Telerehabilitation Versus Home-Based Jaw Exercises in Temporomandibular Disorder With Bruxism

Effectiveness of Telerehabilitation-Based Rocabado Exercises Compared With Home-Based Rocabado Exercises in Patients With Myofascial Temporomandibular Dysfunction Accompanied by Bruxism: A Randomised Controlled Trial

This study looked at whether jaw exercises (the Rocabado exercise programme) work better when delivered through supervised online video sessions than when done at home with written instructions alone, in adults who have jaw-joint pain (temporomandibular disorder) together with teeth grinding (bruxism). Thirty adults were randomly placed into one of two groups. Both groups were taught the same exercises and asked to do them twice a day for four weeks. One group also took part in supervised video sessions three times a week, where a physiotherapist watched their exercises and gave feedback; the other group used printed exercise leaflets with weekly text-message reminders. The researchers measured jaw pain, how wide participants could open their mouth, jaw movement, stress, sleep quality and oral habits before treatment, after two weeks and after four weeks, to see which approach gave better results.

This single-centre, parallel-group, randomised controlled trial was conducted at the Faculty of Dentistry, Nevşehir Hacı Bektaş Veli University. Participants who met the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for myofascial temporomandibular disorder with concurrent bruxism were randomly allocated in a 1:1 ratio using a computer-generated simple randomisation sequence. Allocation was concealed using sequentially numbered, opaque, sealed envelopes that were opened only after enrolment. The outcome assessor was blinded to group allocation; participants were not blinded owing to the nature of the intervention. Both groups received identical initial face-to-face training in the Rocabado 6×6 exercise programme and were instructed to perform the exercises twice daily for four weeks. The telerehabilitation group additionally received supervised video sessions, whereas the comparator group followed the programme at home with printed materials and reminders only. Assessments were performed in person at baseline, at week 2 (mid-treatment) and at week 4 (post-treatment). The sample size was estimated using G*Power, and data were analysed with within-group and between-group statistical comparisons.

Inclusion Criteria:

• Adults aged 18-60 years
• Diagnosis of myofascial temporomandibular disorder (TMD) with bruxism according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)
• Visual Analogue Scale (VAS) pain score ≥ 3
• No medical treatment for TMD in the preceding 6 months
• Access to a smartphone with internet connectivity
• Turkish literacy and communication ability

Exclusion Criteria:

• Active orthodontic or splint treatment
• History of temporomandibular joint surgery
• Systemic inflammatory disease
• Pregnancy
• Major psychiatric disorders
• Neurological deficits in the cervical region