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IRCT20250504065596N1 IRCT 2025-08-27 Shahid Beheshti University Comparison of the Effects of Two Types of Exercise on Women with Upper Crossed Syndrome and Temporomandibular Joint Disorder Comparing the Effects of McKenzie Exercises and PNF on Angles, Performance, and Symptoms in Women with Upper Crossed Syndrome and Temporomandibular Joint Disorder: a randomized clinical trial 2025-09-23 anticipated 42 Complete https://irct.ir/trial/83411 interventional Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Supportive, Randomization description: Simple Randomization: Participants, after confirming the inclusion and exclusion criteria, are randomly assigned to the intervention and control groups using a randomization table. The randomization table consists of a sequence of numbers or letters generated by randomization software, and each participant is assigned to a group based on their enrollment number. This method minimizes bias and ensures an equal distribution of characteristics between the groups. N/A Condition 1: Temporomandibular Joint Disorder. Condition 2: Upper Cross Syndrom. Intervention 1: Control group: No intervention is applied. Only assessment of Upper Crossed Syndrome and Temporomandibular Joint Disorder (TMD) is performed initially, and then reassessed six months later. Intervention 2: Intervention group one: The McKenzie exercise program is performed as a cervical stabilizing exercise. The purpose of the McKenzie exercise program is to eliminate pain and restore postural control and balance. The training protocol lasts for 6 weeks, 3 sessions per week, totaling 16 sessions, and for warm-up 10 minutes and for cool-down 5 minutes in total 15 minutes and 30 minutes of exercise time will be considered. Sufficient explanations and demonstrations were provided to ensure correct exercise performance, and the training was conducted under the supervision of the researcher. The subjects performed 7 movements at maximum static strength for 7 seconds and in total 20 repetitions with 3 seconds rest between each movement. The exercise intensity increased each week by adding 10% to the number of repetitions. The exercises included: chin tuck in sitting position, cervical extension in sitting or standing position, lifting the head in supine position, turning the head to the left and right in supine position, lateral flexion to the left and right, chin tuck with head rotation and looking toward the shoulder, cervical flexion in sitting position. Intervention 3: Intervention group two: The PNF program consists of a total of eight therapeutic exercises. Considering the alignment of the cervical spine and pain in the temporomandibular joint, the position will be performed with greater support. All exercise programs were designed based on the basic principles of PNF, the fundamental procedures, and the philosophy of PNF, and the PNF patterns and techniques were adapted to the hypothesis of activity limitation. The weekly programs were adjusted by combining three to four exercise programs according to the patient’s level of adaptation to the program. Before starting the exercise program, general explanations and precise instructions regarding deep breathing will be given to the patient, and when the patient reports pain or fatigue, the exercise will be stopped for 2 to 3 minutes of rest. Rest will not be considered during the entire exercise period. In the last 3 weeks, all exercises will be performed, and the exercise intensity will be increased each week by adding 10% to the number of repetitions. The training protocol lasts for 6 weeks, 3 sessions per week, totaling 16 sessions, and for warm-up 10 minutes and for cool-down 5 minutes, in total 15 minutes, and 30 minutes of exercise time will be considered. Sufficient explanations and demonstrations were provided to ensure correct exercise performance, and the training was conducted under the supervision of the researcher. The exercises included: stretching of the upper cervical extensor muscles, reciprocal inhibition of suboccipital muscles with strengthening of suprahyoid muscles, increasing stability in the corrected position of the cervical spine and temporomandibular joint (TMJ) with device, tongue exercise in the corrected cervical position, increasing mobility of the mandible in the corrected cervical position, mouth opening, biting an apple, and holding a towel behind the neck while opening the mouth. No - There is not a plan to make this available Justification or reason for not sharing IPD is There is no further information
public Sarvenaz Shabani Panbecholeh
No. 91, Corner of Yousef Alley, Before Dr. Gharib Street, Forsat Shirazi Street, Eskandari North Street, Azadi Street
Tehran Iran (Islamic Republic of) 1419794531 +98 21 6659 5554 sarvenazshabani@yahoo.com Shahid Beheshti University scientific Sarvenaz Shabani Panbecholeh
No. 91, Corner of Yousef Alley, Before Dr. Gharib Street, Forsat Shirazi Street, Eskandari North Street, Azadi Street
Tehran Iran (Islamic Republic of) 1419794531 +98 21 6659 5554 sarvenazshabani@yahoo.com Shahid Beheshti University Iran (Islamic Republic of) Iran (Islamic Republic of) Voluntary Participation Body Mass Index between 18 and 25 Diagnosis of TMD based on the specialist's assessment At least one month has passed since the onset of TMD pain "Forward head posture ≤ 50 degrees, forward shoulder posture ≥ 52 degrees, and hyper kyphosis ≥ 40 degrees." Female participants only 20 to 40 years old Presence of clicking sounds in the temporomandibular joint(TMJ) Functional disability of the temporomandibular joint (TMJ) Presence of pain in the temporomandibular joint (TMJ) and associated structures 20 years 40 years Female Use of medication or other interventions Presence of specific spinal pathologies such as severe disc herniation (grade II or III) History of spinal fracture or surgery Presence of severe deformities in the lumbar spine or pelvis Presence of rheumatologic disorders Presence of sequestrated (migrated) disc displacement, TMJ osteoarthritis, or arthritis according to DC/TMD criteria History of traumatic injuries to the mandible or cervical spine Presence of fibromyalgia syndrome Presence of systemic diseases (rheumatoid arthritis, systemic lupus erythematosus, or psoriatic arthritis) Presence of neurological disorders History of any treatment (physiotherapy, splint therapy, or acupuncture) within 3 months prior to the study M26.6 Temporomandibular joint disorders Treatment - Other Treatment - Other Treatment - Other Control group: No intervention is applied. Only assessment of Upper Crossed Syndrome and Temporomandibular Joint Disorder (TMD) is performed initially, and then reassessed six months later. Intervention group one: The McKenzie exercise program is performed as a cervical stabilizing exercise. The purpose of the McKenzie exercise program is to eliminate pain and restore postural control and balance. The training protocol lasts for 6 weeks, 3 sessions per week, totaling 16 sessions, and for warm-up 10 minutes and for cool-down 5 minutes in total 15 minutes and 30 minutes of exercise time will be considered. Sufficient explanations and demonstrations were provided to ensure correct exercise performance, and the training was conducted under the supervision of the researcher. The subjects performed 7 movements at maximum static strength for 7 seconds and in total 20 repetitions with 3 seconds rest between each movement. The exercise intensity increased each week by adding 10% to the number of repetitions. The exercises included: chin tuck in sitting position, cervical extension in sitting or standing position, lifting the head in supine position, turning the head to the left and right in supine position, lateral flexion to the left and right, chin tuck with head rotation and looking toward the shoulder, cervical flexion in sitting position. Intervention group two: The PNF program consists of a total of eight therapeutic exercises. Considering the alignment of the cervical spine and pain in the temporomandibular joint, the position will be performed with greater support. All exercise programs were designed based on the basic principles of PNF, the fundamental procedures, and the philosophy of PNF, and the PNF patterns and techniques were adapted to the hypothesis of activity limitation. The weekly programs were adjusted by combining three to four exercise programs according to the patient’s level of adaptation to the program. Before starting the exercise program, general explanations and precise instructions regarding deep breathing will be given to the patient, and when the patient reports pain or fatigue, the exercise will be stopped for 2 to 3 minutes of rest. Rest will not be considered during the entire exercise period. In the last 3 weeks, all exercises will be performed, and the exercise intensity will be increased each week by adding 10% to the number of repetitions. The training protocol lasts for 6 weeks, 3 sessions per week, totaling 16 sessions, and for warm-up 10 minutes and for cool-down 5 minutes, in total 15 minutes, and 30 minutes of exercise time will be considered. Sufficient explanations and demonstrations were provided to ensure correct exercise performance, and the training was conducted under the supervision of the researcher. The exercises included: stretching of the upper cervical extensor muscles, reciprocal inhibition of suboccipital muscles with strengthening of suprahyoid muscles, increasing stability in the corrected position of the cervical spine and temporomandibular joint (TMJ) with device, tongue exercise in the corrected cervical position, increasing mobility of the mandible in the corrected cervical position, mouth opening, biting an apple, and holding a towel behind the neck while opening the mouth. Forward Head. Timepoint: One day before the start of the study, followed by six weeks of training, and then one day after the end of the training. Method of measurement: Photogrammetry method for evaluating upper crossed syndrome. Shoulder Forward. Timepoint: One day before the start of the study, followed by six weeks of training, and then one day after the end of the training. Method of measurement: Photogrammetry method for evaluating upper crossed syndrome. Kyphosis. Timepoint: One day before the start of the study, followed by six weeks of training, and then one day after the end of the training. Method of measurement: Photogrammetry method for evaluating upper crossed syndrome. Temporomandibular joint noise. Timepoint: One day before the start of the study, followed by six weeks of training, and then one day after the end of the training. Method of measurement: Diagnostic Criteria for Temporomandibular Disorders. Temporomandibular joint pain. Timepoint: One day before the start of the study, followed by six weeks of training, and then one day after the end of the training. Method of measurement: Diagnostic Criteria for Temporomandibular Disorders. Temporomandibular joint function. Timepoint: One day before the start of the study, followed by six weeks of training, and then one day after the end of the training. Method of measurement: Diagnostic Criteria for Temporomandibular Disorders. Shahid Beheshti University Approved 2025-04-19 Research Ethics Committees of Shahid Beheshti University No. 91, Corner of Yousef Alley, Before Dr. Gharib Street, Forsat Shirazi Street, Eskandari North Street, Azadi Street Tehran Tehran Iran (Islamic Republic of)