Effects of Mulligan Mobilization in Comparison With Maitland Mobilization in Temporomandibular Joint Dysfunction.

NCT ID: NCT07328269

Last Updated: 2026-01-09

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

RECRUITING

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-09-05

Study Completion Date

2026-01-05

Brief Summary

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The temporomandibular joint dysfunction is the second most common musculoskeletal pain after back pain, causing jaw pain, restricted movement, and joint sounds. NPRS and millimeter ruler will be used for the assessment of patient. This study will compare the effects of Mulligan and Maitland mobilization, commonly used treatment, on pain and Temporomandibular joint mobility through a randomized controlled trial, involving 30 participants divided into two groups for treatment.

Detailed Description

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The temporomandibular joint connects the mandible to the temporal bone near the ear's tragus and plays a key role in mastication. It involves joint or muscle pain, jaw movement limitation, and joint popping sound Risk factors include trauma, bruxism, arthritis, stress, and poor posture, while diagnosis is commonly made using the DC/TMD criteria, focusing on pain and intra-articular dysfunction. Manual therapy techniques widely used to restore joint function and reduce pain.

Among these, Mulligan's Mobilization combines therapist-applied glides with active patient movement, while Maitland mobilization uses graded oscillatory techniques to relieve pain and improve mobility.

This study aims to compare the effects of Mulligan and Maitland mobilization on pain reduction and TMJ hypomobility in adults with TMD.

A randomized controlled trial will be conducted over one year. 30 participants will be selected through purposive sampling and randomly divided into two groups.

The intervention will last two weeks, comprising 06 treatment sessions. Assessments will be conducted at baseline, after the third session, and at the end of the second week.

Treatment will include lateral, anterior, medial, and distraction glides, combined with Rocabado's 6x6 exercises to improve functional movement. Myofascial release for the temporalis and masseter muscles will also be applied.

Conditions

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Temporomandibular Joint Dysfunction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participant divided into Two groups Group A recieves Mulligan Mobilization and Group B receives Maitland Mobilization with baseline treatment of myofascial release of temporalis and masseter muscle and Rocabado's 6\*6 exercise program.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants
Participant will just have an idea of two interventions not the one given to him/her.

Study Groups

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Mulligan Mobilization

Experimental Group A-Mulligan Mobilization. Myofascial release of temporalis and masseter muscle, Rocabado 6\*6 exercise program.

Group Type ACTIVE_COMPARATOR

Mulligan Mobilization

Intervention Type PROCEDURE

Both Mulligan and Maitland mobilization techniques with Myofascial release of temporalis and masseter and Rocabado 6\*6 exercise program are applied over a two-week period with six sessions in total, focusing on improving TMJ mobility and reducing pain.

Group A Mulligan mobilization emphasizes active patient involvement combined with therapist-applied glides, including lateral, anterior, medial, and distraction glides performed for 5-10 seconds with 3-5 repetitions per session.

These techniques enhance mouth opening, lateral deviation, protrusion, and joint space while reducing stiffness and pain. And baseline treatment of myofascial release of temporalis and masseter muscle and Rocabado's 6\*6 exercise program

Maitland Mobilization

Experimental Group B-Maitland Mobilization. Myofascial release of temporalis and masseter muscle. Rocabado 6\*6 exercise program.

Group Type EXPERIMENTAL

Maitland Mobilization

Intervention Type PROCEDURE

Group B-Maitland mobilization relies on graded oscillatory movements (Grades I-III) for 5-10 seconds with 3-5 oscillations, targeting pain relief and mobility in the pain-free range. Lower grades (I-II) are used for acute pain with gentle oscillations, while higher grades (II-III) provide moderate mobilization to improve protrusion, lateral deviation, and joint capsule mobility.

And baseline treatment of myofascial release of temporalis and masseter muscle and Rocabado's 6\*6 exercise program.

Interventions

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Mulligan Mobilization

Both Mulligan and Maitland mobilization techniques with Myofascial release of temporalis and masseter and Rocabado 6\*6 exercise program are applied over a two-week period with six sessions in total, focusing on improving TMJ mobility and reducing pain.

Group A Mulligan mobilization emphasizes active patient involvement combined with therapist-applied glides, including lateral, anterior, medial, and distraction glides performed for 5-10 seconds with 3-5 repetitions per session.

These techniques enhance mouth opening, lateral deviation, protrusion, and joint space while reducing stiffness and pain. And baseline treatment of myofascial release of temporalis and masseter muscle and Rocabado's 6\*6 exercise program

Intervention Type PROCEDURE

Maitland Mobilization

Group B-Maitland mobilization relies on graded oscillatory movements (Grades I-III) for 5-10 seconds with 3-5 oscillations, targeting pain relief and mobility in the pain-free range. Lower grades (I-II) are used for acute pain with gentle oscillations, while higher grades (II-III) provide moderate mobilization to improve protrusion, lateral deviation, and joint capsule mobility.

And baseline treatment of myofascial release of temporalis and masseter muscle and Rocabado's 6\*6 exercise program.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age 19-44 years.
* Both Genders (Male and Female).
* Patients diagnosed with TMJ hypomobility using the Manual Functional Analysis questionnaire based on DC/TMD criteria.
* Individuals with myofascial pain, scoring above 5 on the NRS and pain upon palpation of at least two of eight masticatory and neck muscles.
* Subjects with acute TMD and myofascial pain unrelated to active inflammation, infection, or recent trauma for at least six months.

Exclusion Criteria

* Hypermobility of TMJs.
* Pregnancy.
* History of rheumatic and inflammatory diseases.
* A history of temporomandibular disorders treatment within last three months.
* Acute trauma or injuries of face, head or cervical spine, neurological disorders, taking medication that could affect the musculoskeletal system.
Minimum Eligible Age

19 Years

Maximum Eligible Age

44 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Foundation University Islamabad

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Foundation University College of Physical Therapy

Islamabad, Punjab Province, Pakistan

Site Status RECRUITING

Countries

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Pakistan

Central Contacts

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Mah Noor

Role: CONTACT

+92310-5351360

Anam Rehman, MS-OMPT

Role: CONTACT

+923355082299

Facility Contacts

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Mah Noor, DPT

Role: primary

+92310-5351360

Other Identifiers

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FUI/CTR/2025/20

Identifier Type: -

Identifier Source: org_study_id

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