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Completed

NCT Number: NCT05893251

Effectiveness of Cervical Treatment in Wind Musicians With Temporomandibular Dysfunction

Temporomandibular dysfunction (TMD) consists of a series of multifactorial signs and symptoms that occur in the orofacial region, with pain being the most common symptom. There is a close biomechanical and anatomical relationship between the cervical region and the temporomandibular joint (TMJ) through the trigemino-spinal nucleus.

Objectives: To comparatively assess the improvement in subjects with TMD when adding cervical manual therapy to a postural treatment. Additionally, to determine if both cervical treatments separately produce changes in the TMJ.

Materials and methods: An experimental study of randomized controlled clinical trial type was conducted. The study involved 30 wind instrument players randomly assigned to an experimental group (EG) and a control group (CG). After obtaining consent, measurements were taken for maximum mouth opening (MMO), cervical range of motion, and pain threshold to pressure (PTP) in the masseter and temporalis muscles. Both groups underwent active cervical postural treatment for 4 weeks, and the EG additionally received a cervical manual therapy protocol. An initial assessment was conducted before the intervention, and a final assessment was done one week after the last intervention. The statistical program SPSS was used for data analysis.

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Key information

Conditions

Temporomandibular Joint Dysfunction Syndrome Craniomandibular Disorders Jaw Diseases Joint Diseases Mandibular Diseases Muscular Diseases Musculoskeletal Diseases Myofascial Pain Syndromes Stomatognathic Diseases Temporomandibular Joint Disorders

Age range

18 year–40 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University Of Murcia

Murcia, 30120, Spain

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Acceptance of written informed consent.
  • Playing a wind instrument.
  • Age between 18-40 years.
  • Pain in the cranio-cervico-mandibular region and/or masticatory muscles.
  • Hypertrophy in the masticatory muscles.

Exclusion criteria

  • History of trauma and/or fracture in the cranial and/or facial region.
  • Rheumatic injury or degenerative disease.
  • Surgical intervention on the temporomandibular joint (TMJ).
  • Malformations of the cervical or cranial spine.
  • Vestibular, circulatory, or neurological disorders.
  • Degenerative or infectious joint diseases.
  • Current orthodontic treatment.
  • Receiving physiotherapy treatment during the two weeks prior to the study or during the study.

Treatment and study plan

Manual therapy

Other

Within the manual therapy protocol carried out in the experimental group, we performed a series of passive maneuvers. The patient remains in supine position on a treatment table throughout the treatment, while the therapist sits at the head of the patient on a stool. The sequence of application is as follows:

Suboccipital inhibition technique Cervical spinal mobilization Posterior fascia stretching

Postural exercises

Other

The treatment plan includes active postural exercises for the cervical spine.

Primary outcomes

  1. Cranio facial pain and disability inventory

    Time frame: a week after treatment

    CF-PDI (Craniofacial Pain and Disability Inventory): This questionnaire focuses on pain as a common symptom of TMD (Temporomandibular Disorders). It is self-administered and designed to assess patients' perception of their physical and psychosocial health in relation to craniofacial pain. It consists of 21 questions regarding the impact of pain on activities involving the use of the temporomandibular joint, with a scoring range from 0 to 63 in ascending order, where 0 indicates no impact and 63 indicates maximum impact. This questionnaire demonstrates good structure, internal consistency, reproducibility, and validity, making it an objective tool that can be used in research and clinical practice for evaluating patients with craniofacial pain and disability. It is easy to administer and requires a short amount of time. The CF-PDI was created and developed in Spain, based on a biopsychosocial approach.

Secondary outcomes

  1. Maximum mouth opening.

    Time frame: a week after treatment

    The measurement of maximum mouth opening (MMO) is the distance in centimeters between the upper and lower incisor teeth when the subject actively opens their mouth.

Other outcomes

  1. Pain pressure threshold in myofascial trigger points of the masticatory muscles.

    Time frame: a week after treatment

    In TMD, myofascial pain of the masticatory muscles is the most relevant clinical entity that affects the masticatory system. It will be measured using a pressure algometer.

Sponsors and collaborators

Lead sponsor

Universidad de Murcia

Other

Registry information

Acronym: ANAISATM

Important dates

Study start
2017
Primary completion
2018
Study completion
2018
First posted
Jun 7, 2023
Registry last updated
Jun 12, 2023

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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