Adding Core Stabilization Training to Manuel Therapy in Temporomandibular Joint Disorders
NCT ID: NCT05607823
Last Updated: 2025-08-27
Study Results
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Basic Information
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COMPLETED
NA
45 participants
INTERVENTIONAL
2022-11-06
2024-02-10
Brief Summary
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Detailed Description
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* Group 1 (CST group): Orofacial manual therapy + core stabilization training (CST) + home exercise and patient education
* Group 2 (OMT group): Orofacial manual therapy (OMT) + home exercise and patient education
* Group 3 (Control group): Home exercise and patient education.
Pain intensity, pressure pain threshold, joint range of motion, posture, flexibility, stabilization of core muscles, functionality and sleep quality will be evaluated by using Numeric Pain Scale (NPS), digital algometer, ruler, Palpation Meter (PALM), bubble inclinometer, tape measure, Finger-to-floor distance (EPZM) and sit-reach test, pressure biofeedback unit, "Helkimo Index", "Pittsburgh Sleep Quality Index (PUKI)" respectively. Patients will be treated for 10 sessions once a week, for a total of 10 weeks. Evaluation was planned to be done twice, at the beginning and end of the treatment.
Conditions
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Study Design
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RANDOMIZED
FACTORIAL
TREATMENT
SINGLE
Study Groups
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OMT Group
The orofacial manuel therapy group. Participants in this group will be received orofacial manuel therapy and conventional physiotherapy (Home exercise program and patient education) as treatment. The number of participants is planned to be 15.
Orofacial Manual Therapy
As orofacial manual therapy, soft tissue (intraoral and extraoral trigger point therapy and myofascial release of painful muscles) and joint mobilization (caudal and ventro-caudal traction, ventral and mediolateral translation), muscle energy technique, fascia mandibularis release, occipital release and ligamentous treatment was planned.
Conventional Physiotherapy
Conventional physiotherapy consists of home exercise and patient education. Patient education consists of parafunctional behaviors, habits, a diet with soft food, and posture education. The exercises consist of exercises for the mandible, cervical and thoracic region and breathing. All movements are planned to be done at home 3 times a day, every day of the week.
Control Group
Participants in this group will be received only conventional physiotherapy (Home exercise program and patient education) as treatment. The number of participants is planned to be 15.
Conventional Physiotherapy
Conventional physiotherapy consists of home exercise and patient education. Patient education consists of parafunctional behaviors, habits, a diet with soft food, and posture education. The exercises consist of exercises for the mandible, cervical and thoracic region and breathing. All movements are planned to be done at home 3 times a day, every day of the week.
CST Group
The core stabilization group. Participants in this group will be received core stabilization training, orofacial manuel therapy and conventional physiotherapy (Home exercise program and patient education) as treatment. The number of participants is planned to be 15.
Core Stabilization Training
Core Stabilization training will be based on dynamic neuromuscular stabilization and consists of three stages. In the first session, it is to teach the simultaneous activation of the transversus abdominis, pelvic floor, multifidus and diaphragm muscles and to improve muscle coordination and proprioception in the entire spinal region. In the second and third phases, exercises will be made more intense to improve muscular endurance and stability. The difficulty of the exercises will be increased by working in different positions, using resistance bands, exercise balls and body weight, and adding movements to the extremities. A total of 10 sessions of treatment program will be applied to the patients for ten weeks, once a week.
Orofacial Manual Therapy
As orofacial manual therapy, soft tissue (intraoral and extraoral trigger point therapy and myofascial release of painful muscles) and joint mobilization (caudal and ventro-caudal traction, ventral and mediolateral translation), muscle energy technique, fascia mandibularis release, occipital release and ligamentous treatment was planned.
Conventional Physiotherapy
Conventional physiotherapy consists of home exercise and patient education. Patient education consists of parafunctional behaviors, habits, a diet with soft food, and posture education. The exercises consist of exercises for the mandible, cervical and thoracic region and breathing. All movements are planned to be done at home 3 times a day, every day of the week.
Interventions
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Core Stabilization Training
Core Stabilization training will be based on dynamic neuromuscular stabilization and consists of three stages. In the first session, it is to teach the simultaneous activation of the transversus abdominis, pelvic floor, multifidus and diaphragm muscles and to improve muscle coordination and proprioception in the entire spinal region. In the second and third phases, exercises will be made more intense to improve muscular endurance and stability. The difficulty of the exercises will be increased by working in different positions, using resistance bands, exercise balls and body weight, and adding movements to the extremities. A total of 10 sessions of treatment program will be applied to the patients for ten weeks, once a week.
Orofacial Manual Therapy
As orofacial manual therapy, soft tissue (intraoral and extraoral trigger point therapy and myofascial release of painful muscles) and joint mobilization (caudal and ventro-caudal traction, ventral and mediolateral translation), muscle energy technique, fascia mandibularis release, occipital release and ligamentous treatment was planned.
Conventional Physiotherapy
Conventional physiotherapy consists of home exercise and patient education. Patient education consists of parafunctional behaviors, habits, a diet with soft food, and posture education. The exercises consist of exercises for the mandible, cervical and thoracic region and breathing. All movements are planned to be done at home 3 times a day, every day of the week.
Eligibility Criteria
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Inclusion Criteria
* Aged between 18-60 years old,
* Having the diagnosis of Temporomandibular Disorders (TMD) - Reduction Disc Displacement (DDwR)
Exclusion Criteria
* Not being cooperative,
* Regular use of analgesic and anti-inflammatory drugs,
* Having dentofacial anomalies,
* Having active arthritis,
* Having lumbal pathology,
* Having metabolic diseases,
* Having connective tissue, rheumatological and hematological disorders,
* Having a diagnosed psychiatric illness,
* Receiving TMD-related physical therapy less than 6 months ago
18 Years
60 Years
ALL
No
Sponsors
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Marmara University
OTHER
Responsible Party
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Principal Investigators
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Tugba Kuru Colak, Asst. Prof
Role: STUDY_DIRECTOR
Marmara University Institute of Health Sciences
Locations
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Sultan İğrek
Istanbul, , Turkey (Türkiye)
Countries
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References
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Childs JD, Piva SR, Fritz JM. Responsiveness of the numeric pain rating scale in patients with low back pain. Spine (Phila Pa 1976). 2005 Jun 1;30(11):1331-4. doi: 10.1097/01.brs.0000164099.92112.29.
Liu F, Steinkeler A. Epidemiology, diagnosis, and treatment of temporomandibular disorders. Dent Clin North Am. 2013 Jul;57(3):465-79. doi: 10.1016/j.cden.2013.04.006.
Anastassaki Kohler A, Hugoson A, Magnusson T. Prevalence of symptoms indicative of temporomandibular disorders in adults: cross-sectional epidemiological investigations covering two decades. Acta Odontol Scand. 2012 May;70(3):213-23. doi: 10.3109/00016357.2011.634832. Epub 2011 Nov 30.
Nekora-Azak A, Evlioglu G, Ordulu M, Issever H. Prevalence of symptoms associated with temporomandibular disorders in a Turkish population. J Oral Rehabil. 2006 Feb;33(2):81-4. doi: 10.1111/j.1365-2842.2006.01543.x.
Hoffmann RG, Kotchen JM, Kotchen TA, Cowley T, Dasgupta M, Cowley AW Jr. Temporomandibular disorders and associated clinical comorbidities. Clin J Pain. 2011 Mar-Apr;27(3):268-74. doi: 10.1097/AJP.0b013e31820215f5.
Lee KC, Wu YT, Chien WC, Chung CH, Chen LC, Shieh YS. The prevalence of first-onset temporomandibular disorder in low back pain and associated risk factors: A nationwide population-based cohort study with a 15-year follow-up. Medicine (Baltimore). 2020 Jan;99(3):e18686. doi: 10.1097/MD.0000000000018686.
Cuccia A, Caradonna C. The relationship between the stomatognathic system and body posture. Clinics (Sao Paulo). 2009;64(1):61-6. doi: 10.1590/s1807-59322009000100011.
Gangloff P, Louis JP, Perrin PP. Dental occlusion modifies gaze and posture stabilization in human subjects. Neurosci Lett. 2000 Nov 3;293(3):203-6. doi: 10.1016/s0304-3940(00)01528-7.
Espinosa de Santillana IA, Garcia-Juarez A, Rebollo-Vazquez J, Ustaran-Aquino AK. [Frequent postural alterations in patients with different types of temporomandibular disorders]. Rev Salud Publica (Bogota). 2018 May-Jun;20(3):384-389. doi: 10.15446/rsap.V20n3.53529. Spanish.
Saito ET, Akashi PM, Sacco Ide C. Global body posture evaluation in patients with temporomandibular joint disorder. Clinics (Sao Paulo). 2009;64(1):35-9. doi: 10.1590/s1807-59322009000100007.
Fischer MJ, Riedlinger K, Gutenbrunner C, Bernateck M. Influence of the temporomandibular joint on range of motion of the hip joint in patients with complex regional pain syndrome. J Manipulative Physiol Ther. 2009 Jun;32(5):364-71. doi: 10.1016/j.jmpt.2009.04.003.
Fink M, Wahling K, Stiesch-Scholz M, Tschernitschek H. The functional relationship between the craniomandibular system, cervical spine, and the sacroiliac joint: a preliminary investigation. Cranio. 2003 Jul;21(3):202-8. doi: 10.1080/08869634.2003.11746252.
de Oliveira-Souza AIS, de O Ferro JK, Barros MMMB, Oliveira DA. Cervical musculoskeletal disorders in patients with temporomandibular dysfunction: A systematic review and meta-analysis. J Bodyw Mov Ther. 2020 Oct;24(4):84-101. doi: 10.1016/j.jbmt.2020.05.001. Epub 2020 May 11.
von Piekartz H, Hall T. Orofacial manual therapy improves cervical movement impairment associated with headache and features of temporomandibular dysfunction: a randomized controlled trial. Man Ther. 2013 Aug;18(4):345-50. doi: 10.1016/j.math.2012.12.005. Epub 2013 Feb 14.
Wright EF, Domenech MA, Fischer JR Jr. Usefulness of posture training for patients with temporomandibular disorders. J Am Dent Assoc. 2000 Feb;131(2):202-10. doi: 10.14219/jada.archive.2000.0148.
Kalamir A, Pollard H, Vitiello A, Bonello R. Intra-oral myofascial therapy for chronic myogenous temporomandibular disorders: a randomized, controlled pilot study. J Man Manip Ther. 2010 Sep;18(3):139-46. doi: 10.1179/106698110X12640740712374.
Sakpal TV. Sample size estimation in clinical trial. Perspect Clin Res. 2010 Apr;1(2):67-9.
Urbanski P, Trybulec B, Pihut M. The Application of Manual Techniques in Masticatory Muscles Relaxation as Adjunctive Therapy in the Treatment of Temporomandibular Joint Disorders. Int J Environ Res Public Health. 2021 Dec 8;18(24):12970. doi: 10.3390/ijerph182412970.
von Piekartz H, Ludtke K. Effect of treatment of temporomandibular disorders (TMD) in patients with cervicogenic headache: a single-blind, randomized controlled study. Cranio. 2011 Jan;29(1):43-56. doi: 10.1179/crn.2011.008.
Frank C, Kobesova A, Kolar P. Dynamic neuromuscular stabilization & sports rehabilitation. Int J Sports Phys Ther. 2013 Feb;8(1):62-73.
Walker N, Bohannon RW, Cameron D. Discriminant validity of temporomandibular joint range of motion measurements obtained with a ruler. J Orthop Sports Phys Ther. 2000 Aug;30(8):484-92. doi: 10.2519/jospt.2000.30.8.484.
Tuzun C, Yorulmaz I, Cindas A, Vatan S. Low back pain and posture. Clin Rheumatol. 1999;18(4):308-12. doi: 10.1007/s100670050107.
Herrington L. Assessment of the degree of pelvic tilt within a normal asymptomatic population. Man Ther. 2011 Dec;16(6):646-8. doi: 10.1016/j.math.2011.04.006. Epub 2011 Jun 11.
Perret C, Poiraudeau S, Fermanian J, Colau MM, Benhamou MA, Revel M. Validity, reliability, and responsiveness of the fingertip-to-floor test. Arch Phys Med Rehabil. 2001 Nov;82(11):1566-70. doi: 10.1053/apmr.2001.26064.
Mayorga-Vega D, Merino-Marban R, Viciana J. Criterion-Related Validity of Sit-and-Reach Tests for Estimating Hamstring and Lumbar Extensibility: a Meta-Analysis. J Sports Sci Med. 2014 Jan 20;13(1):1-14. eCollection 2014 Jan.
Richardson CA, Jull GA. Muscle control-pain control. What exercises would you prescribe? Man Ther. 1995 Nov;1(1):2-10. doi: 10.1054/math.1995.0243.
Hodges P, Richardson C, Jull G. Evaluation of the relationship between laboratory and clinical tests of transversus abdominis function. Physiother Res Int. 1996;1(1):30-40. doi: 10.1002/pri.45.
Helkimo M. Studies on function and dysfunction of the masticatory system. II. Index for anamnestic and clinical dysfunction and occlusal state. Sven Tandlak Tidskr. 1974 Mar;67(2):101-21. No abstract available.
Thilander B, Rubio G, Pena L, de Mayorga C. Prevalence of temporomandibular dysfunction and its association with malocclusion in children and adolescents: an epidemiologic study related to specified stages of dental development. Angle Orthod. 2002 Apr;72(2):146-54. doi: 10.1043/0003-3219(2002)0722.0.CO;2.
Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989 May;28(2):193-213. doi: 10.1016/0165-1781(89)90047-4.
Tuncer AB, Ergun N, Tuncer AH, Karahan S. Effectiveness of manual therapy and home physical therapy in patients with temporomandibular disorders: A randomized controlled trial. J Bodyw Mov Ther. 2013 Jul;17(3):302-8. doi: 10.1016/j.jbmt.2012.10.006. Epub 2012 Nov 16.
Related Links
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Investigation of the Relationship Between Temporomandibular Disorder and Postural Analysis.
Assessment of Temporomandibular Joint Dysfunctions and the Position of Pelvis
Manual Therapy for Temporomandibular Disorders: A Review of the Literature. J Body Mov Ther.
Effects of Core Stability Exercises, Lumbar Lordosis and Low- Back Pain: A Systematic Review.
Pressure pain threshold and pain perception in temporomandibular disorder patients: is there any correlation?
The Validity and Reliability of the Pittsburgh Sleep Quality Index
Other Identifiers
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09.2022.951
Identifier Type: -
Identifier Source: org_study_id
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