Effect of Rocabado Exercises With Strain Counter-Strain Technique on Muscles of Mastication for Pain, Jaw Function, and Quality of Life in Patients With Temporomandibular Joint Dysfunction
Temporomandibular joint dysfunction (TMD) is a common musculoskeletal disorder affecting the jaw joint and masticatory muscles, leading to pain, limited jaw function, and reduced quality of life. Conservative management includes therapeutic exercises and manual therapy. Rocabado exercises improve jaw mechanics and posture, while the Strain Counterstrain technique reduces muscle tenderness and pain.
This randomized controlled trial aims to evaluate the effectiveness of Rocabado exercises alone versus Rocabado exercises combined with the Strain Counterstrain technique in patients with muscular TMD. The intervention will be conducted over six weeks, with outcomes measured for pain, jaw function, and quality of life. The study seeks to determine whether the combined approach provides superior clinical outcomes.
調査の概要
状態
詳細な説明
Temporomandibular joint dysfunction (TMD) is a common musculoskeletal condition affecting the jaw joint and muscles of mastication, leading to pain, restricted jaw movement, and reduced quality of life. It is often associated with factors such as muscle spasm, poor posture, stress, and abnormal jaw mechanics. Various conservative treatment approaches are used, including physical therapy, exercises, and manual therapy techniques. Among these, Rocabado exercises aim to restore normal jaw function, improve posture, and enhance neuromuscular control, while the Strain Counterstrain technique focuses on reducing muscle tenderness and pain by positioning the affected muscle in a relaxed state.
This study aims to evaluate the combined effect of Rocabado exercises and the Strain Counterstrain technique on pain, jaw function, and quality of life in patients with muscular TMD. A randomized controlled trial will be conducted on participants divided into two groups: one receiving Rocabado exercises alone and the other receiving a combination of Rocabado exercises and Strain Counterstrain technique. The intervention will be carried out over six weeks, with outcomes measured using standardized tools for pain, functional limitation, and quality of life. The findings of this study may help in identifying a more effective physiotherapy approach for managing TMD and improving patient outcomes.
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前：Nimra khalil
- 電話番号：03090505681
- メール：nimrakhalil887@gmail.com
研究場所
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Punjab Province
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Lahore、Punjab Province、パキスタン
- Ghurki Trust and Teaching Hospital
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参加基準
適格基準
就学可能な年齢
- 大人
健康ボランティアの受け入れ
説明
Inclusion Criteria:
- Diagnosed patient of muscular TMJ ;According to Fonseca Questionnaire, ranging in the age group of 20 to 50 years, with both male and female were included in the study; Maximum mouth opening (MMO) 40-60mm for diagnosis of muscular TMJ ; Mild to moderate TMJ pain ; Unilateral TMJ ; Diagnostic features of muscular TMJ dysfunction: Pain location: Jaw, temple and masseter region ; Pain Behavior: Increase with chewing, talking and clenching ; Palpation findings: tenderness at masseter and temporal region ; ROM findings: limited and painful mouth opening (<40mm) when measured with maximum mouth opening test ; MMO Test: The test involves measuring the maximum distance between the incisal edges of the upper and lower central incisors when the mouth is opened as wide as possible. This measurement is typically performed using a calibrated ruler, Vernier calipers, or a fiber ruler, with the subject positioned upright and instructed to open their mouth maximally.
Exclusion Criteria:
- Who do not fall into the mentioned age group, with severe TMJ dysfunction according to Fonseca Questionnaire ; Recent oral surgeries; Spondyloarthropathies ;Recent oral trauma ; Systemic disease(hypothyroidism, hypercalcemia) ; Pregnant females ;Metal implants in the oral cavity ; Patient on TMJ drugs use ; Lactating females ; Neurological deficit (MS, Parkinson diseases) that effects the fascial muscles ; Any other inflammatory diseases
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：ダブル
武器と介入
参加者グループ / アーム |
介入・治療 |
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実験的：Rocabado Exercises + Strain Counterstrain Technique
Participants will receive Rocabado exercises combined with the Strain Counterstrain technique.
A hot pack will be applied for 15 minutes, followed by Rocabado 6×6 exercises and application of Strain Counterstrain to masticatory muscles (masseter, temporalis, pterygoids).
Sessions will be 45 minutes, 2-3 times per week for 6 weeks.
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Rocabado exercises constitute a standardized 6×6 therapeutic protocol aimed at restoring normal temporomandibular joint (TMJ) biomechanics and craniocervical alignment.
The intervention incorporates neuromuscular re-education techniques including tongue resting position, controlled mandibular rotation, rhythmic stabilization, axial extension of the cervical spine, and scapular postural correction.
These exercises are designed to optimize joint kinematics, enhance proprioceptive control, reduce abnormal muscle activity, and improve functional jaw mobility while minimizing pain.
The Strain Counterstrain (SCS) technique is a passive, indirect manual therapy approach targeting myofascial tender points.
It involves precise positioning of the involved muscle in a shortened, position of maximal comfort to reduce aberrant muscle spindle activity and nociceptive input.
Sustained positioning (typically 60-90 seconds) facilitates neuromuscular reset, decreases localized hypertonicity, and alleviates pain.
In this study, SCS will be applied to the masticatory muscles, including the masseter, temporalis, and pterygoid muscles, to improve muscle function and reduce pain sensitivity.
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アクティブコンパレータ：Rocabado Only
Participants will receive Rocabado exercises only.
A hot pack will be applied for 15 minutes, followed by Rocabado 6×6 exercises.
Sessions will be 45 minutes, 2-3 times per week for 6 weeks.
|
Rocabado exercises constitute a standardized 6×6 therapeutic protocol aimed at restoring normal temporomandibular joint (TMJ) biomechanics and craniocervical alignment.
The intervention incorporates neuromuscular re-education techniques including tongue resting position, controlled mandibular rotation, rhythmic stabilization, axial extension of the cervical spine, and scapular postural correction.
These exercises are designed to optimize joint kinematics, enhance proprioceptive control, reduce abnormal muscle activity, and improve functional jaw mobility while minimizing pain.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Numeric Pain Rating Scale for pain (NPRS)
時間枠：6 weeks
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Measures the intensity of pain.
The NPRS is an 11-point scale, ranging from 0 (no pain) to 10 (worst imaginable pain).
Patients are asked to rate their current pain, average pain, or worst pain over a specific period (e.g., past 24 hours or week).
Interpretation as No pain, 1-3 = Mild pain, 46 weeks-6 = Moderate pain 7-10 = Severe pain
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6 weeks
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Jaw Functional Limitation Scale for jaw function (JFLS-8)
時間枠：6 weeks
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Assesses limitations in jaw function in patients with temporomandibular disorders. The JFLS-8 is a short version with 8 items, each rated on a 5-point Likert scale from 0 (no limitation) to 4 (severe limitation). Domains assessed mastication (chewing), jaw mobility (opening/closing), verbal communication (speaking) Scoring as higher scores indicate greater functional limitation. Total score is usually calculated as the sum or average of the 8 items. 0= No jaw functional limitation, 1-3 =Mild functional limitation, 4-6 = Moderate functional limitation, 7-10 = Severe functional limitation. Higher scores indicate greater jaw functional impairment.(20) |
6 weeks
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Oral Health Impact Profile for quality of life (OHIP-14)
時間枠：6 weeks
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Evaluates the impact of oral conditions on quality of life.
OHIP-14 is a shortened version of the original OHIP (49 items), containing 14 questions across 7 domains such as Functional limitation, Physical pain, psychological discomfort, Physical disability, psychological disability, social disability, Handicap Scoring: Each item is rated on a 5-point Likert scale: 0 = never, 1 = hardly ever, 2 = occasionally, 3 = fairly often, 4 = very often.
Higher scores = poorer oral health-related quality of life.
To calculate the total score, sum the scores of all 14 items.
The total score ranges from 0 to 56, where a higher score indicates a greater negative impact on oral health-related quality of life.
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6 weeks
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協力者と研究者
研究記録日
主要日程の研究
研究開始 (推定)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- UBAS/ERB/26/04/028
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