The aim is to reveal to what extent cervical core exercises affect the results of treatment in patients with Temporomandibular Joint Dysfunction caused by Myofascial pain syndrome. Randomization will be carried out by dividing individuals who agree to participate in the study into 3 groups of 20 people.Participants will be divided into three groups, and all three groups will receive treatment in 30-45 minute sessions a day, 2 days a week for 8 weeks.
Being diagnosed with Temporomandibular Disorder caused by Myofascial Pain Syndrome
Female gender aged 18 and over
Volunteering to participate in the study
Not having communication difficulties such as speaking and understanding Turkish or not being able to understand the exercises.
Having a history of acute trauma in and around the Temporomandibular Joint
Having Temporomandibular Joint dysfunction due to neurological disease
Having a history of surgical/invasive procedures or treatments on the Temporomandibular Joint
Presence of infection or tumoral structure within intraoral structures
Parallel
Rocabado Exercises
Other interventionPatients trained by Rocabado Exercises
Servical Core Exercises
Other interventionServical Core Exercises
Visual Analogue Scale
The severity of pain felt by individuals in the Temporomandibular Joint and Cervical Region, at rest, during activity and at night, will be evaluated numerically using the visual analog scale. Individuals will be told that the number "0" on a 10 cm horizontal line indicates "no pain" and the number "10" indicates "unbearable pain". The location marked by the individual will be determined as the pain intensity in cm.
Algometer
Algometer will be used for objective measurement of Pain Threshold Assessment. The pressure will be applied to the massater, temporalis and upper trapezius muscles bilaterally, increasing the pressure by 1kg/cm2 every three seconds until the patient feels pain. The subject is told to report when he/she feels pain while applying force (kg/cm²) with the device. This process is repeated three times to calculate the average value on the muscles.
Mandibular Range of Motion
Mandibular Range of Motion, Pain-free mouth opening, maximum mouth opening, maximum assisted mouth opening, right lateral and left lateral movements will be evaluated by the physiotherapist with the help of a ruler
Jaw Functionality Assessment
'Functional Limitation Scale of the Jaw-8' will be used for functionality evaluation. The individual is asked to determine the level of restriction for each of the 8 items on the scale in the last month. Individuals are told that the number '0' on a 10cm horizontal line indicates 'no restriction' and the number '10' indicates 'severe restriction'. Functionality limitation is calculated by taking the average of the individual's answers.
Neck Disability Assessment
The Neck Disability Index is a tool used to determine how the pain participants feel in their neck affects their daily lives. In the 10-question survey, A = 0 points, B = 1 point, C = 2 points, D = 3 points, E = 4 points, F = 5 points are given for each question and the total score is obtained. According to the test scoring, 0-4=No disability, 5-14=Mild disability, 15-24=Moderate disability, 25-34=Severe disability, 35 or above=Complete disability.
Psychiatric Evaluation
Hospital Anxiety and Depression Scale is used to determine individuals' depression and anxiety levels. The scale consists of two subscales, seven measuring anxiety and seven measuring depression (odd numbers are anxiety, even numbers are depression), and a total of 14 items. Each item is scored on a 4-point Likert scale between 0 and 3. According to the scores obtained from the scales, the anxiety and depression status of individuals is evaluated as not being sick (0-7 points), borderline sick (8-10 points), and significantly sick (11-21). Considering the cut-off scores in Turkey, which are affected by the cultural situation in the country, individuals who score 10 points or more from the anxiety subscale and individuals who score above 7 points from the depression subscale are defined as risky.
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