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NCT Number: NCT07556510

Telerehabilitation Dual-Task Training in Temporomandibular Joint Dysfunction

This randomized controlled trial will be conducted among 18-25-year-old participants who present with temporomandibular joint dysfunction symptoms, including pain, limited range of motion, and joint crepitation. Participants will be randomly allocated into control and intervention groups using block randomization. The control group will receive a standard physiotherapy program, while the intervention group will additionally perform telerehabilitation-based dual-task exercises. The intervention will last for six weeks, with progressive increases in exercise and cognitive task difficulty. Outcomes will be assessed at baseline and at the end of the 6th week. Primary and secondary outcome measures include pain intensity (Visual Analog Scale), jaw functional limitation (Jaw Functional Limitation Scale-20), oral habits, static balance (Tetrax system), and dynamic balance (Timed Up and Go Test). Within-group and between-group comparisons will be performed. The sample size was calculated using power analysis, resulting in 30 participants in total (15 per group), accounting for potential dropouts.

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Key information

Conditions

Temporomandibular Joint Dysfunction Craniomandibular Disorders Jaw Diseases Joint Diseases Mandibular Diseases Muscular Diseases Musculoskeletal Diseases Neurologic Manifestations Pain Pathological Conditions, Signs and Symptoms Signs and Symptoms Stomatognathic Diseases Temporomandibular Joint Disorders

Age range

18 year–25 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Diagnosis of temporomandibular joint dysfunction according to the
  • Temporomandibular Disorders Research Diagnostic Criteria and Diagnostic
  • Criteria for Temporomandibular Disorders
  • No neurological, orthopedic, or systemic condition that may affect balance
  • Ability to comply with a telerehabilitation program
  • Willingness to provide written informed consent
  • No prior physiotherapy treatment for temporomandibular joint dysfunction

Exclusion criteria

  • Inability to participate in regular exercise or telerehabilitation programs
  • Presence of severe systemic diseases (cardiac, rheumatologic, neurological) or other severe chronic conditions
  • Presence of psychiatric disorders or cognitive impairment
  • Use of medications that may affect balance (such as sedatives)
  • History of jaw or dental surgery within the last 6 months
  • Receipt of physiotherapy, splint therapy, or similar treatment for temporomandibular joint dysfunction within the last 3-6 months

Treatment and study plan

Standard Physiotherapy Program

Behavioral

Cervical range of motion exercises, cervical lateral flexion stretching, upper trapezius stretching, pectoral stretching, breathing exercises, seated cervical postural correction exercises, supine and prone cervical postural exercises, postural training exercises, temporomandibular joint (TMJ) rotation control exercises, TMJ opening, closing, protrusion, and retrusion exercises, tongue resting position training, isometric TMJ elevation, depression, and lateral deviation exercises in sitting position, post-isometric relaxation techniques, abdominal strengthening exercises, and back extensor strengthening exercises.

Dual-Task Training

Behavioral

Backward counting from 200 by threes during cervical range of motion exercises and pectoral stretching, naming cities starting with the letter "A" during supine cervical postural exercises, naming animals starting with the letter "A" during TMJ rotation control exercises, simple arithmetic tasks (addition and subtraction) during isometric TMJ elevation and depression exercises, and more complex arithmetic tasks during lateral deviation exercises in sitting position. Cognitive task difficulty will be progressively increased over time.

Primary outcomes

  1. Pain Intensity

    Time frame: Measurements will be recorded at baseline and at week 6. Change in pain intensity will be analyzed.

    Pain intensity will be assessed using a 10-cm Visual Analog Scale. Participants will rate their pain at rest, during chewing, and at night. Scores range from 0 (no pain) to 10 (worst imaginable pain).

  2. Jaw Functional Limitation

    Time frame: Assessments will be performed at baseline and week 6.

    (Jaw Functional Limitation Scale - JFLS-20): Jaw function will be evaluated using the JFLS-20, a 20-item self-report scale assessing functional limitations in mastication, speech, and jaw movement. Each item is scored from 0 (no limitation) to 10 (severe limitation). Higher scores indicate greater functional impairment.

Secondary outcomes

  1. Temporomandibular Disorder Classification

    Time frame: Assessment will be performed at baseline.

    Temporomandibular joint dysfunction diagnosis and classification will be determined using the Temporomandibular Disorders Research Diagnostic Criteria and Diagnostic Criteria for Temporomandibular Disorders questionnaire, which provides a standardized multidimensional assessment of temporomandibular disorders. This assessment includes evaluation of muscle-related disorders, disc displacement conditions, and degenerative joint diseases, and enables a comprehensive clinical and psychosocial classification of temporomandibular dysfunction.

  2. Oral Habits

    Time frame: Assessments will be performed at baseline and week 6.

    Oral Habits Questionnaire: Oral parafunctional habits will be assessed using a 21-item questionnaire evaluating behaviors such as bruxism, nail biting, and gum chewing. Each item is rated on a 0-4 Likert scale, with total scores ranging from 0 to 84. Higher scores indicate more frequent parafunctional habits.

  3. Dynamic Balance

    Time frame: Assessments will be performed at baseline and week 6.

    Functional mobility and dynamic balance will be assessed using the Timed Up and Go Test. The time (in seconds) required to stand up from a chair, walk 3 meters, turn, return, and sit down will be recorded. Shorter times indicate better mobility and balance.

  4. Stability Index (SI)

    Time frame: Baseline and after 6 weeks

    Static balance will be assessed using the Tetrax system (Sunlight Medical Ltd., Israel). The Stability Index reflects overall postural sway and stability performance. Higher scores indicate poorer stability. Unit of measure: index score.

  5. Weight Distribution Index (WDI)

    Time frame: Baseline and after 6 weeks

    Measured using the Tetrax system, the WDI evaluates the distribution of body weight across four force plates. Higher values indicate asymmetry in weight distribution. Unit of measure: index score.

  6. Fourier Harmonic Index (FHI)

    Time frame: Baseline and after 6 weeks

    The FHI is derived from frequency analysis of postural sway signals obtained via the Tetrax system. It provides information about postural control mechanisms. Unit of measure: index score.

  7. Fall Index

    Time frame: Baseline and after 6 weeks

    The Fall Index estimates the risk of falling based on postural stability parameters measured by the Tetrax system. Higher scores indicate greater fall risk. Unit of measure: index score.

Study contacts

Contact information is provided by the study sponsor or research team.

Serkan Bakırhan, Professor

CONTACT

[email protected]

+90 505 663 18 40

Sponsors and collaborators

Lead sponsor

Ege University

Other

Registry information

Official study title

Effect of Telerehabilitation-Based Dual-Task Training on Clinical Outcomes in Temporomandibular Joint Dysfunction

Important dates

Study start
2026
Primary completion
2026
Study completion
2027
First posted
Apr 29, 2026
Registry last updated
May 5, 2026

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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