A Randomized Trial Analyzing the Effects of Core Strengthening Exercises in Physical Therapy for Treating Temporomandibular Joint Dysfunction
Loyola University
Summary
Temporomandibular disorders (TMD) are commonly managed with non-invasive interventions such as manual therapy, therapeutic exercise, relaxation techniques, and patient education. Core strengthening (also known as abdominal strengthening) is a fundamental element of physical therapy that engages deep and superficial trunk musculature to enhance postural control and functional performance. Protocols such as the Shirley Sahrmann progression have demonstrated increased activation of key core stabilizing muscles. Emerging evidence suggests a potential relationship between core stability training and reductions in TMD-related pain, though improvements in functional outcomes remain inconclusive. Biomechanical links between the pelvic floor, spine, and temporomandibular joint further support the rationale for core-focused interventions. Nevertheless, few studies have isolated the effects of core strengthening on TMD symptomatology. This study seeks to determine whether the integration of core stability exercises into TMD management can reduce pain, improve function, and enhance quality of life.
Description
This single-blinded randomized controlled trial will evaluate the effects of core strengthening exercises in addition to standard physical therapy for patients with Temporomandibular Joint Dysfunction (TMD). The study aims to determine whether integrating core stability exercises can reduce TMD-related pain, improve function, and enhance quality of life compared to standard physical therapy alone. A total of 50 participants, aged 18-70, who have a primary complaint of TMD within the last 30 days and are willing to complete at least six physical therapy visits over a three-month period will be…
Eligibility
- Age range
- 18–80 years
- Sex
- All
- Healthy volunteers
- No
Who Can Participate (Inclusion Criteria): Adults between 18 and 70 years old. Have had jaw pain or problems with the jaw joint (TMD) in the last 30 days. Able and willing to attend at least six physical therapy sessions over three months. Speak English or have access to a qualified interpreter. Able to safely do physical exercises. Who Cannot Participate (Exclusion Criteria): Recently had surgery on the jaw, teeth, or spine (within the last 3 months). Recently had head or neck injuries or certain neurological problems (such as dizziness, double vision, trouble swallowing, or sudden fal…
Interventions
- BehavioralExperimental: Group 1: Core Strengthening
Participants perform Shirley Sahrmann core exercises (5 progressive levels maintaining neutral spine and deep core activation), possibly adding upper extremity movements. Standard TMD PT includes jaw exercises, manual therapy, soft tissue mobilization, neuromuscular re-education, and patient education. A home exercise program (\~20 min/day) is provided with printed and video instructions.
- BehavioralGroup 2: Standard TMD PT
Participants receive standard TMD PT including jaw exercises (Rocabado 6x6), manual therapy for TMJ and cervical spine, soft tissue mobilization, neuromuscular re-education to improve jaw mechanics, and education on jaw positioning, diet/chewing modifications, and parafunctional habits. A home exercise program is provided as part of treatment.
Location
- Loyola University Medical CenterMaywood, Illinois