Adding Core Stabilization Training to Manuel Therapy in Temporomandibular Joint Disorders

Adding Core Stabilization Training to Orofacial Manuel Therapy in Individuals With Temporomandibular Joint Disc Displacement With Reduction: A Randomized Controlled Study

This study aims to compare the effectiveness of three different treatment approaches in individuals with DDwR symptoms. It is hypothesized that adding core stabilization training (CST) to orofacial manual therapy (OMT) will enhance treatment outcomes. Patients will be treated for 10 sessions once a week, for a total of 10 weeks. Evaluation was planned to be done twice, at the beginning and end of the treatment.

This study aims to compare the effectiveness of three different treatment approaches in individuals with DDwR symptoms. It is hypothesized that adding core stabilization training (CST) to orofacial manual therapy (OMT) will enhance treatment outcomes. The patients to be included in the study will be randomly divided into three groups and it is planned to include 15 people in each group. Home exercises and patient education will be provided to all patients.

• Group 1 (CST group): Orofacial manual therapy + core stabilization training (CST) + home exercise and patient education
• Group 2 (OMT group): Orofacial manual therapy (OMT) + home exercise and patient education
• Group 3 (Control group): Home exercise and patient education.

Pain intensity, pressure pain threshold, joint range of motion, posture, flexibility, stabilization of core muscles, functionality and sleep quality will be evaluated by using Numeric Pain Scale (NPS), digital algometer, ruler, Palpation Meter (PALM), bubble inclinometer, tape measure, Finger-to-floor distance (EPZM) and sit-reach test, pressure biofeedback unit, "Helkimo Index", "Pittsburgh Sleep Quality Index (PUKI)" respectively. Patients will be treated for 10 sessions once a week, for a total of 10 weeks. Evaluation was planned to be done twice, at the beginning and end of the treatment.

Inclusion Criteria:

• Volunteered to participate,
• Aged between 18-60 years old,
• Having the diagnosis of Temporomandibular Disorders (TMD) - Reduction Disc Displacement (DDwR)

Exclusion Criteria:

• Having a malignant condition, trauma and surgery of the cranial and cervical region,
• Not being cooperative,
• Regular use of analgesic and anti-inflammatory drugs,
• Having dentofacial anomalies,
• Having active arthritis,
• Having lumbal pathology,
• Having metabolic diseases,
• Having connective tissue, rheumatological and hematological disorders,
• Having a diagnosed psychiatric illness,
• Receiving TMD-related physical therapy less than 6 months ago