, chewing recommendations, dietary changes, parafunctional habits, activities to be avoided, posture recommendations.<br>|
| Experimental: disc displacement without reduction<br>Temporomandibular joint disc displacement without reduction | Other: Progressive neck motor control exercise therapy<br>* The exercise programme will be conducted as a single session two days a week for 6 weeks. The sessions will always be conducted by the same physiotherapist. Each exercise session will consist of 10 minutes of warm-up exercises, 40 minutes of neck motor control exercises and 10 minutes of cool down exercises. Each exercise will be performed as 2 sets of 10 repetitions.<br>Other: Patient education<br>* The content of this education consists of information about the disease and symptoms, chewing recommendations, dietary changes, parafunctional habits, activities to be avoided, posture recommendations.<br>|
| Other: Myofascial2<br>Myofascial Temporomandibular Dysfunction | Other: Patient education<br>* The content of this education consists of information about the disease and symptoms, chewing recommendations, dietary changes, parafunctional habits, activities to be avoided, posture recommendations.<br>|
| Other: disc displacement with reduction2<br>Temporomandibular joint disc displacement with reduction | Other: Patient education<br>* The content of this education consists of information about the disease and symptoms, chewing recommendations, dietary changes, parafunctional habits, activities to be avoided, posture recommendations.<br>|
| Other: disc displacement without reduction2<br>Temporomandibular joint disc displacement without reduction | Other: Patient education<br>* The content of this education consists of information about the disease and symptoms, chewing recommendations, dietary changes, parafunctional habits, activities to be avoided, posture recommendations.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fonseca Anamnestic Index | Assessment of Temporomandibular Dysfunction Severity | 1st, sixth week, first mont | 
| Numeric Pain Scale | Assessment of Pain, 0: No pain, 10: Maximum pain | 1st, sixth week, first mont | 
| Pressure pain threshold | Assessment of Pressure pain threshold | 1st, sixth week, first mont | 
| Range of motion | Assessment of Temporomandibular joint and neck range of motion | 1st, sixth week, first mont | 
| Joint position error test | Assessment of Cervical proprioception | 1st, sixth week, first mont | 
| Endurance | Assessment of Deep neck flexor endurance | 1st, sixth week, first mont | 
| Photographic Posture Analysis | Assessment of head and neck posture | 1st, sixth week, first mont | 
| Mandibular Function Impairment Questionnaire | Assessment of Mandibular Function | 1st, sixth week, first mont | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Tampa kinesiophobia scale | Assessment of kinesiophobia for temporomandibular joint, 12 points: low kinesiophobia; 48 points:high kinesiophobia | 1st, sixth week, first mont | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Temporomandibular Joint Dysfunction Syndrome, Pain, neck motor control exercise, posture, kinesiophobia, function