Proprioceptive Neuromuscular Facilitation Exercises in Temporomandibular Dysfunction

Sponsor

Istanbul Medipol University Hospital (Other)

Overall Status

Recruiting

CT.gov ID

NCT04967131

Collaborator

(none)

Enrollment

Location

35.8

Anticipated Duration (Months)

0.7

Patients Per Site Per Month

Study Details

Study Description

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.

Condition or Disease	Intervention/Treatment	Phase
Temporomandibular Disorder Temporomandibular Joint Disorders Pain	Other: PNF exercises

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.

Study Design

Study Type:

Observational [Patient Registry]

Anticipated Enrollment :

25 participants

Observational Model:

Case-Only

Time Perspective:

Prospective

Official Title:

The Immediate Effect of Proprioceptive Neuromuscular Facilitation on Pain and Maximal Mouth Opening in Temporomandibular Dysfunction: Pilot Study

Actual Study Start Date :

Jan 7, 2020

Anticipated Primary Completion Date :

Dec 1, 2021

Anticipated Study Completion Date :

Dec 31, 2022

Arms and Interventions

Arm	Intervention/Treatment
PNF group Proprioceptive Neuromuscular Fascilitation exercises were given this group	Other: PNF exercises PNF exercises were applied in 3 sets of 15 repetitions based on movement in the diagonal plane, using head, neck and chin patterns. Contractions were sustained for at least 10 seconds.

Arm

Intervention/Treatment

PNF group

Proprioceptive Neuromuscular Fascilitation exercises were given this group

Other: PNF exercises

PNF exercises were applied in 3 sets of 15 repetitions based on movement in the diagonal plane, using head, neck and chin patterns. Contractions were sustained for at least 10 seconds.

Outcome Measures

Primary Outcome Measures

Pain Treshold [the immediate effect will be measured as soon as the exercise is finished]
The pain threshold will be measured with an algometer at certain points on the muscles in the area where the exercise is applied.
Pain intensity [the immediate effect will be measured as soon as the exercise is finished]
The level of pain felt will be marked with a visual analog scale on a 10-centimeter paper.
Maximum mouth opening [the immediate effect will be measured as soon as the exercise is finished]
Individuals will be asked to open their mouths as much as they can, and mouth opening will be measured with a caliper.

Secondary Outcome Measures

Unassisted opening [the immediate effect will be measured as soon as the exercise is finished]
the individual is told to open their mouth and the gap is measured with a caliper.
maximum unassisted opening [the immediate effect will be measured as soon as the exercise is finished]
Without trying to increase the mouth opening with hand or any help, the individual actively opens mouth as much as they can and the opening is measured with a caliper.
maximum assisted opening [the immediate effect will be measured as soon as the exercise is finished]
It is measured with a caliper by asking individuals to open their mouths as much as they can and open more by helping with their hands at the last point.

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years to 25 Years

Sexes Eligible for Study:

Female

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.