Efficacy of Therapeutic Exercise and Pain Neurophysiology Education in Temporomandibular Disorders

NCT ID: NCT06502769

Last Updated: 2024-07-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

36 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-09-01

Study Completion Date

2026-09-30

Brief Summary

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The aim of this study is to compare the effects in pain of two different treatments in pacients with temporomandibular disorders (TMD). One group will receive isolated therapeutic exercise (TE) and the other will receive TE combined with pain neurophysiology education (PNE). The hypothesis of this study is that the PNE+TE group will obtain superior therapeutic results than an isolated TE program.

Detailed Description

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Objective: To evaluate the differences in pain intensity by performing isolated therapeutic exercise (TE) versus performing the same exercise combined with pain neurophysiology education (PNE) in patients with temporomandibular disorders (TMD).

Design: Single-blind randomized controlled trial. Setting: Faculty of Physical Therapy of Alcalá de Henares. Participants: Subjects with TMD lasting more than 6 months (N= 36). Interventions: Participants will be randomly assigned to receive a TE program consisting of stretching, coordination and strengthening exercises (n= 18) or the same TE program in addition to a PNE program (n= 18), performed in two sessions of 40 minutes in groups of 6 participants. The intervention will last 12 weeks, where all participants must complete the exercise program daily, one year later they will be evaluated again.

Main outcome measures: The primary outcome will be pain intensity through the visual analogue scale (VAS) which will be completed at baseline, immediately after treatment, at 4 and 12 weeks and one year after treatment. Secondary outcome measures include pain-free mouth opening, Craniofacial Pain and Disability Inventory (CF-PDI), Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK-11), pressure pain thresholds (PPT) and Patient Global Impression of Change (PGIC). They will be recorded through blinded assessments performed by 2 physiotherapists at baseline, immediately after treatment, 4 and 12 weeks after treatment. Student's t test will be used to determine differences between group interventions.

Conditions

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Temporomandibular Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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TE+PNE group

patients with TMD who are going to combine therapeutic exercise with education in pain neurophysiology

Group Type EXPERIMENTAL

Therapeutic Exercise

Intervention Type BEHAVIORAL

A therapeutic exercise program will be carried out

Pain Neurophysiology Education

Intervention Type BEHAVIORAL

A PNE program will be carried out

TE group

patients with TMD who are going to perform isolated therapeutic exercise

Group Type OTHER

Therapeutic Exercise

Intervention Type BEHAVIORAL

A therapeutic exercise program will be carried out

Interventions

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Therapeutic Exercise

A therapeutic exercise program will be carried out

Intervention Type BEHAVIORAL

Pain Neurophysiology Education

A PNE program will be carried out

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Over 18 years of age
* Limitation of mouth opening and/or jaw pain lasting more than 6 months
* Being able to understand the objective and carry out the study procedures
* Sign the informed consent.

Exclusion Criteria

* Suffer from any underlying disease
* Pain due to tumors or infections, metastases, osteoporosis, inflammatory arthritis or fractures
* Be receiving any other treatment for TMD or consuming some type of substance that alters muscle tone.
* Patients with myopathies, diseases of the Peripheral Nervous System, mental disorders diagnosed by a doctor
* Inability to collaborate
* Any other situation in which the evaluation could be altered.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Alcala

OTHER

Sponsor Role lead

Responsible Party

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María Teresa Ortiz Moreno

MSc

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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María Teresa Ortiz-Moreno, MSc

Role: PRINCIPAL_INVESTIGATOR

University of Alcalá

Gema Bodes-Pardo, PhD

Role: STUDY_DIRECTOR

University of Alcalá

Locations

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Campus Científico Tecnológico UAH. AV. de León, 3A.

Alcalá de Henares, Madrid, Spain

Site Status

Countries

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Spain

Central Contacts

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María Teresa Ortiz-Moreno, MSc

Role: CONTACT

+34662422993

Gema Bodes-Pardo, PhD

Role: CONTACT

Facility Contacts

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María Teresa Ortiz-Moreno, MSc

Role: primary

+34662422993

References

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Calixtre LB, Gruninger BL, Haik MN, Alburquerque-Sendin F, Oliveira AB. Effects of cervical mobilization and exercise on pain, movement and function in subjects with temporomandibular disorders: a single group pre-post test. J Appl Oral Sci. 2016 May-Jun;24(3):188-97. doi: 10.1590/1678-775720150240.

Reference Type BACKGROUND
PMID: 27383698 (View on PubMed)

Chellappa D, Thirupathy M. Comparative efficacy of low-Level laser and TENS in the symptomatic relief of temporomandibular joint disorders: A randomized clinical trial. Indian J Dent Res. 2020 Jan-Feb;31(1):42-47. doi: 10.4103/ijdr.IJDR_735_18.

Reference Type BACKGROUND
PMID: 32246680 (View on PubMed)

Sousa BM, Lopez-Valverde N, Lopez-Valverde A, Caramelo F, Fraile JF, Payo JH, Rodrigues MJ. Different Treatments in Patients with Temporomandibular Joint Disorders: A Comparative Randomized Study. Medicina (Kaunas). 2020 Mar 5;56(3):113. doi: 10.3390/medicina56030113.

Reference Type BACKGROUND
PMID: 32151101 (View on PubMed)

Dos Santos Aguiar A, Bataglion C, Felicio LR, Azevedo B, Chaves TC. Additional effect of pain neuroscience education to craniocervical manual therapy and exercises for pain intensity and disability in temporomandibular disorders: a study protocol for a randomized controlled trial. Trials. 2021 Sep 6;22(1):596. doi: 10.1186/s13063-021-05532-x.

Reference Type BACKGROUND
PMID: 34488856 (View on PubMed)

Wanman A, Marklund S. Treatment outcome of supervised exercise, home exercise and bite splint therapy, respectively, in patients with symptomatic disc displacement with reduction: A randomised clinical trial. J Oral Rehabil. 2020 Feb;47(2):143-149. doi: 10.1111/joor.12888. Epub 2019 Sep 30.

Reference Type BACKGROUND
PMID: 31520538 (View on PubMed)

Yamaguchi Y, Sakuma S, Takagi S, Ogi N, Kurita K, Ariji Y, Taguchi N. Efficacy of therapeutic exercise for temporomandibular disorders as assessed by magnetic resonance imaging: a case report. J Phys Ther Sci. 2020 Jul;32(7):477-482. doi: 10.1589/jpts.32.477. Epub 2020 Jul 3.

Reference Type BACKGROUND
PMID: 32753791 (View on PubMed)

Garrigos-Pedron M, La Touche R, Navarro-Desentre P, Gracia-Naya M, Segura-Orti E. Effects of a Physical Therapy Protocol in Patients with Chronic Migraine and Temporomandibular Disorders: A Randomized, Single-Blinded, Clinical Trial. J Oral Facial Pain Headache. 2018 Spring;32(2):137-150. doi: 10.11607/ofph.1912.

Reference Type BACKGROUND
PMID: 29694464 (View on PubMed)

Michelotti A, de Wijer A, Steenks M, Farella M. Home-exercise regimes for the management of non-specific temporomandibular disorders. J Oral Rehabil. 2005 Nov;32(11):779-85. doi: 10.1111/j.1365-2842.2005.01513.x.

Reference Type BACKGROUND
PMID: 16202040 (View on PubMed)

Malfliet A, Kregel J, Coppieters I, De Pauw R, Meeus M, Roussel N, Cagnie B, Danneels L, Nijs J. Effect of Pain Neuroscience Education Combined With Cognition-Targeted Motor Control Training on Chronic Spinal Pain: A Randomized Clinical Trial. JAMA Neurol. 2018 Jul 1;75(7):808-817. doi: 10.1001/jamaneurol.2018.0492.

Reference Type BACKGROUND
PMID: 29710099 (View on PubMed)

Bodes Pardo G, Lluch Girbes E, Roussel NA, Gallego Izquierdo T, Jimenez Penick V, Pecos Martin D. Pain Neurophysiology Education and Therapeutic Exercise for Patients With Chronic Low Back Pain: A Single-Blind Randomized Controlled Trial. Arch Phys Med Rehabil. 2018 Feb;99(2):338-347. doi: 10.1016/j.apmr.2017.10.016. Epub 2017 Nov 11.

Reference Type BACKGROUND
PMID: 29138049 (View on PubMed)

Other Identifiers

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Temporomandibular Disorders

Identifier Type: -

Identifier Source: org_study_id

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