Effects of Soft Tissue Mobilization of Neck Muscles in Individuals With Myogenous Temporomandibular Disorders: Muscle Energy Technique and Strain-counterstrain

This is a prospective case series study.There were 20 individuals with chronic neck pain accompanied by myogenous temporomandibular disorders(mTMD) from Linkou and Taoyuan Chang Gung hospitals, and Chang-Gung university. The purpose of this study was, first, to investigate the effects of muscle energy technique (MET) or strain-counterstrain (SCS) applied on the tender or trigger points of neck muscles on improving pain and pressure pain sensitivity in neck and masticatory muscles, the maximal mouth-opening range of motion, chewing endurance, and head-neck-shoulder posture in patients with chronic neck pain accompanied by mTMD. Second, whether the significant effects could be reached within the four-week intervention duration.

Study Overview

• Status: Completed
• Conditions: Myogenous Temporomandibular Disorders (mTMD)
• Intervention / Treatment: Behavioral: Muscle energy technique (MET); Behavioral: Strain-counterstrain (SCS); Behavioral: sham SCS

• Study Type: Interventional
• Enrollment (Actual): 20
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Taiwan
  • Taoyuan, Taiwan, 33302
    • Yang-Hua, Lin

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years to 65 years (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Aged 20~65
• Self-report neck pain ≥3 months (pain occurs between superior nuchal line and 1st level of thoracic spine)
• At least one tender point at both Upper trapezius and Sternocleidomastoid muscles
• Diagnosed as mTMD according to the Diagnostic Criteria for Temporomandibular Disorders(DC/TMD)

Exclusion Criteria:

• Cognitive deficit
• Malignancy, infection, cervical or orthognathic surgery, acute pain, and history of trauma in craniocervical region
• Neurological problem or cervical radiculopathy/myelopathy
• Cervical instability with positive rotational alar ligament stress test and transverse ligament stress test, jaw dislocation
• Tooth implantation or extraction a week before study
• Vertebrobasilar insufficiency

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: SEQUENTIAL
• Masking: SINGLE

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: Muscle energy technique group; Use one of the muscle energy technique methods -- postisometric relaxation technique(PIR) as the intervention method.	Behavioral: Muscle energy technique (MET); A manual therapy technique that uses the gentle muscle contractions of the patient to relax and lengthen muscles and normalize joint motion.
EXPERIMENTAL: Strain-counterstrain group; Use the Strain-counterstrain technique as the intervention method.	Behavioral: Strain-counterstrain (SCS); It's also called the "positional release technique", a manual therapy technique that passively positions the hypertonic (spasmed) muscles and dysfunctional joints in positions of shortened or comfort.
SHAM_COMPARATOR: Control group; Use the modified Strain-counterstrain technique as the intervention method.	Behavioral: sham SCS; SCS intervention that position with opposite site limb and direction, and with modified method as consider the easiness of a practitioner to press the tender points

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain intensity in neck and masticatory muscles	ask participants the self-report pain intensity with the NPRS scale	4 weeks
Tenderness sensitivity in neck and masticatory muscles	measure the pressure pain threshold with digital pressure algometer	4 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Maximal mouth-opening	measure the maximal pain free mouth-opening distance	4 weeks
Chewing endurance	test for 5 minutes with chewing gum in the affected site	4 weeks
Head-neck-shoulder posture	measure the Head tilt angle(HTA), Craniovertebral angle(CVA) & Forward shoulder angle (FSA) by Photography in sagittal plane	4 weeks

Collaborators and Investigators

• Sponsor: Chang Gung University

Study record dates

Study Major Dates

• Study Start (ACTUAL): January 11, 2021
• Primary Completion (ACTUAL): June 30, 2021
• Study Completion (ACTUAL): June 30, 2021

Study Registration Dates

• First Submitted: January 8, 2021
• First Submitted That Met QC Criteria: January 8, 2021
• First Posted (ACTUAL): January 11, 2021

Study Record Updates

• Last Update Posted (ACTUAL): August 6, 2021
• Last Update Submitted That Met QC Criteria: July 30, 2021
• Last Verified: July 1, 2021

More Information

Terms related to this study

• Keywords: myogenous temporomandibular disorders, neck pain, muscle energy technique, strain-counterstrain, head-neck posture
• Additional Relevant MeSH Terms: Pathologic Processes; Joint Diseases; Musculoskeletal Diseases; Muscular Diseases; Stomatognathic Diseases; Jaw Diseases; Craniomandibular Disorders; Mandibular Diseases; Myofascial Pain Syndromes; Disease; Temporomandibular Joint Disorders; Temporomandibular Joint Dysfunction Syndrome
• Other Study ID Numbers: 2010280044

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No