Condylar Remodeling ExercisesNCT07642609
To Investigate the Effect of Condylar Remodeling Exercises on Proprioception of Neck and Temporomandibular Joint in Cranio-cervico-mandibular Malalignment.
A study testing Condylar remodeling exercises Included 1)Range of motion phase, 2)Bite phase, 3)Bite return phase, 4)Protrusion, 5)isometric contraction phase Tubing distraction phase and Postural correction exercises Kendall exercises in people with Condylar Remodeling Exercises and CCM Malalignment, run by Cairo University at 1 site in Egypt.
Trial summary
Cranio-cervico-mandibular (CCM) malalignment is associated with forward head posture (FHP) and tempromandibular joint (TMJ) disorders and affects masticatory muscles. Patients who present with dysfunctions of CCM malalignment can be treated effectively by a physical therapist who has specialized skills and… Read more about this study
- Who is it for?
- Ages 18 to 40 years
- Conditions the study is for
- Condylar Remodeling Exercises, CCM Malalignment
- What is being tested?
- Condylar remodeling exercises Included 1)Range of motion phase, 2)Bite phase, 3)Bite return phase, 4)Protrusion, 5)isometric contraction phase Tubing distraction phase and Postural correction exercises Kendall exercises
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 1 siteEgypt
- Study dates
- 20 Jun 2026to 20 Oct 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 40 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- The participants will be excluded if they:
- The patient's ages from 18 to 40 years
- having TMD symptoms sustained for at least twelve weeks duration established by expert physician or orthopaedician.
- having forward head posture with CVA < 53o.
- mouth opening < 25mm.
- Pain level greater than 20 mm and less than 80 mm on Numeric Rating Scale (NRS).
Who cannot join
- (1) TMJ fracture undergone any surgical procedure for TMJ; (2) Fracture surrounding TMJ; (3) Dislocation or subluxation of TMJ; (4) Systemic joint diseases including rheumatoid arthritis and osteoporosis, congenital conditions orofacial paralysis; (5) recent dental work or TMJ surgery; (6) Hematological cervical disorders which may affect the jaw; (7) Neurological deficits e.g. Bells palsy, Trigeminal neuralgia;(8) Recent infections affecting head and neck (within the last six months) e.g. bone infections, meningitis, encephalitis, malaria, ear infection; (9) Participants who were using any functional appliances e.g.dentures, braces, bite appliances altered or fitted within the previous 12 weeks prior to the commencement of this study; (10) Patients who underwent any physical therapy treatment within the last 2 weeks before the trial; (11) Internal derangement, including disc displacement with or without reduction
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Effect of Condylar Remodeling Exercises on Proprioception of Neck and Temporomandibular Joint in Cranio-cervico-mandibular Malalignment: A Randomized, Double-blind, Controlled Trial
Cranio-cervico-mandibular (CCM) malalignment is associated with forward head posture (FHP) and tempromandibular joint (TMJ) disorders and affects masticatory muscles. Patients who present with dysfunctions of CCM malalignment can be treated effectively by a physical therapist who has specialized skills and experiences. A temporomandibular joint exercise developed by Rocabado called "Condylar remodeling exercises" considered as a new method for treatment of such cases. Those exercises stimulate mechanoreceptors that converts mechanical energy of physical deformation into action nerve potential yielding proprioceptive information, detecting change and rate of change, as opposed to steady state conditions. This input was analyzed in the central nervous system for joint position and movement influences muscle tone, motor execution programes and kinesthetic awareness around temporomandibular joint protecting joint from damage and helps to restore appropriate balance of synergistic and antagonistic forces. Although condylar remodeling exercises has been used in clinical practice, limited evidence exists to support such a treatment approach. So, the current study will conduct to investigate the effect of Condylar Remodeling Exercises on proprioception of neck and TMJ in CCM malalignment
Read the detailed description
To determine if there is an effect for the effect of Condylar Remodeling Exercises on proprioception of neck and TMJ in CCM malalignment. 40 of both sexes will participate in this study. Assessment of all participants will be carried out before and after the treatment program. Outcome measures will include assessment of neck proprioception, Temporomandibular joint position sense, cranio-vertebral angle, active pain-free mouth opening, pain assessment.A total of 40 subjects of both sexes having CCM malalignment will be recruited in this study. They will be randomly assigned to one of the following groups: Study group include 20 subjects will receive Condylar remodeling exercises in addition to postural correction Exercise, Control group: include 20 subjects will receive postural correction Exercise only. All subjects in both groups will receive the exercise program 3 days a week for four weeks.
- Conditions
- Condylar Remodeling Exercises, CCM Malalignment
- Being tested
- Condylar remodeling exercises Included 1)Range of motion phase, 2)Bite phase, 3)Bite return phase, 4)Protrusion, 5)isometric contraction phase Tubing distraction phase, Postural correction exercises Kendall exercises
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Condylar remodeling exercises Included 1)Range of motion phase, 2)Bite phase, 3)Bite return phase, 4)Protrusion, 5)isometric contraction phase Tubing distraction phaseOther
A temporomandibular joint exercise developed by Rocabado called "Condylar remodeling exercises" considered as a new method for treatment of such cases. Those exercises stimulate mechanoreceptors that converts mechanical energy of physical deformation into action nerve potential yielding proprioceptive information, detecting change and rate of change, as opposed to steady state conditions. This input was analysed in the central nervous system for joint position and movement influences muscle tone, motor execution programmes and kinaesthetic awareness around temporomandibular joint protecting joint from damage and helps to restore appropriate balance of synergistic and antagonistic forces. Although condaylar remodling exercises has been used in clinical practice, limited evidence exists to support such a treatment approach
Postural correction exercises Kendall exercisesOther
Kendall exercises were performed as follows:
- Strengthening the deep cervical flexors: The patient was asked to do a flat-back, chin-down position and hold this position for 2-8 seconds
- Stretching the cervical extensors: The patient was asked to place one hand on the occipital area and other on the chin in a seated position, then a head-down, flexed neck position to stretch the cervical extensors.
- Strengthening shoulder retractors: This exercise was done in order to move the shoulder blades towards one another while standing, the patient was instructed to wrap red (medium) Theraband around a stable item and then draw the band back as far as they could with both hands.
- Stretching of the pectoralis major muscle: The therapist stood behind the patient and held both elbows and performed bilateral pectoralis stretching. To stretch the costal division, the arm should be elevated to approximately 135 degrees. For sternal division, the arm abducted to 90 degrees. For clavicula
| Study group | Role | What they receive |
|---|---|---|
| Study group (Condylar remodeling exercises in addition to postural correction Exercise | Experimental | Study group include 20 subjects will receive Condylar remodeling exercises in addition to postural correction Exercise, Receives: Other: Condylar remodeling exercises Included 1)Range of motion phase, 2)Bite phase, 3)Bite return phase, 4)Protrusion, 5)isometric contraction phase Tubing distraction phase; Other: Postural correction exercises Kendall exercises |
| Control group (postural correction Exercise only) | Active comparator | Control group: include 20 subjects will receive postural correction Exercise only Receives: Other: Postural correction exercises Kendall exercises |
What is being measured
The primary outcome is the main question the study is designed to answer.
Temporomandibular joint position sense (TMJPS)
For the TMJPS measurement, a 6 mm-thick wooden reference stick and 9 wooden test sticks from 4 mm to 8 mmin thickness (increment 0.5 mm) will be used. First, the participants will be asked to sense the position by biting the 6 mm thick reference test stick with their front teeth for 1 minute. Then, they will be asked to randomly bite each of the 9 test sticks and compare each of them with the 6 mm reference test stick. Each of the test sticks will be administered in a random order 5 times (45 tests in total). The participants will be asked how thick they felt compared to the reference stick that they have bitten down on and indicated their answers as "thinner", "thicker" or "equal". During the test, the participant's eyes will be closed, and the answers give about the stick thicknesses will be recorded as true (1 point) or false (0 points).
Measured: 24 hours from first and last session
Active pain-free mouth opening
In a supine position, participants will be asked to 'open the mouth as wide as possible without causing pain'. At the end position of pain-free mouth opening, the distance between upper-lower central incisors was measured in millimeters. The mean of three trials was calculated and used for the main analysis. Active pain-free mouth opening will be assessed pre-intervention, 48 h after the last treatment (post-intervention) and at 12-week follow up period.
Measured: 24 hours from first and last session
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Jun 2026
- Study start20 Jun 2026 (estimated)
- Primary completion20 Sep 2026 (estimated)
- Study completion20 Oct 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Condylar Remodeling ExercisesStudies of the same condition, open and under way.
- More trials run by Cairo UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- A randomized, double-blind, controlled trial
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 40 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Walaa Mohsen Mohammed, Misr University for Science and Technology
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07642609
- Sponsor's protocol ID
- Condylar Remodeling Exercises
- Status last verified
- Jun 2026
- First submitted
- 8 Jun 2026
- Last updated
- 11 Jun 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Yuzbasioglu U, Kaynak BA, Tas S. Assessment of Cervical Joint Position Sense and Head Posture in Individuals With Myogenic Temporomandibular Dysfunctions and Identifying Related Factors: A Case-Control Study. J Oral Rehabil. 2025 Feb;52(2):160-168. doi: 10.1111/joor.13885. Epub 2024 Oct 20.
PubMed 39428342Dinsdale A, Thomas L, Forbes R, Treleaven J. Is proprioception affected in those with persistent intra-articular temporomandibular disorders? A cross-sectional study exploring joint position sense and force sense of the jaw. Musculoskelet Sci Pract. 2024 Feb;69:102904. doi: 10.1016/j.msksp.2023.102904. Epub 2023 Dec 29.
PubMed 38171215Micoogullari M, Yuksel I, Angin S. Effect of pain on cranio-cervico-mandibular function and postural stability in people with temporomandibular joint disorders. Korean J Pain. 2024 Apr 1;37(2):164-177. doi: 10.3344/kjp.23301.
PubMed 38516795Furto ES, Cleland JA, Whitman JM, Olson KA. Manual physical therapy interventions and exercise for patients with temporomandibular disorders. Cranio. 2006 Oct;24(4):283-91. doi: 10.1179/crn.2006.044.
PubMed 17086858
Study at a glance
From the registry record, last updated by the sponsor on 11 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Condylar Remodeling Exercises on Proprioception of Neck and Temporomandibular Joint in Cranio-cervico-mandibular Malalignment: A Randomized, Double-blind, Controlled Trial
- ClinicalTrials.gov ID
- NCT07642609
- Acronym / sponsor ID
- Condylar Remodeling Exercises
- Conditions
- Condylar Remodeling Exercises, CCM Malalignment
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 40 participants (estimated)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 20 Jun 2026 (estimated)
- Primary completion
- 20 Sep 2026 (estimated)
- Study completion
- 20 Oct 2026 (estimated)
- First posted
- 11 Jun 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Cranio-cervico-mandibular (CCM) malalignment is associated with forward head posture (FHP) and tempromandibular joint (TMJ) disorders and affects masticatory muscles. Patients who present with dysfunctions of CCM malalignment can be treated effectively by a physical therapist who has specialized skills and experiences. A temporomandibular joint exercise developed by Rocabado called "Condylar remodeling exercises" considered as a new method for treatment of such cases. Those exercises stimulate mechanoreceptors that converts mechanical energy of physical deformation into action nerve potential yielding proprioceptive information, detecting change and rate of change, as opposed to steady state conditions. This input was analyzed in the central nervous system for joint position and movement influences muscle tone, motor execution programes and kinesthetic awareness around temporomandibular joint protecting joint from damage and helps to restore appropriate balance of synergistic and antagonistic forces. Although condylar remodeling exercises has been used in clinical practice, limited evidence exists to support such a treatment approach. So, the current study will conduct to investigate the effect of Condylar Remodeling Exercises on proprioception of neck and TMJ in CCM malalignment
Detailed description
To determine if there is an effect for the effect of Condylar Remodeling Exercises on proprioception of neck and TMJ in CCM malalignment. 40 of both sexes will participate in this study. Assessment of all participants will be carried out before and after the treatment program. Outcome measures will include assessment of neck proprioception, Temporomandibular joint position sense, cranio-vertebral angle, active pain-free mouth opening, pain assessment.A total of 40 subjects of both sexes having CCM malalignment will be recruited in this study. They will be randomly assigned to one of the following groups: Study group include 20 subjects will receive Condylar remodeling exercises in addition to postural correction Exercise, Control group: include 20 subjects will receive postural correction Exercise only. All subjects in both groups will receive the exercise program 3 days a week for four weeks.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
- Model description
- A randomized, double-blind, controlled trial
| Arm | Type | Receives |
|---|---|---|
| Study group (Condylar remodeling exercises in addition to postural correction Exercise | Experimental | Other: Condylar remodeling exercises Included 1)Range of motion phase, 2)Bite phase, 3)Bite return phase, 4)Protrusion, 5)isometric contraction phase Tubing distraction phase, Other: Postural correction exercises Kendall exercisesStudy group include 20 subjects will receive Condylar remodeling exercises in addition to postural correction Exercise, |
| Control group (postural correction Exercise only) | Active comparator | Other: Postural correction exercises Kendall exercisesControl group: include 20 subjects will receive postural correction Exercise only |
Who may qualify
- Ages
- 18 to 40 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (6 listed)
- The participants will be excluded if they:
Key exclusion criteria (1 listed)
- (1) TMJ fracture undergone any surgical procedure for TMJ; (2) Fracture surrounding TMJ; (3) Dislocation or subluxation of TMJ; (4) Systemic joint diseases including rheumatoid arthritis and osteoporosis, congenital conditions orofacial paralysis; (5) recent dental work or TMJ surgery; (6) Hematological cervical disorders which may affect the jaw; (7) Neurological deficits e.g. Bells palsy, Trigeminal neuralgia;(8) Recent infections affecting head and neck (within the last six months) e.g. bone infections, meningitis, encephalitis, malaria, ear infection; (9) Participants who were using any functional appliances e.g.dentures, braces, bite appliances altered or fitted within the previous 12 weeks prior to the commencement of this study; (10) Patients who underwent any physical therapy treatment within the last 2 weeks before the trial; (11) Internal derangement, including disc displacement with or without reduction
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Condylar remodeling exercises Included 1)Range of motion phase, 2)Bite phase, 3)Bite return phase, 4)Protrusion, 5)isometric contraction phase Tubing distraction phaseA temporomandibular joint exercise developed by Rocabado called "Condylar remodeling exercises" considered as a new method for treatment of such cases. Those exercises stimulate mechanoreceptors that converts mechanical energy of physical deformation into action nerve potential yielding proprioceptive information, detecting change and rate of change, as opposed to steady state conditions. This input was analysed in the central nervous system for joint position and movement influences muscle tone, motor execution programmes and kinaesthetic awareness around temporomandibular joint protecting joint from damage and helps to restore appropriate balance of synergistic and antagonistic forces. Although condaylar remodling exercises has been used in clinical practice, limited evidence exists to support such a treatment approach | Other | Study group (Condylar remodeling exercises in addition to postural correction Exercise |
| Postural correction exercises Kendall exercisesKendall exercises were performed as follows: 1. Strengthening the deep cervical flexors: The patient was asked to do a flat-back, chin-down position and hold this position for 2-8 seconds 2. Stretching the cervical extensors: The patient was asked to place one hand on the occipital area and other on the chin in a seated position, then a head-down, flexed neck position to stretch the cervical extensors. 3. Strengthening shoulder retractors: This exercise was done in order to move the shoulder blades towards one another while standing, the patient was instructed to wrap red (medium) Theraband around a stable item and then draw the band back as far as they could with both hands. 4. Stretching of the pectoralis major muscle: The therapist stood behind the patient and held both elbows and performed bilateral pectoralis stretching. To stretch the costal division, the arm should be elevated to approximately 135 degrees. For sternal division, the arm abducted to 90 degrees. For clavicula | Other | Control group (postural correction Exercise only), Study group (Condylar remodeling exercises in addition to postural correction Exercise |
Primary outcome
Temporomandibular joint position sense (TMJPS)
Time frame: 24 hours from first and last session
For the TMJPS measurement, a 6 mm-thick wooden reference stick and 9 wooden test sticks from 4 mm to 8 mmin thickness (increment 0.5 mm) will be used. First, the participants will be asked to sense the position by biting the 6 mm thick reference test stick with their front teeth for 1 minute. Then, they will be asked to randomly bite each of the 9 test sticks and compare each of them with the 6 mm reference test stick. Each of the test sticks will be administered in a random order 5 times (45 tests in total). The participants will be asked how thick they felt compared to the reference stick that they have bitten down on and indicated their answers as "thinner", "thicker" or "equal". During the test, the participant's eyes will be closed, and the answers give about the stick thicknesses will be recorded as true (1 point) or false (0 points).
Active pain-free mouth opening
Time frame: 24 hours from first and last session
In a supine position, participants will be asked to 'open the mouth as wide as possible without causing pain'. At the end position of pain-free mouth opening, the distance between upper-lower central incisors was measured in millimeters. The mean of three trials was calculated and used for the main analysis. Active pain-free mouth opening will be assessed pre-intervention, 48 h after the last treatment (post-intervention) and at 12-week follow up period.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Jun 2026.
- Results publication: PubMed 39428342Yuzbasioglu U, Kaynak BA, Tas S. Assessment of Cervical Joint Position Sense and Head Posture in Individuals With Myogenic Temporomandibular Dysfunctions and Identifying Related Factors: A Case-Control Study. J Oral Rehabil. 2025 Feb;52(2):160-168. doi: 10.1111/joor.13885. Epub 2024 Oct 20.
- Results publication: PubMed 38171215Dinsdale A, Thomas L, Forbes R, Treleaven J. Is proprioception affected in those with persistent intra-articular temporomandibular disorders? A cross-sectional study exploring joint position sense and force sense of the jaw. Musculoskelet Sci Pract. 2024 Feb;69:102904. doi: 10.1016/j.msksp.2023.102904. Epub 2023 Dec 29.
- Results publication: PubMed 38516795Micoogullari M, Yuksel I, Angin S. Effect of pain on cranio-cervico-mandibular function and postural stability in people with temporomandibular joint disorders. Korean J Pain. 2024 Apr 1;37(2):164-177. doi: 10.3344/kjp.23301.
- Results publication: PubMed 17086858Furto ES, Cleland JA, Whitman JM, Olson KA. Manual physical therapy interventions and exercise for patients with temporomandibular disorders. Cranio. 2006 Oct;24(4):283-91. doi: 10.1179/crn.2006.044.
- Individual participant dataSharing planned: No
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Condylar remodeling exercises Included 1)Range of motion phase, 2)Bite phase, 3)Bite return phase, 4)Protrusion, 5)isometric contraction phase Tubing distraction phase and Postural correction exercises Kendall exercises in people with Condylar Remodeling Exercises and CCM Malalignment, run by Cairo University at 1 site in Egypt.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 11 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact walaa Mohsen Mohamed, Doctoral degree (01004174717, wala.mohamed@must.edu.eg), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Temporomandibular joint position sense (TMJPS) (time frame: 24 hours from first and last session). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07642609, which also lists 4 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Jun 2026.