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Manual Therapy and Exercises Applied to Cervical Spine in Patients With Temporomandibular Disorders

This study has been completed.
Information provided by (Responsible Party):
Bruno Leonardo da Silva Grüninger, Universidade Federal de Sao Carlos Identifier:
First received: September 17, 2013
Last updated: January 29, 2015
Last verified: January 2015
The objective of this study was to investigate the effect of a manual therapy and exercise program, focused on the rehabilitation of cervical function, on clinical signs and mandibular function in subjects with TMD.

Condition Intervention
Temporomandibular Joint Dysfunction Syndrome
Other: Manual therapy
Device: Pressure biofeedback device

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Effects of Manual Therapy and Exercises Applied to Cervical Spine in Patients With Temporomandibular Disorders: Pilot Study

Resource links provided by NLM:

Further study details as provided by Universidade Federal de Sao Carlos:

Primary Outcome Measures:
  • Changing in maximum mouth opening pain free [ Time Frame: Before and 5 days follow-up intervetion ]
    The clinical signs was based on Research Diagnostic Criteria protocol and it was measured maximum mouth opening pain free using a caliper ((Somet, 150mm, Inox, Czechoslovakia)

Secondary Outcome Measures:
  • Changing of Pain [ Time Frame: Before and 5 days follow-up intervetion ]
    To evaluate pain it was applied a scale from Research Diagnostic Criteria protocol, that consists of a line scored from 0 to 10, where 0 represents no pain and 10 the worst pain that the subject has experienced, allowing it to check the number that features their pain at the moment.

Other Outcome Measures:
  • Changing in Mandibular Function Impairment Questionnaire -MFIQ [ Time Frame: Before and 5 days follow-up intervetion ]
    To evaluated mandibular function was used the Mandibular Function Impairment Questionnaire

Enrollment: 12
Study Start Date: July 2012
Study Completion Date: December 2012
Primary Completion Date: December 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
No Intervention: Manual therapy
Upper cervical flexion mobilization, C5 central posterior-anterior mobilization, Pressure biofeedback device
Other: Manual therapy
The patient was supine with the cervical spine in a neutral position. The therapist brought about a contact of the occipital bone with the first finger and medial aspect of the hand, and other hand over the frontal region of the patient's head. The mobilizing force was delivered by flexing the upper cervical region using a combination of cephalic traction with the occipital hand and caudal pressure with the frontal hand. This technique was applied for 10 minutes
Other Name: Upper cervical flexion mobilization
Other: Manual therapy
The patient was prone with the cervical spine in a neutral position. The therapist placed the tips of his thumbs on the posterior surface of the C5 spinous process, while the other fingers rested gently around the patients' neck. This technique was applied for 9 minutes
Other Name: C5 central posterior-anterior mobilization
Device: Pressure biofeedback device
Device: Stabilizer - Chattanooga Group Inc., Chattanooga, Tennessee, USA The cranio-cervical flexor stabilization exercise was done 10 times holding 10 seconds the flexing position graded through feedback from a pressure biofeedback device
Other Name: Stabilizer

Detailed Description:

Temporomandibular disorder (TMD) is a general term that refers to disorders associated with the temporomandibular joint (TMJ) and the masticatory muscles. Among the main symptoms are pre-auricular pain (in the region of the TMJ) and/or pain in the masticatory muscles.

It's usual to observe that subjects with TMD also present cervical alteration. Beside this, cervical postural alterations produced by muscle tension can influence mandibular position.

The intervention protocol was based on manual therapy, stabilization exercises and stretching.

The technique are:.

  1. Upper cervical flexion mobilization;
  2. C5 central posterior-anterior mobilization;
  3. Stabilization exercise: Cranio-cervical flexor stabilization exercise
  4. Stretching of muscles: upper trapezius, scalenes, semispinalis capitis; splenius capitis, sternocleidomastoid

Ages Eligible for Study:   18 Years to 25 Years   (Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Patients diagnosed with myogenic or mixed temporomandibular disorders

Exclusion Criteria:

  • Patients diagnosed with arthrogenic or discogenic temporomandibular disorders
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Please refer to this study by its identifier: NCT01954511

Sponsors and Collaborators
Universidade Federal de Sao Carlos
Study Director: Ana Beatriz Oliveira, Phd Clinical professor - UFSCar
Principal Investigator: Letícia Bojikian Calixtre, Pt UFSCar
Principal Investigator: Francisco Alburquerque Sendín, Phd University of Salamanca
Principal Investigator: Melina Nevoeiro Haik, MSc UFSCar
  More Information

Responsible Party: Bruno Leonardo da Silva Grüninger, Pt, Universidade Federal de Sao Carlos Identifier: NCT01954511     History of Changes
Other Study ID Numbers: U1111-1139-4055
0300.0.135.000-11 ( Other Identifier: CEP/UFSCar )
Study First Received: September 17, 2013
Last Updated: January 29, 2015

Keywords provided by Universidade Federal de Sao Carlos:
Stomatognathic diseases;
Temporomandibular Joint Dysfunction Syndrome

Additional relevant MeSH terms:
Joint Diseases
Temporomandibular Joint Disorders
Temporomandibular Joint Dysfunction Syndrome
Musculoskeletal Diseases
Craniomandibular Disorders
Mandibular Diseases
Jaw Diseases
Muscular Diseases
Stomatognathic Diseases
Myofascial Pain Syndromes processed this record on May 25, 2017