Proprioceptive Neuromuscular Facilitation Exercises in Temporomandibular Dysfunction

Pain Clinical Trial

Official title:

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

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT04967131
• Other study ID #: 10840098-604.01.01-E.60748
• Status: Recruiting
• Start date: January 7, 2020
• Est. completion date: December 31, 2022

Study information

• Verified date: April 2021
• Source: Istanbul Medipol University Hospital
• Contact: Gizem Ergezen, MSc
• Phone: +905347098414
• Email: gizem-ergezen[@]hotmail.com
• Is FDA regulated: No
• Study type: Observational [Patient Registry]

Clinical Trial 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.

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.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 25
• Est. completion date: December 31, 2022
• Est. primary completion date: December 1, 2021
• Gender: Female
• Age group: 18 Years to 25 Years

Eligibility

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.

Related Conditions & MeSH terms

• Disease
• Joint Diseases
• Pain
• Temporomandibular Disorder
• Temporomandibular Joint Disorders
• Temporomandibular Joint Dysfunction Syndrome

Intervention

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.

Locations

Country	Name	City	State
Turkey	Istanbul Medipol University	Istanbul	Beykoz

Sponsors (1)

Lead Sponsor	Collaborator
Istanbul Medipol University Hospital

Country where clinical trial is conducted

Turkey, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Pain Treshold	The pain threshold will be measured with an algometer at certain points on the muscles in the area where the exercise is applied.	the immediate effect will be measured as soon as the exercise is finished
Primary	Pain intensity	The level of pain felt will be marked with a visual analog scale on a 10-centimeter paper.	the immediate effect will be measured as soon as the exercise is finished
Primary	Maximum mouth opening	Individuals will be asked to open their mouths as much as they can, and mouth opening will be measured with a caliper.	the immediate effect will be measured as soon as the exercise is finished
Secondary	Unassisted opening	the individual is told to open their mouth and the gap is measured with a caliper.	the immediate effect will be measured as soon as the exercise is finished
Secondary	maximum unassisted opening	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.	the immediate effect will be measured as soon as the exercise is finished
Secondary	maximum assisted opening	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.	the immediate effect will be measured as soon as the exercise is finished