Effect of Emg-Biofeedback and Multimodal Exercise on Temporomandibular Joint Dysfunction

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Conditions studied: Temporomandibular Joint Disease

In brief

Temporomandibular joint dysfunction (TMD) is a multifactorial musculoskeletal disorder affecting the masticatory muscles, temporomandibular joint, and related structures, characterized by pain and functional limitations. In TMD, myofascial pain is particularly prominent, leading to decreased mandibular range of motion, impaired masticatory function, and reduced quality of life. Current literature shows that conservative treatment approaches, especially multimodal physiotherapy programs, are effective in reducing TMD symptoms. However, evidence regarding the clinical effectiveness of adding EMG-Biofeedback-based relaxation training, aimed at increasing awareness of muscle activity, to multimodal treatment programs is limited. The aim of this randomized controlled trial is to investigate the effect of EMG-Biofeedback-based relaxation training, added to a multimodal exercise program, on pain levels and functional parameters in individuals diagnosed with temporomandibular joint dysfunction. Participants will be divided into two groups using a simple randomization method. The control group will receive multimodal physiotherapy consisting of manual therapy and a home exercise program, while the experimental group will receive EMG-Biofeedback-based relaxation training in addition to the same program. Assessments will be conducted before the intervention and at the end of the 4-week intervention. Pain intensity will be measured with a Visual Analog Scale (VAS), pressure pain threshold with a digital algometer, mandibular joint range of motion with a linear scale, and cervical joint range of motion with a digital goniometer. Functional status will be assessed using the Fonseca Anamnestic Index, Neck Disability Index, and Oral Health Impact Profile-14. The obtained data will be compared using appropriate statistical analysis methods. This study is expected to provide scientific evidence regarding the clinical effectiveness of adding EMG-Biofeedback-based relaxation training to multimodal exercise programs in the conservative treatment of TMD and to contribute to filling the methodological gap mentioned in the literature.

Key facts

Study ID

NCT07577687

Run by

Yuzuncu Yil University

People needed

40

Starts

2026-06-18

Expected to finish

2026-12-15

Last updated by the study team

2026-06-09

Who can join

Age: 18 and older, up to 65. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Having been diagnosed with TMD, meaning having been diagnosed with Group 1 (1a: myofascial pain - 1b: referral myofascial pain) within Axis 1 according to the RDC/TMD diagnostic system.
• Having experienced TMJ pain for at least 3 months
• Having a sufficient cognitive level to follow simple instructions and take tests.

You may not qualify if…

• Having a malignant condition in the TMJ and/or cervical spine and having undergone surgery,
• Having neurological or psychiatric disorders, pregnancy,
• Having a history of BTA (Botulinum toxin injection) within the last year,
• Having received physical therapy related to TMJ less than 6 months ago,
• Being under orthodontic treatment,
• Having uncontrolled diabetes,
• Having inflammatory rheumatic diseases (rheumatoid arthritis, etc.)

Where it is running

• Van Yüzüncü Yıl University — Van, Tuşba, Turkey (Türkiye)

Full record on ClinicalTrials.gov

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