Temporomandibular Disorders Physiotherapy (TMD/VAS/ROM)

Palestine Polytechnic University

Status: Completed

Conditions: Temporomandibular Disorders (TMD)

Treatments: Other: Maitland mobilization techniques

Study type: Interventional

Funder types: Other

Identifiers

NCT06994910

CAMS/PTBR/3/127

Details and patient eligibility

About

This study aims to investigate the effectiveness of the Maitland joint mobilization technique in alleviating symptoms related to (temporomandibular disorders) TMD and to investigate its influence on patient clinical outcomes, including pain intensity, TMJ range of motion (ROM), functional limitations, disability, and oral behaviors.

Full description

Physiotherapeutic procedures for TMD aim to reduce pain, enhance neuromuscular coordination and strength, and promote joint range of motion (ROM), mastication, mouth opening, and general mobility. The literature highlights a variety of physiotherapy techniques used to treat TMD, including manual therapy, stretching, active and passive exercises, as well as modalities like thermotherapy, ultrasound, electrotherapy, iontophoresis, laser therapy, shockwave therapy, infrared therapy, kinesiology taping, and dry needling. Clinical research supports the efficacy of physiotherapy as a conservative treatment for TMD, effectively addressing pain, muscular dysfunctions, and psychosocial factors. Optimal results are achieved through a combination of therapeutic exercises and manual therapy, which is considered one of the most effective approaches.

The Maitland joint mobilization technique is a key physiotherapeutic procedure for managing TMD. This technique involves passive, rhythmic joint mobilizations aimed at restoring joint functionality and alleviating pain. The technique employs five grades of mobility, each designed for specific therapeutic goals. Grades I and II are used to reduce pain and relax soft tissues, while Grades III, IV, and V focus on addressing joint hypomobility by stretching soft tissues and improving joint mobility. The technique enhances both osteokinematic and arthrokinematic movements, with osteokinematic referring to voluntary joint motion, and arthrokinematic to the small, involuntary movements that occur during normal joint ROM. Maitland joint mobilization utilizes controlled forces in specific directions, based on Kaltenborn's concave-convex rule, to optimize both movements and improve joint function. This research is essential for providing further evidence that supports enhanced physiotherapeutic techniques, resulting in enhancing patient clinical outcomes and enhancing professional practices for the optimal management of TMD.

Enrollment: 30 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Diagnosis: individuals diagnosed with TMD, whether it is unilateral or bilateral.
• Myofascial pain and myo-spasm.
• Anterior disk displacement with reduction and anterior disk displacement without reduction.
• Craniofacial and craniomandibular pain.
• Myofascial pain with or without limited mouth opening.

Exclusion criteria

• Patients with a documented history of surgical procedures involving the TMJ.
• Patients with a confirmed diagnosis of systemic diseases (e.g., rheumatic and metabolic diseases).
• Patients with congenital or developmental craniofacial anomalies, including conditions like as ankylosis.
• Patients with diagnosed cancer.
• Patients with mental, physical disorders and language difficulties.
• Patients with diagnosed neuropathic and dental pain.
• Patients with diagnosed general myopathy (e.g., fibromyalgia).

Trial design

Primary purpose: Supportive Care

Allocation: Non-Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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30 participants in 2 patient groups

Before Maitland joint mobilization

Experimental group

Description:

Participants with temporomandibular joint dysfunction received Maitland mobilization techniques applied to the TMJ over a defined treatment period. Outcomes were assessed at baseline (pre-intervention) and after completion of the intervention (post-intervention)

Treatment:

Other: Maitland mobilization techniques

After Maitland joint mobilization

Experimental group

Description:

Participants with temporomandibular joint dysfunction received Maitland mobilization techniques applied to the TMJ over a defined treatment period. Outcomes were assessed at baseline (pre-intervention) and after completion of the intervention (post-intervention).

Treatment:

Other: Maitland mobilization techniques