OMT vs Exercise in TMD

Temporomandibular disorders (TMD) are multifactorial conditions characterized by pain, functional limitations, and alterations in sensorimotor control. Although various rehabilitation approaches are commonly used in clinical practice, the relationship between TMD and postural stability remains unclear, particularly regarding the differential effects of specific treatment strategies.

This randomized controlled trial aims to compare the effects of osteopathic manipulative treatment (OMT) and a structured home-based exercise program on pain, functional outcomes, and postural control in individuals with myogenic TMD.

Participants diagnosed with myogenic TMD are randomly allocated to either an OMT group or a home-based exercise group. The OMT intervention consists of manual techniques targeting the temporomandibular joint and related musculoskeletal structures, while the exercise program includes structured therapeutic exercises designed to improve mobility, muscle function, and sensorimotor control.

Outcome measures include pain intensity assessed using the Visual Analog Scale (VAS), pressure pain threshold, mandibular movements, cervical range of motion (ROM), postural stability parameters, and quality of life. All assessments are performed before and after the intervention period by a blinded assessor.

This study is designed to explore whether different rehabilitation approaches produce distinct effects on pain reduction, functional improvement, and postural control, thereby contributing to a better understanding of mechanism-based rehabilitation strategies in TMD.

Inclusion criteria

TMD Group:

• Diagnosis of temporomandibular disorder (TMD) confirmed by a dentist
• Pain intensity ≥ 3.5 cm on the Visual Analog Scale (VAS)
• Presence of TMD-related pain for at least 3 months
• Aged between 18 and 50 years
• Willingness to participate in the study

Control Group:

• No history or clinical signs of temporomandibular disorder (TMD)
• Aged between 18 and 50 years
• Willingness to participate in the study

Exclusion criteria

TMD Group:

• Presence of any condition other than TMD that may affect the assessment outcomes
• Presence of musculoskeletal pain in any other body region
• Any orthopedic or neurological condition that may interfere with assessments
• Diagnosed psychiatric disorder
• Conditions impairing communication or ability to complete assessments
• Illiteracy
• History of orthopedic surgery in any body region
• Presence of systemic pathological conditions such as fractures, rheumatoid arthritis, or suspected malingering
• Receipt of physiotherapy or other treatment targeting the temporomandibular joint or spinal region within the last 6 months

Control Group:

• History of chronic musculoskeletal disorders within the past year
• Any orthopedic or neurological condition that may interfere with assessments
• Diagnosed psychiatric disorder
• Conditions impairing communication or ability to complete assessments
• Illiteracy