Post-Isometric Relaxation in Temporomandibular Disorders

Официальное название

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

Обзор

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.

Подробное описание

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.

Вмешательства

• Поведенческое 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.
• Поведенческое 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.

Первичные конечные точки

• Change in mandibular depression (mouth opening) [Срок оценки: Baseline and after 6 weeks of intervention]
• Change in cervical range of motion [Срок оценки: Baseline and after 6 weeks of intervention]
• Change in mandibular lateral deviation (right and left) [Срок оценки: Baseline and after 6 weeks of intervention]
• Change in mandibular protrusion [Срок оценки: Baseline and after 6 weeks of intervention]
• Change in head anterior tilt - chin-sternum distance [Срок оценки: Baseline and after 6 weeks of intervention]
• Change in head anterior tilt - occiput-wall distance [Срок оценки: Baseline and after 6 weeks of intervention]
• Change in thoracic kyphosis index [Срок оценки: Baseline and after 6 weeks of intervention]

Критерии участия

Критерии включения

• 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

Критерии исключения

• 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

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Простое слепое

Основная цель

Лечение

Центры проведения

Список центров уточняется — проверьте первичный протокол.

Идентификаторы

NCT: NCT07130279 · TME-PIR-2024-01

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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