Effectiveness of cervical stabilization training in individuals with temporomandibular joint disorders: a randomized controlled trial

The aim of this randomized controlled trial was to evaluate the effects of cervical stabilization training (CST) on temporomandibular joint (TMJ) pain intensity and symptom severity and cervical posture, mobility and muscle performance in individuals with TMJ disorders. Thirty participants were randomized to control (n = 15, age = 20.73 ± 1.70 years, body mass index = 21.75 ± 4.28 kg/m2) or CST (n = 15, age = 21.20 ± 5.10 years, body mass index = 21.81 ± 2.81 kg/m2) groups. Both groups received an 8-week standard treatment program (education + home exercises), with the CST group receiving additional cervical stabilization training (3 sessions/week: 1 supervised, 2 home-based). TMJ pain intensity with the Numeric Pain Rating Scale (NPRS), symptom severity with Fonseca Anamnestic Index (FAI), and cervical posture with craniovertebral angle measurement, mobility with universal goniometer and muscle performance with craniocervical flexion test were evaluated before and after the intervention. CST improved TMJ symptom severity (p = 0.012), cervical posture (Craniovertebral angle) (p = 0.040), cervical flexion (p = < 0.001), extension (p = < 0.001), right lateral flexion (p = < 0.001) and left lateral flexion (p = < 0.001) mobility and cervical muscle performance (CCFT) (p = < 0.001) but did not lead to improvements in TMJ pain intensity (p > 0.05) within the intervention group. However, between-group differences were significant only for TMJ pain intensity at rest ([95% confidence interval]{CI}: 0.06 to 1.55, d = 0.81, p = 0.034) and cervical muscle performance (CCFT) ([95% confidence interval]{CI}: -2.10 to -0.51, d = 1.32, p = 0.001). In addition, in standard treatment, only improved cervical flexion (p = 0.007) and right lateral flexion (p = 0.036) within the control group (Table 2). This study demonstrates that CST may contribute to alleviating TMJ symptom severity and improving cervical posture, mobility, and muscle performance in individuals with temporomandibular disorders. However, the effects on TMJ pain intensity were limited, and the lack of long-term follow-up warrants caution in generalizing these findings. Future studies with larger samples and longitudinal designs are needed to validate these results and explore the sustainability of the intervention’s effects. NCT06472141-10.06.2024.