Does forward head posture correction improve temporomandibular joint dysfunction? A pilot randomized trial using a...

Area of Science:

• Orthopedics
• Physical Therapy
• Dental Medicine

Background:

• Forward head posture (FHP) is linked to temporomandibular disorders (TMDs).
• Conservative TMD treatments can be enhanced by addressing FHP.
• Pilot studies are crucial for determining sample size and feasibility for full-scale trials.

Purpose of the Study:

• To assess the effectiveness of adding FHP correction via a cervical extension traction (CET) orthotic to standard conservative TMD treatment.
• To evaluate the impact on TMD severity, pain, and mouth opening.
• To determine adherence rates and effect size for future study sample size calculations.

Main Methods:

• A randomized clinical trial with 21 participants (19 females) comparing a CET orthotic plus conservative treatment versus a placebo plus conservative treatment.
• Outcome measures included TMD severity (Fonseca's questionnaire), pain intensity (NRS), maximum mouth opening (MMO), and craniovertebral angle (CVA) for FHP.
• Assessments were conducted at baseline, 3 weeks, and 6 weeks over a 6-week treatment period.

Main Results:

• High adherence rates (≥90%) were achieved in both groups.
• Significant improvements in orofacial pain, TMD severity, MMO, and CVA were observed within groups.
• The experimental group showed significant improvements in CVA (weeks 3 and 6) and TMD severity (week 6) compared to the control group.

Conclusions:

• Adding FHP correction with a CET orthotic may provide short-term benefits for TMD symptoms.
• Further research in a full-scale trial is needed to confirm these preliminary findings.
• A moderate effect size suggests approximately 38 participants are needed for a larger study.