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To Investigate the Effect of Condylar Remodeling Exercises on Proprioception of Neck and Temporomandibular Joint in Cranio-cervico-mandibular Malalignment.

8 juni 2026 uppdaterad av: Walaa Mohsen Mohammed, Cairo University

Effect of Condylar Remodeling Exercises on Proprioception of Neck and Temporomandibular Joint in Cranio-cervico-mandibular Malalignment: A Randomized, Double-blind, Controlled Trial

Cranio-cervico-mandibular (CCM) malalignment is associated with forward head posture (FHP) and tempromandibular joint (TMJ) disorders and affects masticatory muscles. Patients who present with dysfunctions of CCM malalignment can be treated effectively by a physical therapist who has specialized skills and experiences. A temporomandibular joint exercise developed by Rocabado called "Condylar remodeling exercises" considered as a new method for treatment of such cases. Those exercises stimulate mechanoreceptors that converts mechanical energy of physical deformation into action nerve potential yielding proprioceptive information, detecting change and rate of change, as opposed to steady state conditions. This input was analyzed in the central nervous system for joint position and movement influences muscle tone, motor execution programes and kinesthetic awareness around temporomandibular joint protecting joint from damage and helps to restore appropriate balance of synergistic and antagonistic forces. Although condylar remodeling exercises has been used in clinical practice, limited evidence exists to support such a treatment approach. So, the current study will conduct to investigate the effect of Condylar Remodeling Exercises on proprioception of neck and TMJ in CCM malalignment

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Detaljerad beskrivning

To determine if there is an effect for the effect of Condylar Remodeling Exercises on proprioception of neck and TMJ in CCM malalignment. 40 of both sexes will participate in this study. Assessment of all participants will be carried out before and after the treatment program. Outcome measures will include assessment of neck proprioception, Temporomandibular joint position sense, cranio-vertebral angle, active pain-free mouth opening, pain assessment.A total of 40 subjects of both sexes having CCM malalignment will be recruited in this study. They will be randomly assigned to one of the following groups: Study group include 20 subjects will receive Condylar remodeling exercises in addition to postural correction Exercise, Control group: include 20 subjects will receive postural correction Exercise only. All subjects in both groups will receive the exercise program 3 days a week for four weeks.

Studietyp

Interventionell

Inskrivning (Beräknad)

40

Fas

  • Inte tillämpbar

Kontakter och platser

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Studiekontakt

Studieorter

  • Egypten
      • Giza, Egypten
        • Misr University for Science and Technology

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen

Tar emot friska volontärer

Nej

Beskrivning

Inclusion Criteria:

  • The participants will be excluded if they:

    1. The patient's ages from 18 to 40 years
    2. having TMD symptoms sustained for at least twelve weeks duration established by expert physician or orthopaedician.
    3. having forward head posture with CVA < 53o.
    4. mouth opening < 25mm.
    5. Pain level greater than 20 mm and less than 80 mm on Numeric Rating Scale (NRS).

Exclusion Criteria:

  • (1) TMJ fracture undergone any surgical procedure for TMJ; (2) Fracture surrounding TMJ; (3) Dislocation or subluxation of TMJ; (4) Systemic joint diseases including rheumatoid arthritis and osteoporosis, congenital conditions orofacial paralysis; (5) recent dental work or TMJ surgery; (6) Hematological cervical disorders which may affect the jaw; (7) Neurological deficits e.g. Bells palsy, Trigeminal neuralgia;(8) Recent infections affecting head and neck (within the last six months) e.g. bone infections, meningitis, encephalitis, malaria, ear infection; (9) Participants who were using any functional appliances e.g.dentures, braces, bite appliances altered or fitted within the previous 12 weeks prior to the commencement of this study; (10) Patients who underwent any physical therapy treatment within the last 2 weeks before the trial; (11) Internal derangement, including disc displacement with or without reduction

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Dubbel

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Study group (Condylar remodeling exercises in addition to postural correction Exercise
Study group include 20 subjects will receive Condylar remodeling exercises in addition to postural correction Exercise,
Övrig: Condylar remodeling exercises Included 1)Range of motion phase, 2)Bite phase, 3)Bite return phase, 4)Protrusion, 5)isometric contraction phase Tubing distraction phase
A temporomandibular joint exercise developed by Rocabado called "Condylar remodeling exercises" considered as a new method for treatment of such cases. Those exercises stimulate mechanoreceptors that converts mechanical energy of physical deformation into action nerve potential yielding proprioceptive information, detecting change and rate of change, as opposed to steady state conditions. This input was analysed in the central nervous system for joint position and movement influences muscle tone, motor execution programmes and kinaesthetic awareness around temporomandibular joint protecting joint from damage and helps to restore appropriate balance of synergistic and antagonistic forces. Although condaylar remodling exercises has been used in clinical practice, limited evidence exists to support such a treatment approach
Övrig: Postural correction exercises Kendall exercises

Kendall exercises were performed as follows:

  1. Strengthening the deep cervical flexors: The patient was asked to do a flat-back, chin-down position and hold this position for 2-8 seconds
  2. Stretching the cervical extensors: The patient was asked to place one hand on the occipital area and other on the chin in a seated position, then a head-down, flexed neck position to stretch the cervical extensors.
  3. Strengthening shoulder retractors: This exercise was done in order to move the shoulder blades towards one another while standing, the patient was instructed to wrap red (medium) Theraband around a stable item and then draw the band back as far as they could with both hands.
  4. Stretching of the pectoralis major muscle: The therapist stood behind the patient and held both elbows and performed bilateral pectoralis stretching. To stretch the costal division, the arm should be elevated to approximately 135 degrees. For sternal division, the arm abducted to 90 degrees. For clavicula
Aktiv komparator: Control group (postural correction Exercise only)
Control group: include 20 subjects will receive postural correction Exercise only
Övrig: Postural correction exercises Kendall exercises

Kendall exercises were performed as follows:

  1. Strengthening the deep cervical flexors: The patient was asked to do a flat-back, chin-down position and hold this position for 2-8 seconds
  2. Stretching the cervical extensors: The patient was asked to place one hand on the occipital area and other on the chin in a seated position, then a head-down, flexed neck position to stretch the cervical extensors.
  3. Strengthening shoulder retractors: This exercise was done in order to move the shoulder blades towards one another while standing, the patient was instructed to wrap red (medium) Theraband around a stable item and then draw the band back as far as they could with both hands.
  4. Stretching of the pectoralis major muscle: The therapist stood behind the patient and held both elbows and performed bilateral pectoralis stretching. To stretch the costal division, the arm should be elevated to approximately 135 degrees. For sternal division, the arm abducted to 90 degrees. For clavicula

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Temporomandibular joint position sense (TMJPS)
Tidsram: 24 hours from first and last session
For the TMJPS measurement, a 6 mm-thick wooden reference stick and 9 wooden test sticks from 4 mm to 8 mmin thickness (increment 0.5 mm) will be used. First, the participants will be asked to sense the position by biting the 6 mm thick reference test stick with their front teeth for 1 minute. Then, they will be asked to randomly bite each of the 9 test sticks and compare each of them with the 6 mm reference test stick. Each of the test sticks will be administered in a random order 5 times (45 tests in total). The participants will be asked how thick they felt compared to the reference stick that they have bitten down on and indicated their answers as "thinner", "thicker" or "equal". During the test, the participant's eyes will be closed, and the answers give about the stick thicknesses will be recorded as true (1 point) or false (0 points).
24 hours from first and last session
Active pain-free mouth opening
Tidsram: 24 hours from first and last session
In a supine position, participants will be asked to 'open the mouth as wide as possible without causing pain'. At the end position of pain-free mouth opening, the distance between upper-lower central incisors was measured in millimeters. The mean of three trials was calculated and used for the main analysis. Active pain-free mouth opening will be assessed pre-intervention, 48 h after the last treatment (post-intervention) and at 12-week follow up period.
24 hours from first and last session

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Sponsor

Cairo University

Publikationer och användbara länkar

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Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

20 juni 2026

Primärt slutförande (Beräknad)

20 september 2026

Avslutad studie (Beräknad)

20 oktober 2026

Studieregistreringsdatum

Först inskickad

8 juni 2026

Först inskickad som uppfyllde QC-kriterierna

8 juni 2026

Första postat (Faktisk)

11 juni 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

11 juni 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

8 juni 2026

Senast verifierad

1 juni 2026

Mer information

Termer relaterade till denna studie

Andra studie-ID-nummer

  • Condylar Remodeling Exercises

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