Temporomandibular joint dysfunction (TMJD) is an important health problem that occurs approximately in 22 to 35 percent of adults, different physiotherapy methods are reported as treatment options for management of TMJD. Although that, there is no previous studies about the efficacy of PNF exercises in treatment of TMJD in patients with forward head posture. So, the purpose of the present double-blind, randomized, controlled trial is to investigate the efficacy of PNF exercises in treatment of TMJD in patients with forward head posture.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
24
PNF exercises will be done for Masseter, Temporalis, Lateral pterygoid and medial pterygoid muscles. Each contraction will be held for 10 seconds, and each stretch (relaxation phase) will be allowed to continue as long as the muscle tension continued to give away.
* Ultrasound: Continuous ultrasound at 1MHZ to temporomandibular joint at 1.0-1.25 W/CM2 for 5 min over each affected TMJ and masseter area, with the mouth in a slightly open position. * Forward head posture correction exercises including: chin tuck exercise, Strengthening shoulder retractors, stretching of sternocleidomastoid muscle, and Stretching of pectoralis muscle.
marwa S saleh
Giza, Egypt
Pressure Pain Threshold
A pressure algometer will be used for the objective measurement of the PPT. The algometer was pressed on the masseter, temporalis muscles until the patient feel pain. The unit of measurement will be in kg/cm2, and three measurements will be taken every 30 seconds. The average of the three consecutive measurements will be taken as the final value.
Time frame: change from base line at 6 weeks.
ROM assessment
A caliper will be used to measure mandibular depression, protrusion and lateral deviation.
Time frame: change from base line at 6 weeks.
Temporomandibular Disorder Disability Questionnaire
This questionnaire consists of the following: * The Temporomandibular Disorder Disability Index. It consists of 10 questions with 5 possible answers, rating a 0 to 4 score level for each of the answers. * The Temporomandibular Disorder symptom intensity scale and the Temporomandibular Disorder symptom frequency scale are two visual analogue scales which address the frequency and intensity of a patient's TMJ symptoms and consist of 7 sections for each scale where the patient must rate his/her intensity and frequency of symptoms on a scale of 0 to 10 score level. * The Pain Drawing sheet is used by the patients to capture pain location and quality.
Time frame: change from base line at 6 weeks.
Numerical Rating Scale (NRS)
The patient will be asked to indicate a number between 0 and 100 on a horizontal line, that best described his/her perceived level of pain intensity when it is at its worst and when it is at is least. The average of these two totals indicates the average pain experienced by the patient as a percentage.
Time frame: change from baseline at 6 weeks.
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