Effects of Stomatognathic Alignment Exercise Program in Craniomandibular Dysfunction.

The study was conducted to determine the effects of stomatognathic alignment exercise program in craniomandibular dysfunction.

Study Overview

• Status: Completed
• Conditions: Craniomandibular Dysfunction
• Intervention / Treatment: Other: Stomatognathic Alignment Exercise Program; Other: Standard Physical therapy treatment

• Study Type: Interventional
• Enrollment (Actual): 64
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab Province
    • Lahore, Punjab Province, Pakistan, 54000
      • Fatima Memorial Hospital (Oral & Maxillofacial Surgery Department)

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Male and female with age group of 20-65 years.
• Patients diagnosed with temporomandibular dysfunction
• Individuals with the sedentary life style
• Craniovertebral angle <50 degrees
• Patients who presented with at least one symptom of temporomandibular dysfunction, able to communicate effectively, cooperative with imaging examinations, and able to complete the prescribed treatment and patients with no contraindications for the required examinations or treatments.

Exclusion Criteria:

• Serious musculoskeletal problems of cervical and thoracic spine
• Neurological disease affecting balance and postural control
• Dental prosthesis
• Disc prolapsed
• Previous surgery in TMJ area
• Vertebral artery compromise test
• Cerebrovascular disease

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Stomatognathic alignment exercise program along with standard physical therapy; Stomatognathic alignment exercise program along with standard treatment.	Other: Stomatognathic Alignment Exercise Program; Chin Tuck Exercise: Starting position: Supine and standing against a wall. Tuck chin backward over the sternal notch to place the patient's ears in line with the tips of the shoulders. Repetitions: Supine: Ten repetitions of a 10-second hold. Standing against a wall: Two repetitions of a 5-minute hold. Anterior Chest Stretching Exercise: Starting position: Standing against a wall with a flattened back; arms at 45° shoulder abduction with elbow in full extension. Active ROM exercises of neck and TMJ: Starting position: Sitting in a back-supported chair. Neck motions: flexion, extension, lateral flexion, and rotation. TMJ: Mouth opening, lateral excursion, and protrusion. Repetitions: A 10-second hold at the end range of each motion. Two series of ten repetitions for each motion. Standard physiotherapy including hot pack and myofascial release of masticatory muscles. A total of 12 sessions were conducted for 4 weeks with 3 sessions scheduled each week.; Other: Standard Physical therapy treatment; Control Group received only standard physiotherapy including hot pack and myofascial release of masticatory muscles. A total of 12 sessions were conducted for 4 weeks with 3 sessions scheduled each week.
Active Comparator: Traditional physical therapy; Myofascial release of masticatory muscles and heating pad at cervical.	Other: Standard Physical therapy treatment; Control Group received only standard physiotherapy including hot pack and myofascial release of masticatory muscles. A total of 12 sessions were conducted for 4 weeks with 3 sessions scheduled each week.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Numeric Pain Rating Scale	Numeric Pain Rating Scale is utilized to evaluate pain. It consists of 11 points, having an overall score ranging from 0 to 10, where; 0 represents no pain, 1 to 3 represents mild pain, 4 to 6 represents moderate pain and 7 to 10 represents the most severe pain.	From enrollment until the end of treatment at the fourth week.
Mandibular function impairment questionnaire	MFIQ is used to evaluate the degree of jaw function impairment in TMJD patients. Two dimensions and 17 questions make up this questionnaire, which assigns a score ranging from 0 (no problem) to 4 (extreme difficulty or impossible without support) for a certain jaw function. The "functional capacity" dimension is made up of the first eleven components, whereas the "nutrition" dimension is made up of the next six. A high degree of jaw function impairment is indicated by a high overall score on the questionnaire.	From enrollment until the end of treatment at the fourth week.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
ROM Cervical Spine (Felxion)	Changes in cervical spine flexion ROM at baseline and 4th week of intervention was measured using goniometer.	From enrollment until the end of treatment at the fourth week
ROM Cervical Spine (Extension)	Changes in cervical spine extension ROM at baseline and 4th week of intervention was measured using goniometer.	From enrollment until the end of treatment at the fourth week.
ROM Cervical Spine (Lateral Flexion) Left Side	Changes in cervical spine lateral flexion on left side ROM at baseline and 4th week of intervention was measured using goniometer.	From enrollment until the end of treatment at the fourth week.
ROM Cervical Spine (Lateral Flexion) Right Side	Changes in cervical spine lateral flexion on right side ROM at baseline and 4th week of intervention was measured using goniometer.	From enrollment until the end of treatment at the fourth week.
ROM Cervical Spine (Rotation) Left Side	Changes in cervical spine rotation on left side ROM at baseline and 4th week of intervention was measured using goniometer.	From enrollment until the end of treatment at the fourth week.
ROM Cervical Spine (Rotation) Right Side	Changes in cervical spine rotation on right side ROM at baseline and 4th week of intervention was measured using goniometer.	From enrollment until the end of treatment at the fourth week.
ROM temporomandibular joint, mouth opening (Depression)	Changes in mouth opening ROM at baseline and 4th week of intervention was measured using ruler.	From enrollment until the end of treatment at the fourth week.
ROM temporomandibular joint (Protrusion)	Changes in protrusion ROM at baseline and 4th week of intervention was measured using ruler.	From enrollment until the end of treatment at the fourth week.
ROM temporomandibular joint (Lateral Excursion) Left side	Changes in lateral excursion on left side ROM at baseline and 4th week of intervention was measured using ruler.	From enrollment until the end of treatment at the fourth week.
ROM temporomandibular joint (Lateral Excursion) Right side	Changes in lateral excursion on right side ROM at baseline and 4th week of intervention was measured using ruler	From enrollment until the end of treatment at the fourth week.
Craniovertebral angle	For assessing the severity and alignment of forward head posture by evaluating the position of the head in relation to the trunk. Changes in craniovertebral angle at baseline and 4th week of intervention was measured using Markus Bader-Software solution.	From enrollment until the end of treatment at the fourth week.

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Saba Rafique, MS.OMPT, Riphah International University

Publications and helpful links

General Publications

• Oh DW, Kang TW, Kim SJ. Effect of stomatognathic alignment exercise on temporomandibular joint function and swallowing function of stroke patients with limited mouth opening. J Phys Ther Sci. 2013;25(10):1325-9
• Pundkar S, Patil D, Naqvi W. A Comparative Study on Effectiveness of Rocabado Approach and Conventional Physiotherapy on Pain, ROM and QOL in Patients with TMJ Dysfunction. Journal of Pharmaceutical Research International. 2021;33(58B):201-9
• Byra J, Kulesa-Mrowiecka M, Pihut M. Physiotherapy in hypomobility of temporomandibular joints. Folia Med Cracov. 2020;60(2):123-34
• Oleksy Ł, Kielnar R, Mika A, Jankowicz-Szymańska A, Bylina D, Sołtan J, et al. Impact of Cervical Spine Rehabilitation on Temporomandibular Joint Functioning in Patients with Idiopathic Neck Pain. Biomed Res Int. 2021;2021:6886373
• Yılmaz V, Aras B, Umay E. Temporomandibular Joint Dysfunction and Impaired Stomatognathic Alignment: A Problem Beyond Swallowing in Patients With Stroke. Indian J Otolaryngol Head Neck Surg. 2020;72(3):329-34
• Militi A, Bonanno M, Calabrò RS. It Is Time for a Multidisciplinary Rehabilitation Approach: A Scoping Review on Stomatognathic Diseases in Neurological Disorders. J Clin Med. 2023;12(10)
• de Oliveira-Souza AIS, do Valle Sales LR, de Fontes Coutinho AD, de Oliveira DA, Armijo-Olivo S. Effectiveness of an 8-week neck exercise training on pain, jaw function, and oral health-related quality of life in women with chronic temporomandibular disorders: a randomized controlled trial. J Oral Facial Pain Headache. 2024;38(1):40-51
• Ilhanlı M, Ilhanlı I, Aksakallı S. Effectiveness of Rocabado exercises in patients with rheumatoid arthritis in remission with temporomandibular joint involvement: A randomized-controlled study. Turk J Phys Med Rehabil. 2024;70(3):319-26
• O. W. Conservative Management of Temporomandibular Joint Dysfunction: A Case Report. Journal of Health Directories. 2024;1(1):16-23
• Yu LJ, Yan X, Kim TH. Effects of combined jaw and cervicoscapular exercises on mouth opening and muscle properties in cervical extension type. Sci Rep. 2025;15(1):19049.

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2025
• Primary Completion (Actual): November 30, 2025
• Study Completion (Actual): November 30, 2025

Study Registration Dates

• First Submitted: February 4, 2026
• First Submitted That Met QC Criteria: February 4, 2026
• First Posted (Actual): February 11, 2026

Study Record Updates

• Last Update Posted (Actual): February 11, 2026
• Last Update Submitted That Met QC Criteria: February 4, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: functional disability; Myofascial release; Forward head posture; Temporomandibular joint; Stomatognathic Alignment Exercise; Stomatognathic disease; Craniomandibular Dysfunction
• Additional Relevant MeSH Terms: Stomatognathic Diseases
• Other Study ID Numbers: REC/RCR & AHS/24/0186

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