TMJ Dysfunction: Effects on Proprioception, Pain, and Body Awareness

November 20, 2025 updated by: Nagihan Acet

The Role of Temporomandibular Joint Dysfunction on Proprioception, Pain-related Parameters, and Body Awareness

The term "temporomandibular joint dysfunction" (TMJ dysfunction) refers to a range of anatomical and functional problems, with or without clinical signs and symptoms, that affect the TMJ and/or the chewing muscles. It is more frequent in women and young people ages between 20 and 40. Its frequency ranges from 28% to 88%. The term "temporomandibular joint dysfunction" (TMJ dysfunction) refers to a range of anatomical and functional problems, with or without clinical signs and symptoms, that affect the TMJ and/or the chewing muscles. It is more frequent in women and young people ages between 20 and 40. Its frequency ranges from 28% to 88%. This condition is frequently disregarded because of inadequate diagnosis . Additionally, TMJ dysfunction can particularly emerge in the early stages without the presence of pain. Due to the insidious onset of the disease, especially in the early stages, other TMJ-related factors, in addition to pain-related parameters, need to be considered.Therefore, the aim of the study is to investigate the effect of TME disorder on proprioception, body awareness, and pain-related parameters including pain threshold, pain tolerance, and temporal summation in young adults.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

"In the study, young adults aged 18-25 will be included, with TMJ dysfunction being measured using the Fonseca Amnestic Index. Based on Fonseca scores, two groups will be formed: those scoring over 20 will be labeled 'with TMJ dysfunction,' while the others will be classified as 'without TMJ dysfunction.' Proprioception will be assessed both through self-reports using the Fremantle Neck Awareness Questionnaire and via joint position sense measured by a CROM device. Body awareness will also be evaluated using the Body Awareness Questionnaire. Pain assessment, including pain threshold, tolerance, and temporal summation, will be conducted using a pressure algometer. The 'pain threshold' will refer to the point at which a person first feels pain, 'pain tolerance' will be the last point that a person can tolerate, and 'temporal summation' will be the pain sensation evaluated after 10 repetitions of the pain threshold.

Study Type

Observational

Enrollment (Actual)

60

Contacts and Locations

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

Study Locations

  • Turkey (Türkiye)
    • Ankara
      • Ankara, Ankara, Turkey (Türkiye), 06560
        • Atılım University

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

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The study population consists of young adults aged 18-25, including those with temporomandibular joint (TMJ) dysfunction and asymptomatic controls without TMJ dysfunction. Participants are recruited from Atılım University.

Description

Inclusion Criteria:

*Being between 18-25 years old

Exclusion Criteria:

  • History of cervical spine injuries or disorders
  • Chronic pain conditions or diagnosed musculoskeletal disorders
  • Previous neck or spine surgeries
  • Neurological or psychiatric conditions affecting proprioception or pain perception
  • Use of medications influencing pain sensitivity or proprioception
  • Pregnancy

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

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
"TMJ Dysfunction" for the group with TMJ dysfunction.
This group consists of young adults aged 18-25 who have been diagnosed with temporomandibular joint (TMJ) dysfunction. The diagnosis was determined using the Fonseca Amnestic Index, where participants with a score greater than 20 were classified into this group. The participants in this group are being analyzed for proprioception, body awareness, and pain-related parameters, including pain threshold, pain tolerance, and temporal summation.
Other: Assessment of temporomandibular dysfunction
TMJ dysfunction will be measured using the Fonseca Amnestic Index. The Fonseca Amnestic Index is used to assess the severity of temporomandibular joint (TMJ) dysfunction. The index consists of 10 questions, with each question scored as 0, 5, or 10 points, depending on the severity of symptoms. The maximum total score is 100, where a higher score indicates a more severe level of TMJ dysfunction. Therefore, patients with higher scores on the Fonseca Amnestic Index are considered to have more significant TMJ issues. Based on Fonseca scores, two groups will be formed: those with scores over 20 will be labeled 'with TMJ dysfunction,' and the others 'without TMJ dysfunction.
"No TMJ Dysfunction" for the group without TMJ dysfunction.
This group includes young adults aged 18-25 who do not exhibit temporomandibular joint (TMJ) dysfunction. Participants in this group have a Fonseca Amnestic Index score of 20 or lower. Similar to the TMJ dysfunction group, these participants are being evaluated for proprioception, body awareness, and pain-related parameters such as pain threshold, pain tolerance, and temporal summation.
Other: Assessment of temporomandibular dysfunction
TMJ dysfunction will be measured using the Fonseca Amnestic Index. The Fonseca Amnestic Index is used to assess the severity of temporomandibular joint (TMJ) dysfunction. The index consists of 10 questions, with each question scored as 0, 5, or 10 points, depending on the severity of symptoms. The maximum total score is 100, where a higher score indicates a more severe level of TMJ dysfunction. Therefore, patients with higher scores on the Fonseca Amnestic Index are considered to have more significant TMJ issues. Based on Fonseca scores, two groups will be formed: those with scores over 20 will be labeled 'with TMJ dysfunction,' and the others 'without TMJ dysfunction.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Proprioception Assessment-1 (self-reported)
Time Frame: Single assessment at baseline
Evaluation of proprioception using the Fremantle Neck Awareness Questionnaire:Self-reported proprioception will be assessed using the Fremantle Neck Awareness Questionnaire. The Fremantle Neck Awareness Questionnaire (FreNAQ) typically consists of 9 items, each rated on a Likert scale from 0 to 4. The scale ranges from 0 to 36 points. Higher scores on this scale indicate impaired neck awareness.
Single assessment at baseline
Proprioception assessment-2
Time Frame: Single assessment at baseline.
Evaluation of proprioception with joint position sense measurement via a CROM device: Proprioception will also be assessed with joint position sense via a CROM device. After finding the target angle in right and left rotation directions, the patient is asked to repeat the target angle with their eyes closed. The difference is recorded. Three measurements are taken, and the average is calculated.
Single assessment at baseline.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain-related parameters
Time Frame: Single assessment at baseline.
Pain assessment, including pain threshold, tolerance, and temporal summation, will be conducted using a pressure algometer. The 'pain threshold' will be the point at which a person first feels pain, the 'pain tolerance' will be the last point that a person can tolerate, and the 'temporal summation' will be the pain sensation evaluated after 10 repetitions of the pain threshold.
Single assessment at baseline.
Assessment of body awareness
Time Frame: Single assessment at baseline.
Body awareness will be evaluated using the Body Awareness Questionnaire.The Body Awareness Questionnaire (BAQ) consists of 18 items scored on a 1-7 scale. The total score is the sum of all items, with a minimum score of 18 and a maximum score of 126. Higher scores indicate better body awareness.
Single assessment at baseline.

Collaborators and Investigators

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

Sponsor

Nagihan Acet

Investigators

  • Study Director: Nagihan Acet, Phd., Atılım University
  • Principal Investigator: Sena Nur Begen, MSc., Atılım University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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)

August 19, 2024

Primary Completion (Actual)

December 19, 2024

Study Completion (Actual)

January 19, 2025

Study Registration Dates

First Submitted

August 14, 2024

First Submitted That Met QC Criteria

August 14, 2024

First Posted (Actual)

August 16, 2024

Study Record Updates

Last Update Posted (Actual)

November 25, 2025

Last Update Submitted That Met QC Criteria

November 20, 2025

Last Verified

November 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • AtılımU

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

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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