Neck Exercises in Patients With Temporomandibular Disorders
Temporomandibular Disorders, Temporomandibular Joint Pain
About this trial
This is an interventional treatment trial for Temporomandibular Disorders focused on measuring Pain, Temporomandibular Disorders, Therapeutic exercises, Musculoskeletal disorders, Randomized controlled trial, Imaging, Brain plasticity, Clinical outcomes, Chronic pain, Neck
Eligibility Criteria
Inclusion Criteria:
- females 18-60 years of age (TMDs are more prevalent in females);
- diagnosed with muscle pain disorders as classified by the new Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) or mixed TMD;
- have had pain in the masticatory muscle for at least 3 months;
- have chronic masticatory muscle pain not attributable to recent acute trauma, previous infection, or active inflammation; and
- have a moderate or severe baseline pain score of 30 mm or greater using a 100 mm VAS.
Exclusion Criteria:
- metabolic, rheumatoid, or vascular diseases;
- commonly comorbid functional chronic pain disorders (e.g., irritable bowel syndrome, fibromyalgia);
- psychiatric disorders (e.g., depression, schizophrenia);
- abnormal neurological examination;
- contraindication for MRI scanning (e.g., metallic surgical implant);
- self-report of substance abuse;
- exercise therapy in the 6 months before entry into the study or current treatment for TMD;
- previous experience with electrotherapy; or
- pregnant or planning a pregnancy.
After confirming eligibility to participate in the study, all participants will be asked to sign an informed consent in accordance with the UofA´s policies on research using human participants.
Sites / Locations
- Corbett Hall-Sports LaboratoryRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Exercises
Placebo
Neck flexors Training: Each patient will initially perform cranio-cervical flexion to sequentially reach 5 pressure targets in 2 mmHg increments from a baseline of 20 mmHg to the final level of 30 mmHg. For each target level, the contraction duration will be increased to 10 s, and the participant trained to perform 10 repetitions with brief rest periods between each contraction. Once one set of 10 repetitions of 10 s is achieved at one target level, the exercise will be progressed to train at the next target level up to the final target. Neck extensors training: Patients will perform cranio-cervical extension and upper cervical rotation in a prone on elbows position while maintaining the cervical spine in a neutral position, progressing to a 4-pt kneeling position.
The placebo group will receive placebo TENS (switched-off TENS apparatus with no perceptible stimulation). Four electrodes, 50 x 35 mm, will be placed on the neck muscles. The participant will be informed that this therapy is called a "subthreshold current" and they might not be able to feel any sensation underneath the electrodes during the treatment. The placebo treatment will be for 30 min twice a week for 8 weeks, as for the intervention group.