Effects of Rocabado's Approach Versus Kraus Exercise Therapy

Riphah International University

Status: Completed

Conditions: Temporomandibular Dysfunction

Treatments: Other: Kraus exercises; Other: Rocabado's approach

Study type: Interventional

Funder types: Other

Identifiers

NCT05618938

REC/RCR & AHS/22/0151 Amna

Details and patient eligibility

About

TMJ dysfunction is linked to trauma, joint overloading owing to para-functional behaviors, mechanical stress, and metabolic issues. Myofascial pain and dysfunction, functional derangement, and osteoarthrosis are the three most frequent TMJ-related disorders. Temporomandibular joint disorders are a type of craniofacial problems. They affect the temporomandibular joint, muscles of mastication, and other musculoskeletal tissues. The most common clinical sign and symptoms associated with TMJ dysfunction are orofacial pain and clicking. The aim of study will be to compare the effects of Rocabado's approach versus Kraus therapy on Pain and Disability in patients with temporomandibular dysfunction.

Full description

A Randomized Clinical Trial will be conducted at FMH Physiotherapy Clinic and Boston Physiotherapy Clinic Lahore through consecutive sampling technique on 40 patients which will be allocated using random sampling through opaque sealed enveloped into Group A and Group B. Group A will be treated with Rocabado's approach and Group B will be treated with Kraus exercises. Outcome measures tools will be conducted through NPRS, TMD disability index, Fonseca questionnaire after four weeks. Data will be analyzed during SPSS software version 21. After assessing normality of data by Shapiro-wilk test, it will be decided either parametric or non-parametric test will be used within a group or between two groups.

Enrollment: 40 patients

Sex: All

Ages: 30 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Male and female between the ages of 30 to 60 years
• Patients with jaw pain
• Patients with limited jaw range of motion and associated joint pain
• Patients with TMJ clicking sounds
• Patients with pain upon muscle and joint palpation

Exclusion criteria

• Diagnosis of ear, nose, and throat medical pathology underlying the tinnitus;
• Neurological problems that could potentially cause the tinnitus
• Inability to read, understand, and complete the questionnaires or understand and follow commands (e.g., illiteracy, dementia, or blindness)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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40 participants in 2 patient groups

Group: A Rocabado's approach

Experimental group

Description:

1. Rest position of the tongue: The anterior 1/3 of the tongue is placed at the palate with mild pressure. 2. Control of TMJ rotation: The jaw is repeatedly opened and closed with the anterior 1/3 of the tongue on the palate. 3. Rhythmic stabilization technique: Gentle isometrics in the resting position are performed for jaw opening, closing, and lateral deviation. 4. Axial extension of the neck: Combined upper cervical flexion with lower cervical extension.

Treatment:

Other: Rocabado's approach

Group B: Kraus exercises

Experimental group

Description:

Group B will be treated with Kraus exercises. Kraus exercises will be comprised of eight exercise programs. 1. Tongue position at rest: The patient will be instructed to maintain a resting tongue position except during function, which involves the tip of the tongue sitting on the palate with the tip resting just posterior to the upper incisors 2. Teeth apart: the patient will be educated to maintain the teeth apart can be therapeutic, which facilitates the resting tongue position 3. Nasal-diaphragmatic breathing: The patient will be instructed in nasal breathing to facilitate function of the diaphragm, which reinforces positioning of both the tongue and teeth 4. Tongue up and wiggle: Place the tongue to the palate, then move the jaw from side to side. 5. Strengthening: Resisted closing via self-manual resistance using tongue depressor between lower incisors: 5-10-second contractions.

Treatment:

Other: Kraus exercises