Effects of Mulligan Mobilization in Comparison With Maitland Mobilization in Temporomandibular Joint Dysfunction.

December 26, 2025 updated by: Foundation University Islamabad

Effects of Mulligan Mobilization in Comparison With Maitland Mobilization in Temporomandibular Joint Dysfunction

The temporomandibular joint dysfunction is the second most common musculoskeletal pain after back pain, causing jaw pain, restricted movement, and joint sounds. NPRS and millimeter ruler will be used for the assessment of patient. This study will compare the effects of Mulligan and Maitland mobilization, commonly used treatment, on pain and Temporomandibular joint mobility through a randomized controlled trial, involving 30 participants divided into two groups for treatment.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

The temporomandibular joint connects the mandible to the temporal bone near the ear's tragus and plays a key role in mastication. It involves joint or muscle pain, jaw movement limitation, and joint popping sound Risk factors include trauma, bruxism, arthritis, stress, and poor posture, while diagnosis is commonly made using the DC/TMD criteria, focusing on pain and intra-articular dysfunction. Manual therapy techniques widely used to restore joint function and reduce pain.

Among these, Mulligan's Mobilization combines therapist-applied glides with active patient movement, while Maitland mobilization uses graded oscillatory techniques to relieve pain and improve mobility.

This study aims to compare the effects of Mulligan and Maitland mobilization on pain reduction and TMJ hypomobility in adults with TMD.

A randomized controlled trial will be conducted over one year. 30 participants will be selected through purposive sampling and randomly divided into two groups.

The intervention will last two weeks, comprising 06 treatment sessions. Assessments will be conducted at baseline, after the third session, and at the end of the second week.

Treatment will include lateral, anterior, medial, and distraction glides, combined with Rocabado's 6x6 exercises to improve functional movement. Myofascial release for the temporalis and masseter muscles will also be applied.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
30

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

  • Pakistan
    • Punjab Province
      • Islamabad, Punjab Province, Pakistan
        • Recruiting
        • Foundation University College of Physical Therapy
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion criteria

  • Age 19-44 years.
  • Both Genders (Male and Female).
  • Patients diagnosed with TMJ hypomobility using the Manual Functional Analysis questionnaire based on DC/TMD criteria.
  • Individuals with myofascial pain, scoring above 5 on the NRS and pain upon palpation of at least two of eight masticatory and neck muscles.
  • Subjects with acute TMD and myofascial pain unrelated to active inflammation, infection, or recent trauma for at least six months.

Exclusion criteria

  • Hypermobility of TMJs.
  • Pregnancy.
  • History of rheumatic and inflammatory diseases.
  • A history of temporomandibular disorders treatment within last three months.
  • Acute trauma or injuries of face, head or cervical spine, neurological disorders, taking medication that could affect the musculoskeletal system.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Active Comparator: Mulligan Mobilization
Experimental Group A-Mulligan Mobilization. Myofascial release of temporalis and masseter muscle, Rocabado 6*6 exercise program.
Procedure: Mulligan Mobilization

Both Mulligan and Maitland mobilization techniques with Myofascial release of temporalis and masseter and Rocabado 6*6 exercise program are applied over a two-week period with six sessions in total, focusing on improving TMJ mobility and reducing pain.

Group A Mulligan mobilization emphasizes active patient involvement combined with therapist-applied glides, including lateral, anterior, medial, and distraction glides performed for 5-10 seconds with 3-5 repetitions per session.

These techniques enhance mouth opening, lateral deviation, protrusion, and joint space while reducing stiffness and pain. And baseline treatment of myofascial release of temporalis and masseter muscle and Rocabado's 6*6 exercise program
Experimental: Maitland Mobilization
Experimental Group B-Maitland Mobilization. Myofascial release of temporalis and masseter muscle. Rocabado 6*6 exercise program.
Procedure: Maitland Mobilization

Group B-Maitland mobilization relies on graded oscillatory movements (Grades I-III) for 5-10 seconds with 3-5 oscillations, targeting pain relief and mobility in the pain-free range. Lower grades (I-II) are used for acute pain with gentle oscillations, while higher grades (II-III) provide moderate mobilization to improve protrusion, lateral deviation, and joint capsule mobility.

And baseline treatment of myofascial release of temporalis and masseter muscle and Rocabado's 6*6 exercise program.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Pain intensity
Time Frame: 2 weeks
Pain will be measured through Numeric Pain Rating Scale. The scoring for NPRS involves a scale from 0 to 10, where 0 indicates no pain. The interpretation of scores is as follows: 0 to 3 for mild pain, 4 to 6 for moderate pain, and 7 to 10 for severe pain.
2 weeks
Temporomandibular joint Hypomobility
Time Frame: 2 weeks
Mandibular movements were assessed using a millimeter ruler to measure depression (50-60 mm), protrusion (5 mm), and lateral deviation (12-15 mm). Any "click" sounds or deviations during movement were recorded. Jaw movements maintained upper and lower teeth contact.
2 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Foundation University Islamabad

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
September 5, 2025

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 30, 2025

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
January 5, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
December 26, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 26, 2025

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
January 9, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
January 9, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 26, 2025

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
December 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • FUI/CTR/2025/20

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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