COMPARATIVE EFFECTIVENESS OF MANUAL THERAPY AND ROCABADO TECHNIQUES IN THE MANAGEMENT OF TEMPOROMANDIBULAR JONT DYSFUNCTION: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: TMJ Dysfunction are trauma to the jaw, such as a blow to the face or a sudden impact, can cause TMJ dysfunction. The occurance rate of temporomandibular joint (TMJ) dysfunction approximately 31% of adults and elderly individuals experience TMJ dysfunction, with disc displacement with reduction (DDwR) being the most common condition, affecting around 25.9% of this population Objective: To determine which treatment tecnique either manual therapy or Rocabado techniques) is more effective in reducing pain and improving jaw function in patients with TMJ dysfunction Methods: The design of this study was Randomized controlled trial (RCT). Data was collected from Physiotherapy and Rehab center shadrah, lahore. Based on these calculations, the calculated total sample size to check statistically main differences was 38 participants. However, to account for an expected 10% withdrawal rate during the study, the sample size is set to 42 participants to maintain the urge power, a 5% margin of error, and 95% power, as calculated by G-Power version 3.1.9.7. Each participant was randomized into either the Group A (Manual therapy) or ROCABADO techniques was perform in group B. One conciliator and one examiner participated in this study. In addition, the examiner was unsure of in which classified subjects were chosen. Pain, Rom were examined by the examiner before and after treatment. Participants of both group warmed up by hot packs for 5 minutes. The evaluator, who was blinded to measures given to each group, measured the ROM, and pain intensity around one minute after this warm up. The intensity of pain was assessed on a 11 points Numeric Pain Rating Scale (NPRS) in each patient. The pain free maximal distance between the incisal edges of the mandibular central incisor and the maxillary central incisor is referred to as the maximal mouth opening and was measured by Therabite scale. Results: The Mann–Whitney U test was applied to compare outcomes between Manual Therapy (Group A) and Rocabado Technique (Group B) in a total sample of 38 participants. At baseline, no statistically important differences were observed between groups for pain (p = 0.205) and maximum mouth opening (MMO) (p = 1.000), indicating similarty. However, post-treatment analysis shows important differences (p < 0.01), with Group A explain marked decrease in pain (10.79 ± 0.205) compared to an increase in Group B (28.21 ± 0.536). Similarly, MMO significantly improved in Group A (28.61 ± 0.543), while it decreased in Group B (10.39 ± 0.197). The Z-values further supported these findings, show a stronger treatment effect of Manual Therapy over the Rocabado Technique. Conclusion: Group A show a maint reduction in pain and a marked improvement in mouth opening (MMO), whereas Group B showed less favorable changes. Therefore, Manual Therapy can be considered a more effective treatment for reducing pain and improving functional mouth opening in the studied population