Post-Isometric Relaxation in Temporomandibular Disorders
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Postural Exercises + Post-Isometric Relaxation (PIR) Technique, Postural Exercises.
- Who it may be relevant to
- Registry conditions: Temporomandibular Joint Disorders, Myofascial Pain Syndromes, Mandibular Dysfunction. Basic parameters: 18 years — 25 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
The Effect of Post-Isometric Relaxation Technique on Cervical Range of Motion, Mandibular Mobility, Head Anterior Tilt, and Kyphotic Posture in Individuals With Temporomandibular Joint Dysfunction
Overview
This planned randomized, single-blind clinical trial will investigate the effects of adding the Post-Isometric Relaxation (PIR) technique to a standard postural exercise program in individuals with moderate to severe temporomandibular joint dysfunction (TMD). Forty volunteers aged 18-25 years will be recruited and randomly assigned to either an experimental group (postural exercises + PIR) or a control group (postural exercises only). The intervention will be delivered three times per week for six weeks. Primary outcomes will include cervical range of motion, mandibular mobility, head anterior tilt, and thoracic kyphosis index, measured before and after the intervention. The study aims to determine whether PIR provides additional benefits to standard postural exercises in improving jaw and neck function and postural alignment in young adults with TMD.
Detailed description
Temporomandibular joint dysfunction (TMD) is a common musculoskeletal condition characterized by jaw pain, limited mouth opening, and joint sounds, often accompanied by postural deviations such as forward head posture and thoracic kyphosis. Conservative treatments, including postural exercises and manual therapy, are recommended to improve jaw and neck function and reduce symptoms.
The Post-Isometric Relaxation (PIR) technique is a manual therapy method that uses gentle isometric contractions followed by passive stretching to reduce muscle tension and increase mobility. While PIR has been shown to improve masticatory muscle function, its combined use with postural exercises in TMD management has not been fully evaluated.
In this planned study, forty volunteers aged 18-25 years with moderate or severe TMD (diagnosed using the Fonseca Anamnestic Questionnaire) will be recruited. Participants will be randomly assigned into two groups:
Experimental group: Postural exercise program + PIR technique
Control group: Postural exercise program only
The postural exercise program will include strengthening, stretching, and mobility exercises for the cervical and thoracic regions, performed three times per week for six weeks. In the experimental group, the PIR technique will be applied to jaw muscles according to a standardized protocol.
Outcome measures will include:
Cervical range of motion (flexion, extension, lateral flexion, rotation) measured with a goniometer
Mandibular mobility (depression, lateral deviation, protrusion) measured with a caliper
Head anterior tilt (chin-sternum distance, occiput-wall distance)
Thoracic kyphosis index measured with a flexicurve
Assessments will be conducted before the intervention and after the six-week program. The primary hypothesis is that the addition of PIR to postural exercises will produce greater improvements in cervical and mandibular mobility than postural exercises alone.
This trial is expected to provide new evidence for combining manual therapy with exercise in the management of TMD in young adults and may help guide future rehabilitation strategies.
Interventions
- Behavioral Postural Exercises + Post-Isometric Relaxation (PIR) Technique
Participants will perform a standardized postural exercise program (strengthening, stretching, and mobility exercises for the cervical and thoracic regions) three times per week for six weeks. In addition, the Post-Isometric Relaxation (PIR) technique will be applied to jaw muscles during each session to reduce muscle tension and improve mandibular mobility. - Behavioral Postural Exercises
Participants will perform a standardized postural exercise program designed to improve cervical and thoracic mobility and postural alignment. The program will include strengthening, stretching, and mobility exercises targeting the cervical spine, thoracic spine, and related musculature. Each session will last approximately 30-40 minutes and will be conducted three times per week for six weeks under the supervision of a trained therapist.
Primary outcome measures
- Change in mandibular depression (mouth opening) [Time frame: Baseline and after 6 weeks of intervention]
- Change in cervical range of motion [Time frame: Baseline and after 6 weeks of intervention]
- Change in mandibular lateral deviation (right and left) [Time frame: Baseline and after 6 weeks of intervention]
- Change in mandibular protrusion [Time frame: Baseline and after 6 weeks of intervention]
- Change in head anterior tilt - chin-sternum distance [Time frame: Baseline and after 6 weeks of intervention]
- Change in head anterior tilt - occiput-wall distance [Time frame: Baseline and after 6 weeks of intervention]
- Change in thoracic kyphosis index [Time frame: Baseline and after 6 weeks of intervention]
Eligibility criteria
Inclusion criteria
- Age between 18 and 25 years
- Diagnosis of moderate or severe temporomandibular joint dysfunction (TMD) according to the Fonseca Anamnestic Questionnaire
- Presence of TMD symptoms for at least 6 months
- No TMD treatment received within the last 6 months
- Presence of chewing muscle pain for at least 6 months
- Able and willing to participate in the study and follow the exercise program
- Signed informed consent form
Exclusion criteria
- History of jaw or facial trauma within the past year
- History of temporomandibular joint surgery
- Presence of systemic rheumatologic, neurological, or musculoskeletal disorders affecting the jaw, neck, or spine
- Pregnancy
- Current participation in another clinical trial
- Inability to perform the exercise program due to medical or physical limitations
- Refusal to provide informed consent
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Treatment
Study locations
Center list to be confirmed — check the primary protocol.
Identifiers
NCT: NCT07130279 · TME-PIR-2024-01