CAN NECK STABILIZATION TRANSFORM TMJ REHABILITATION? EFFECTS OF CERVICAL STABILIZATION TRAINING IN INDIVIDUALS WITH TEMPOROMANDIBULAR DISORDERS: A RANDOMIZED CONTROLLED TRIA

Abstract

Background Temporomandibular disorders (TMDs) are common musculoskeletal conditions associated with pain, jaw dysfunction, cervical impairment, and postural abnormalities. Increasing evidence suggests a functional relationship between the temporomandibular joint and cervical spine; however, limited randomized controlled trials have evaluated the effectiveness of cervical stabilization training in TMD rehabilitation. Objective To determine the effectiveness of cervical stabilization training combined with conventional TMJ rehabilitation on pain, jaw function, cervical mobility, neck disability, posture, and quality of life in individuals with temporomandibular disorders. Methods A single-blinded randomized controlled trial was conducted involving 60 participants diagnosed with TMD according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Participants were randomly allocated into an experimental group receiving conventional TMJ rehabilitation plus cervical stabilization training (n = 30) and a control group receiving conventional TMJ rehabilitation alone (n = 30). Interventions were administered three sessions per week for six weeks. Outcome measures included Visual Analog Scale (VAS), Jaw Functional Limitation Scale (JFLS), maximum mouth opening (MMO), cervical range of motion (CROM), Neck Disability Index (NDI), pressure pain threshold (PPT), postural alignment, and SF-36 quality-of-life questionnaire. Repeated measures ANOVA with Bonferroni post hoc correction was used for statistical analysis, with significance set at p < 0.05. Results Both groups demonstrated significant improvement following intervention; however, the experimental group showed significantly greater improvement compared with the control group across primary and secondary outcome measures. Repeated measures ANOVA revealed significant group × time interaction effects for pain intensity (F = 6.21, p = 0.003), jaw functional limitation (F = 5.84, p = 0.005), maximum mouth opening (F = 4.97, p = 0.009), cervical range of motion (F = 5.66, p = 0.004), and Neck Disability Index scores (F = 6.03, p = 0.003). Significant improvements were maintained at 12-week follow-up assessment. No major adverse events were reported. Conclusion Cervical stabilization training combined with conventional TMJ rehabilitation appears to be more effective than conventional rehabilitation alone in improving pain, mandibular function, cervical mobility, posture, and quality of life in individuals with temporomandibular disorders.