Efficacy of the Myofunctional Therapy on Oral Dysphagia

Hasan Kalyoncu University

Status: Completed

Conditions: Dysphagia, Oral Phase; Temporomandibular Disorders

Treatments: Procedure: Manual Therapy Combined with Home Exercise; Procedure: Home Exercise; Procedure: Orofacial Myofunctional Therapy combined with Manual Therapy and Home Exercise

Study type: Interventional

Funder types: Other

Identifiers

NCT04636606

2019/131

Details and patient eligibility

About

The aim of the study is to analyze the effects of orofacial myofunctional therapy (OMT) on oral dysphagia (OD) in patients with temporomandibular disorders (TMD).

Full description

60 subjects with TMD, according to the Research Diagnostic Criteria, will be included in the study after voluntary consent form will be filled out. Subjects will randomly be divided into 3 groups according to the order.

Home Exercise (n=20) will be the Group 1, Home Exercise combined with Manual Therapy (n=20) will be the Group 2, and Orofacial Myofunctional Therapy combined with Home Exercise and MT treatment (n=20) will be the Group 3.

Group 1 will include educational training program about parafunctional activities of TMD disorders and active exercises for masticatory and neck muscles with 10 repetitions, 3 times a day, and for 10 weeks.

Group 2 will receive home exercise training program and manual therapy program which is planned to last 30 minutes; will be applied twice a week, for 10 weeks.

Group 3 will include stretching and strengthening of the tongue muscles, tongue rotation exercises, effortful swallowing, strengthen the hyoidal muscles, which is planned to last 40 minutes, will be applied twice a week, for 10 weeks.

Enrollment: 60 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Ages between 18 and 65 years old
• Patients with diagnosis of Group Ia, Ib, IIa and and III according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD)
• Having pain ≥ 4 according to the Visual Analog Scale
• Having score ≥2 points on the Eating Assessment Tool-10 questionnaire
• Patients who had difficulty in water swallowing tests

Exclusion criteria

• Ages under 18 and over 65 years old
• Patients with a diagnosis of Group II b,c according to the RDC / TMD evaluation
• Diagnosis of psychiatric illness
• Patients with musculoskeletal problems in which systemic specific pathological conditions such as cervical and / or temporomandibular joint (TMJ) problem malignancy, fracture, rheumatoid disease is proven
• Patients who have undergone any surgery related to the cervical and/or TMJ
• Patients with facial paralysis
• Patients with swallowing difficulties due to the neurological disorders
• Patients who have received physical therapy associated with TMJ in less than 6 months
• Patients with cognitive deficits
• Participation rate lower than 80% of the program schedule

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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60 participants in 3 patient groups

Home Exercise

Active Comparator group

Description:

Home Exercise program includes educational training program about parafunctional activities of patients having oral dysphagia with temporomandibular disorders. Program includes stretching and strengthening of masticatory and neck muscles and posture exercises as well as diaphragmatic breathing exercises.

Treatment:

Procedure: Home Exercise

Manual Therapy Combined with Home Exercise

Active Comparator group

Description:

Manual Therapy includes deep friction massage and myofascial relaxation techniques to masticatory and neck muscles, active and resistant temporomandibular joint movements, temporomandibular joint distraction and mobilization, stretching techniques to the temporomandibular joint, mobilization of upper cervical joints. Home Exercise program includes educational training program about parafunctional activities of patients having oral dysphagia with temporomandibular disorders. Program includes stretching and strengthening of masticatory and neck muscles and posture exercises as well as diaphragmatic breathing exercises.

Treatment:

Procedure: Manual Therapy Combined with Home Exercise

Orofacial Myofunctional Therapy combined with Manual Therapy and Home Exercise

Active Comparator group

Description:

Orofacial Myofunctional therapy includes stretching the tongue muscles, tongue rotation exercises, isometric and isotonic strengthening of the tongue, special maneuver, effortful swallow exercise, strengthening exercise of hyoidal muscles. Manual Therapy includes deep friction massage and myofascial relaxation techniques to masticatory and neck muscles, active and resistant temporomandibular joint movements, temporomandibular joint distraction and mobilization, stretching techniques to the temporomandibular joint, mobilization of upper cervical joints. Home Exercise program includes educational training program about parafunctional activities of patients having oral dysphagia with temporomandibular disorders. Program includes stretching and strengthening of masticatory and neck muscles and posture exercises as well as diaphragmatic breathing exercises.

Treatment:

Procedure: Orofacial Myofunctional Therapy combined with Manual Therapy and Home Exercise