How is Aerobic Exercise Compared to Localized Pain Relief Exercises in Patients With Jaw Pain and Neck Pain?
Temporomandibular Disorder, Neck Pain
About this trial
This is an interventional treatment trial for Temporomandibular Disorder focused on measuring Temporomandibular disorder, Neck pain, Exercise therapy, Motor control exercise
Eligibility Criteria
Inclusion Criteria:
- Be between 18-60 years of age
- Be diagnosed with idiopathic chronic neck pain as described the IASP and/or presence of temporomandibular disorders identified by DC/TMD screening
- Have pain in the neck or jaw area for at least 3 months (chronic pain)
- Have pain not attributable to recent acute trauma, previous infection, or to an active inflammatory cause in the last month
- Have a moderate or severe baseline pain score of 30mm or greater using a 100mm VAS
Exclusion Criteria:
- Present red flags for serious pathologies related to neck pain or jaw pain
- Report comorbidity functional chronic pain disorders (e.g., fibromyalgia)
- Have been diagnosed with psychiatric disorders (e.g., depression, schizophrenia)
- Have received therapy within 3 months prior to entry into the study
Sites / Locations
- Hochschule Osnabrück - University of Applied SciencesRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Aerobic exercise group (AE)
Neck motor control exercise group
The session training will be divided into a warm-up, main exercise period, and cool-down, with a total duration of 60 minutes (guided by a PT). The training will be performed on a cycle ergometer, three times per week for 12 weeks. The duration of the main AE will be between 30-45 minutes and the intensity will be based on the maximal heart rate (HRmax), heart rate reserve (HRR), and the Borg Rating of Perceived Exertion Scale (Borg Scale), which will be monitored. The intensity of the AE program will be progressively increased according to each patient's response and tolerance but will be standardized as much as possible: 1) first two weeks, low to moderate intensity (60% HRmax or 9-11 on the Borg scale); 2) 2-6 weeks, moderate-intensity (55-70% HRmax or 12-14 on the Borg scale), and 3) last 6 weeks, high intensity interval training (HIT) (75-90% HRmax or 15-17 on the Borg scale; 4 min*4 times HIT followed by 3 min of 70%HRmax in between) will be targeted per literature endorsements.
The treatment will consist of a 12-week progressive exercise program targeted to the neck flexor and extensor muscles supervised by a physical therapist (PT). This exercise protocol has been successfully tested in subjects with NP. Low load craniocervical exercises (nodding) will be performed at early stages (first 6 weeks) guided by visual feedback from a pressure unit. Higher-load neck exercises will be performed at later stages (last 6 weeks). During the first month, subjects will receive 30-45 min of MCTF three times per week, in the second month twice per week, and in the third month once per week. This duration of treatment is commonly used in clinical settings and has proven to be sufficient to improve muscle function, clinical, and brain outcomes.