Temporomandibular Joint Dysfunction Clinical Trial
Official title:
The Effects of Trigger Point Treatment on Pain and Functionality in Temporomandibular Joint Dysfunction
The aim of this study to investigate the effectiveness of trigger point treatments (ischemic compression) on pain intensity, chronic pain severity, range of motion(ROM), pain pressure threshold (PPT) and functionality on patient with temporomandibular joint dysfunction.(TMD)
TMD is most common of pain and functional limitations of jaw. The ischemic compression and
the exercises (Rocabado's 6x6 exercises and posture exercises) each relieve pain and increase
funcitonality on TMD but which one has the more effect should be investigated.
The ROCABODO's 6x6 exercise program, which is a special for temporomandibular joint, includes
repetitive movements that include patient education, patient self-care, lifestyle
modifications, and recognizing which actions have the effect of increasing the symptoms of an
individual's active participation. The repetitive movements relax the chewing muscles and
reduce pain by helping the synovial fluid move along the joint surfaces, increasing
circulation, removing joint nutrition, and removing the metabolites of articular cartilage.
Postural exercise is commonly used for pain/tension in neck or back, but can also be applied
in the orofacial region, aiming to relief muscle symptoms such as pain, tension, stiffness,
and tiredness ,by improving the position of the head or the mandibular. It is believed that
wrong head position can cause muscle pain due to acceleration of muscle activity in the neck
and jaw muscles, as well as postural reflex. Postural exercise includes head posture
correction and myofascial release.
Ischemic compression, that is a frequently used manual pressure technique, is a pressure
application that is applied with the thumb to the maximum tolerable pain point on the trigger
points. With this application, the sense of pain signals reduce pain by inhibiting the sense
of touch signals.
The aim of this study to investigate the effectiveness of trigger point treatments (ischemic
compression) on pain intensity, chronic pain severity, ROM, PPT and functionality on patient
with TMD. 42 patients were randomized into 2 groups : Group 2 (n:21) received only exercises
(Rocabado's 6x6 exercises and posture exercises) as treatment, Group 1(n:21) received
exercises (Rocabado's 6x6 exercises and posture exercises) and ischemic compression as
treatment.The rest, activity and night pain in activity were assessed by visual analog scale,
ROM assessed by a ruler and PPT assessed by a digital algometer at baseline (before
treatment), after 1week treatment, after 2 week treatment and after 4 week treatment. Chronic
pain severity were assessed by Graded Chronic Pain Scale version 2 and functionality were
assessed by Jaw Function Limitation Scale-8 at baseline (before treatment) and after 4 week
treatment. The efect size was calculated for the assessments used in the study.
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