Clinical trial NCT04967131: Proprioceptive Neuromuscular Facilitation Exercises in Temporomandibular Dysfunction
Official title: The Immediate Effect of Proprioceptive Neuromuscular Facilitation on Pain and Maximal Mouth Opening in Temporomandibular Dysfunction: Pilot Study
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Temporomandibular Disorder
Temporomandibular Joint Disorders
Pain
Keywords: Orofacial Pain
Proprioceptive Neuromuscular Facilitation
Therapeutic Management
Threshold Pressure
Temporomandibular Joint Disorders
Pressure Pain
Lead sponsor: Istanbul Medipol University Hospital
Sponsor class: OTHER
First posted: 2021-07-19
Enrollment: 25
Sex: FEMALE
Minimum age (years): 18
Maximum age (years): 25
Standard ages: ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: University students

Brief summary: Individuals who were diagnosed with reduction disc displacement by Research Diagnostic criteria for Temporomandibular Disorder (TMD / RDC) were included in the study. Proprioceptive neuromuscular facilitation exercises were performed for 30 minutes using neck jaw and tongue patterns with rhythmic stabilization (RS) and combination of isotonics (CI) techniques by physiotherapist. Maximal mouth openings were measured with caliper, pain intensities were measured with visual analogue scale and pressure pain thresholds with hand algometer.

Detailed description: TMD patients who are diagnosed by TMD/RDC are firstly assessed by physiotherapist for maximal mouth opening(MMO), pain intensity and pressure pain threshold. Then they will taught exercises with rhythmic initiation which includes repetation of the patern and 15 repetitions are applied as warm-up period. Proprioceptive neuromuscular facilitation (PNF) exercises are performed in the neck and jaw patterns with rhythmic stabilization (RS) and combination of isotonics (CI) techniques. In the neck, right rotation-right lateral flexion, left rotation-left lateral flexion pattern, and the opening and closing pattern according to the working mechanics of the masseter and temporal muscle in the chin, RS and CI techniques are used. By providing maximum resistance in accordance with the needs of each individual, the RS protocol consist of isometric contractions that would not involve changing movements for 10 seconds. The combination of isotonics technique include combined concentric, isometric, and eccentric contraction of the agonist muscle for 5 seconds of each contraction without rest. CI exercises consist of 15 repetitions per set. A 30-second rest given between sets to include recovery. After exercises immediate MMO, pain intensity and pain treshold assessment will be applied.

Eligibility criteria: Inclusion Criteria:

* Volunteers between 18-25 years female, admitted to the study with clenching, grinding, clicking, jaw pain when eating hard foods, and limited and painful mouth movements.

Exclusion Criteria:

* Having orthopedic, neurological or rheumatological cervical disorders which affect the jaw motions; receiving occlusal therapy as a companion to treatment, those who have an operation in the area of jaw, head and neck and those with vertigo that prevents head movements during exercises.

Primary outcomes:
measure: Pain Treshold
timeFrame: the immediate effect will be measured as soon as the exercise is finished
measure: Pain intensity
timeFrame: the immediate effect will be measured as soon as the exercise is finished
measure: Maximum mouth opening
timeFrame: the immediate effect will be measured as soon as the exercise is finished
Secondary outcomes:
measure: Unassisted opening
timeFrame: the immediate effect will be measured as soon as the exercise is finished
measure: maximum unassisted opening
timeFrame: the immediate effect will be measured as soon as the exercise is finished
measure: maximum assisted opening
timeFrame: the immediate effect will be measured as soon as the exercise is finished
Other outcomes:
Locations:
city: Istanbul
country: Turkey
facility: Istanbul Medipol University
state: Beykoz
Study officials:
affiliation: Medipol University
name: Esra Atılgan, PhD
role: STUDY_CHAIR
References: