Telerehabilitation Versus Home-Based Jaw Exercises in Temporomandibular Disorder With Bruxism (TELEROC)

June 24, 2026 updated by: Mehmet Turgut

Effectiveness of Telerehabilitation-Based Rocabado Exercises Compared With Home-Based Rocabado Exercises in Patients With Myofascial Temporomandibular Dysfunction Accompanied by Bruxism: A Randomised Controlled Trial

This study looked at whether jaw exercises (the Rocabado exercise programme) work better when delivered through supervised online video sessions than when done at home with written instructions alone, in adults who have jaw-joint pain (temporomandibular disorder) together with teeth grinding (bruxism). Thirty adults were randomly placed into one of two groups. Both groups were taught the same exercises and asked to do them twice a day for four weeks. One group also took part in supervised video sessions three times a week, where a physiotherapist watched their exercises and gave feedback; the other group used printed exercise leaflets with weekly text-message reminders. The researchers measured jaw pain, how wide participants could open their mouth, jaw movement, stress, sleep quality and oral habits before treatment, after two weeks and after four weeks, to see which approach gave better results.

Study Overview

Detailed Description

This single-centre, parallel-group, randomised controlled trial was conducted at the Faculty of Dentistry, Nevşehir Hacı Bektaş Veli University. Participants who met the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for myofascial temporomandibular disorder with concurrent bruxism were randomly allocated in a 1:1 ratio using a computer-generated simple randomisation sequence. Allocation was concealed using sequentially numbered, opaque, sealed envelopes that were opened only after enrolment. The outcome assessor was blinded to group allocation; participants were not blinded owing to the nature of the intervention. Both groups received identical initial face-to-face training in the Rocabado 6×6 exercise programme and were instructed to perform the exercises twice daily for four weeks. The telerehabilitation group additionally received supervised video sessions, whereas the comparator group followed the programme at home with printed materials and reminders only. Assessments were performed in person at baseline, at week 2 (mid-treatment) and at week 4 (post-treatment). The sample size was estimated using G*Power, and data were analysed with within-group and between-group statistical comparisons.

Study Type

Interventional

Enrollment (Actual)

40

Phase

  • 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 Locations

    • Nevşehir Province
      • Nevşehir, Nevşehir Province, Turkey (Türkiye), 50300
        • Nevşehir Hacı Bektaş Veli University, Faculty of Dentistry

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

Description

Inclusion Criteria:

  • Adults aged 18-60 years
  • Diagnosis of myofascial temporomandibular disorder (TMD) with bruxism according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)
  • Visual Analogue Scale (VAS) pain score ≥ 3
  • No medical treatment for TMD in the preceding 6 months
  • Access to a smartphone with internet connectivity
  • Turkish literacy and communication ability

Exclusion Criteria:

  • Active orthodontic or splint treatment
  • History of temporomandibular joint surgery
  • Systemic inflammatory disease
  • Pregnancy
  • Major psychiatric disorders
  • Neurological deficits in the cervical region

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
Intervention / Treatment
Experimental: Telerehabilitation group
Participants received supervised Rocabado 6×6 exercise training through video sessions delivered via WhatsApp three times per week, with real-time physiotherapist feedback, in addition to performing the Rocabado exercises at home twice daily for four weeks.
Supervised Rocabado 6×6 exercise programme delivered through video sessions via WhatsApp three times per week, with real-time physiotherapist feedback on exercise performance and technique, performed in addition to twice-daily home Rocabado exercises for four weeks.
Active Comparator: Home exercise group
Participants performed the same Rocabado 6×6 exercise programme at home twice daily for four weeks, supported by printed exercise brochures and weekly SMS reminders, without supervised video sessions.
Rocabado 6×6 exercise programme performed at home twice daily for four weeks, supported by printed exercise brochures and weekly SMS reminders, without supervised video sessions or physiotherapist feedback.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain intensity (Visual Analogue Scale)
Time Frame: Baseline, week 2 (mid-treatment) and week 4 (post-treatment)
Pain intensity assessed using the Visual Analogue Scale (VAS), scored from 0 to 10 cm, for morning pain, pain during chewing (mastication) and night pain. Higher scores indicate greater pain.
Baseline, week 2 (mid-treatment) and week 4 (post-treatment)
Maximum mouth opening
Time Frame: Baseline, week 2 (mid-treatment) and week 4 (post-treatment)
Maximum mouth opening measured in millimetres using a digital calliper (Mitutoyo, Japan); the mean of three consecutive measurements was recorded.
Baseline, week 2 (mid-treatment) and week 4 (post-treatment)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Temporomandibular joint range of motion
Time Frame: Baseline, week 2 (mid-treatment) and week 4 (post-treatment)
Active and passive maximum mouth opening, right and left lateral movements, and protrusion measured in millimetres using a digital calliper (Mitutoyo, Japan).
Baseline, week 2 (mid-treatment) and week 4 (post-treatment)
TMD severity (Fonseca Anamnestic Index)
Time Frame: Baseline and week 4 (post-treatment)
Severity of temporomandibular disorder assessed using the Fonseca Anamnestic Index (0-100 points); higher scores indicate greater severity.
Baseline and week 4 (post-treatment)
Perceived stress (Perceived Stress Scale)
Time Frame: Baseline and week 4 (post-treatment)
Perceived stress assessed using the Perceived Stress Scale (PSS-14), scored from 0 to 40; higher scores indicate greater perceived stress.
Baseline and week 4 (post-treatment)
Sleep quality (Jenkins Sleep Scale)
Time Frame: Baseline and week 4 (post-treatment)
Sleep quality assessed using the Jenkins Sleep Scale, scored from 0 to 20; higher scores indicate poorer sleep quality.
Baseline and week 4 (post-treatment)
Oral parafunctional habits (Oral Behaviours Checklist)
Time Frame: Baseline and week 4 (post-treatment)
Oral parafunctional habits assessed using the Oral Behaviours Checklist (OBC), scored from 0 to 40; higher scores indicate more frequent oral parafunctional behaviours.
Baseline and week 4 (post-treatment)

Collaborators and Investigators

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

Sponsor

Investigators

  • Study Director: Nevin Ergun, Sanko University
  • Principal Investigator: Taha Turgut, Msc. PT., Nevşehir Hacı Bektaş Veli University
  • Principal Investigator: Mehmet Turgut, Nevsehir Haci Bektas Veli 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

  • Turgut T. Effectiveness of telerehabilitation-based Rocabado exercises compared to home-based Rocabado exercises in myofascial temporomandibular dysfunctions accompanied by bruxism [master's thesis]. Nevşehir: Nevşehir Hacı Bektaş Veli University; 2024.

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)

December 15, 2023

Primary Completion (Actual)

July 20, 2024

Study Completion (Actual)

July 20, 2024

Study Registration Dates

First Submitted

June 24, 2026

First Submitted That Met QC Criteria

June 24, 2026

First Posted (Actual)

June 30, 2026

Study Record Updates

Last Update Posted (Actual)

June 30, 2026

Last Update Submitted That Met QC Criteria

June 24, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data are not made publicly available. De-identified data generated and analysed during the study are available from the corresponding author on reasonable request, subject to institutional and ethical approval.

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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