The efficacy of adding proprioceptive neuromuscular facilitation to conventional treatments for myogenous temporomandibular disorders: a randomized controlled trial
Physiotherapy Theory and Practice, cilt.42, sa.9, ss.1181-1192, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 42 Sayı: 9
- Basım Tarihi: 2026
- Doi Numarası: 10.1080/09593985.2026.2624517
- Dergi Adı: Physiotherapy Theory and Practice
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, MEDLINE
- Sayfa Sayıları: ss.1181-1192
- Anahtar Kelimeler: mandibular function, orofacial pain, proprioceptive neuromuscular facilitation, Rocabado exercises, Temporomandibular joint disorders
- Marmara Üniversitesi Adresli: Evet
Özet
Background: Temporomandibular disorders (TMDs) are associatedwith orofacial pain and functional limitations. Although conventionalphysiotherapy is commonly used, the additional benefits ofproprioceptive neuromuscular facilitation (PNF) remain unclear. Thisstudy investigated the effects of adding PNF to conventional exercisetherapy in individuals with myogenous TMD. Methods: A randomized controlled trial was conducted with 66participants aged 18–65 years diagnosed with myogenic TMD.Participants were divided into two groups for 4 weeks: a traditionalexercise group (CEG) or a traditional + PNF exercise group (PNFE).Pain intensity was assessed using the Numerical Pain Rating Scale(NPRS). Patient-reported mandibular function was evaluated using theMandibular Function Impairment Questionnaire (MFIQ). Mandibularmobility was assessed using jaw range of motion measures, includingactive range of motion (AROM) parameters (pain-free opening (PFO) andmaximum unassisted opening (MUO)) and assisted active range of motion(AAROM), measured as maximum mouth opening (MMO). Evaluations wereperformed at baseline (T0) and immediately after completion of the4-week intervention (T1). Results: From T0 to T1, pain intensity decreased significantlyin both groups (p <.001), with a moderate effect size indicating a greater reduction in the PNFE group (ηp2 = 0.110, p =.043).Patient-reported mandibular function(MFIQ), improved in both groupsover the 4-week intervention period (p <.001). The PNFE groupdemonstrated greater gains in jaw range of motion (MMO and MUO);however, these changes were small (ηp2 = 0.021 and ηp2 = 0.002). Conclusion: PNF exercises, when combined with conventionalexercises, provided greater pain relief and improved ROM compared toconventional exercises alone, suggesting their potential value inTMDs rehabilitation. Further research is needed to assess long-termeffects.