Temporal Mandibular Joint DysfunctionNCT07703059
Effect of Rocabado Exercises With Strain Counter-Strain Technique on Muscles of Mastication for Pain, Jaw Function, and Quality of Life in Patients With Temporomandibular Joint Dysfunction
A study testing Rocabado Exercise and Strain Counterstrain Technique in people with Temporal Mandibular Joint Dysfunction, run by Lahore University of Biological and Applied Sciences at 1 site in Pakistan.
Trial summary
Temporomandibular joint dysfunction (TMD) is a common musculoskeletal disorder affecting the jaw joint and masticatory muscles, leading to pain, limited jaw function, and reduced quality of life. Conservative management includes therapeutic exercises and manual therapy. Read more about this study
- Who is it for?
- Ages 20 to 50 years
- Conditions the study is for
- Temporal Mandibular Joint Dysfunction
- What is being tested?
- Rocabado Exercise and Strain Counterstrain Technique
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 44 participants
- Where
- 1 sitePakistan
- Study dates
- 1 Jul 2026to 20 Nov 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 20 to 50 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Diagnosed patient of muscular TMJ ;According to Fonseca Questionnaire, ranging in the age group of 20 to 50 years, with both male and female were included in the study; Maximum mouth opening (MMO) 40-60mm for diagnosis of muscular TMJ ; Mild to moderate TMJ pain ; Unilateral TMJ ; Diagnostic features of muscular TMJ dysfunction: Pain location: Jaw, temple and masseter region ; Pain Behavior: Increase with chewing, talking and clenching ; Palpation findings: tenderness at masseter and temporal region ; ROM findings: limited and painful mouth opening (<40mm) when measured with maximum mouth opening test ; MMO Test: The test involves measuring the maximum distance between the incisal edges of the upper and lower central incisors when the mouth is opened as wide as possible. This measurement is typically performed using a calibrated ruler, Vernier calipers, or a fiber ruler, with the subject positioned upright and instructed to open their mouth maximally.
Who cannot join
- Who do not fall into the mentioned age group, with severe TMJ dysfunction according to Fonseca Questionnaire ; Recent oral surgeries; Spondyloarthropathies ;Recent oral trauma ; Systemic disease(hypothyroidism, hypercalcemia) ; Pregnant females ;Metal implants in the oral cavity ; Patient on TMJ drugs use ; Lactating females ; Neurological deficit (MS, Parkinson diseases) that effects the fascial muscles ; Any other inflammatory diseases
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
Temporomandibular joint dysfunction (TMD) is a common musculoskeletal disorder affecting the jaw joint and masticatory muscles, leading to pain, limited jaw function, and reduced quality of life. Conservative management includes therapeutic exercises and manual therapy. Rocabado exercises improve jaw mechanics and posture, while the Strain Counterstrain technique reduces muscle tenderness and pain.
This randomized controlled trial aims to evaluate the effectiveness of Rocabado exercises alone versus Rocabado exercises combined with the Strain Counterstrain technique in patients with muscular TMD. The intervention will be conducted over six weeks, with outcomes measured for pain, jaw function, and quality of life. The study seeks to determine whether the combined approach provides superior clinical outcomes.
Read the detailed description
Temporomandibular joint dysfunction (TMD) is a common musculoskeletal condition affecting the jaw joint and muscles of mastication, leading to pain, restricted jaw movement, and reduced quality of life. It is often associated with factors such as muscle spasm, poor posture, stress, and abnormal jaw mechanics. Various conservative treatment approaches are used, including physical therapy, exercises, and manual therapy techniques. Among these, Rocabado exercises aim to restore normal jaw function, improve posture, and enhance neuromuscular control, while the Strain Counterstrain technique focuses on reducing muscle tenderness and pain by positioning the affected muscle in a relaxed state.
This study aims to evaluate the combined effect of Rocabado exercises and the Strain Counterstrain technique on pain, jaw function, and quality of life in patients with muscular TMD. A randomized controlled trial will be conducted on participants divided into two groups: one receiving Rocabado exercises alone and the other receiving a combination of Rocabado exercises and Strain Counterstrain technique. The intervention will be carried out over six weeks, with outcomes measured using standardized tools for pain, functional limitation, and quality of life. The findings of this study may help in identifying a more effective physiotherapy approach for managing TMD and improving patient outcomes.
- Conditions
- Temporal Mandibular Joint Dysfunction
- Being tested
- Rocabado Exercise, Strain Counterstrain Technique
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Rocabado ExerciseOther
Rocabado exercises constitute a standardized 6×6 therapeutic protocol aimed at restoring normal temporomandibular joint (TMJ) biomechanics and craniocervical alignment. The intervention incorporates neuromuscular re-education techniques including tongue resting position, controlled mandibular rotation, rhythmic stabilization, axial extension of the cervical spine, and scapular postural correction. These exercises are designed to optimize joint kinematics, enhance proprioceptive control, reduce abnormal muscle activity, and improve functional jaw mobility while minimizing pain.
Strain Counterstrain TechniqueOther
The Strain Counterstrain (SCS) technique is a passive, indirect manual therapy approach targeting myofascial tender points. It involves precise positioning of the involved muscle in a shortened, position of maximal comfort to reduce aberrant muscle spindle activity and nociceptive input. Sustained positioning (typically 60-90 seconds) facilitates neuromuscular reset, decreases localized hypertonicity, and alleviates pain. In this study, SCS will be applied to the masticatory muscles, including the masseter, temporalis, and pterygoid muscles, to improve muscle function and reduce pain sensitivity.
| Study group | Role | What they receive |
|---|---|---|
| Rocabado Exercises + Strain Counterstrain Technique | Experimental | Participants will receive Rocabado exercises combined with the Strain Counterstrain technique. A hot pack will be applied for 15 minutes, followed by Rocabado 6×6 exercises and application of Strain Counterstrain to masticatory muscles (masseter, temporalis, pterygoids). Sessions will be 45 minutes, 2-3 times per week for 6 weeks. Receives: Other: Rocabado Exercise; Other: Strain Counterstrain Technique |
| Rocabado Only | Active comparator | Participants will receive Rocabado exercises only. A hot pack will be applied for 15 minutes, followed by Rocabado 6×6 exercises. Sessions will be 45 minutes, 2-3 times per week for 6 weeks. Receives: Other: Rocabado Exercise |
What is being measured
The primary outcome is the main question the study is designed to answer.
Numeric Pain Rating Scale for pain (NPRS)
Measures the intensity of pain. The NPRS is an 11-point scale, ranging from 0 (no pain) to 10 (worst imaginable pain). Patients are asked to rate their current pain, average pain, or worst pain over a specific period (e.g., past 24 hours or week). Interpretation as No pain, 1-3 = Mild pain, 46 weeks-6 = Moderate pain 7-10 = Severe pain
Measured: 6 weeks
Jaw Functional Limitation Scale for jaw function (JFLS-8)
Assesses limitations in jaw function in patients with temporomandibular disorders. The JFLS-8 is a short version with 8 items, each rated on a 5-point Likert scale from 0 (no limitation) to 4 (severe limitation). Domains assessed mastication (chewing), jaw mobility (opening/closing), verbal communication (speaking) Scoring as higher scores indicate greater functional limitation.
Total score is usually calculated as the sum or average of the 8 items. 0= No jaw functional limitation, 1-3 =Mild functional limitation, 4-6 = Moderate functional limitation, 7-10 = Severe functional limitation. Higher scores indicate greater jaw functional impairment.(20)
Measured: 6 weeks
Secondary outcomes (1)
Oral Health Impact Profile for quality of life (OHIP-14)
Evaluates the impact of oral conditions on quality of life. OHIP-14 is a shortened version of the original OHIP (49 items), containing 14 questions across 7 domains such as Functional limitation, Physical pain, psychological discomfort, Physical disability, psychological disability, social disability, Handicap Scoring: Each item is rated on a 5-point Likert scale: 0 = never, 1 = hardly ever, 2 = occasionally, 3 = fairly often, 4 = very often. Higher scores = poorer oral health-related quality of life. To calculate the total score, sum the scores of all 14 items. The total score ranges from 0 to 56, where a higher score indicates a greater negative impact on oral health-related quality of life.
Measured: 6 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Jul 2026
- Study start1 Jul 2026 (estimated)
- Primary completion30 Oct 2026 (estimated)
- Study completion20 Nov 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Temporal Mandibular Joint DysfunctionStudies of the same condition, open and under way.
- More trials run by Lahore University of Biological and Applied SciencesThe 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
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 44 participants (estimated)
Sponsor and investigators
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07703059
- Sponsor's protocol ID
- UBAS/ERB/26/04/028
- Status last verified
- Jul 2026
- First submitted
- 9 Jul 2026
- Last updated
- 14 Jul 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 14 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Rocabado Exercises With Strain Counter-Strain Technique on Muscles of Mastication for Pain, Jaw Function, and Quality of Life in Patients With Temporomandibular Joint Dysfunction
- ClinicalTrials.gov ID
- NCT07703059
- Acronym / sponsor ID
- UBAS/ERB/26/04/028
- Conditions
- Temporal Mandibular Joint Dysfunction
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 44 participants (estimated)
- Lead sponsor
- Lahore University of Biological and Applied SciencesUniversity, hospital or other
- Study start
- 1 Jul 2026 (estimated)
- Primary completion
- 30 Oct 2026 (estimated)
- Study completion
- 20 Nov 2026 (estimated)
- First posted
- 14 Jul 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.
Temporomandibular joint dysfunction (TMD) is a common musculoskeletal disorder affecting the jaw joint and masticatory muscles, leading to pain, limited jaw function, and reduced quality of life. Conservative management includes therapeutic exercises and manual therapy. Rocabado exercises improve jaw mechanics and posture, while the Strain Counterstrain technique reduces muscle tenderness and pain.
This randomized controlled trial aims to evaluate the effectiveness of Rocabado exercises alone versus Rocabado exercises combined with the Strain Counterstrain technique in patients with muscular TMD. The intervention will be conducted over six weeks, with outcomes measured for pain, jaw function, and quality of life. The study seeks to determine whether the combined approach provides superior clinical outcomes.
Detailed description
Temporomandibular joint dysfunction (TMD) is a common musculoskeletal condition affecting the jaw joint and muscles of mastication, leading to pain, restricted jaw movement, and reduced quality of life. It is often associated with factors such as muscle spasm, poor posture, stress, and abnormal jaw mechanics. Various conservative treatment approaches are used, including physical therapy, exercises, and manual therapy techniques. Among these, Rocabado exercises aim to restore normal jaw function, improve posture, and enhance neuromuscular control, while the Strain Counterstrain technique focuses on reducing muscle tenderness and pain by positioning the affected muscle in a relaxed state.
This study aims to evaluate the combined effect of Rocabado exercises and the Strain Counterstrain technique on pain, jaw function, and quality of life in patients with muscular TMD. A randomized controlled trial will be conducted on participants divided into two groups: one receiving Rocabado exercises alone and the other receiving a combination of Rocabado exercises and Strain Counterstrain technique. The intervention will be carried out over six weeks, with outcomes measured using standardized tools for pain, functional limitation, and quality of life. The findings of this study may help in identifying a more effective physiotherapy approach for managing TMD and improving patient outcomes.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Rocabado Exercises + Strain Counterstrain Technique | Experimental | Other: Rocabado Exercise, Other: Strain Counterstrain TechniqueParticipants will receive Rocabado exercises combined with the Strain Counterstrain technique. A hot pack will be applied for 15 minutes, followed by Rocabado 6×6 exercises and application of Strain Counterstrain to masticatory muscles (masseter, temporalis, pterygoids). Sessions will be 45 minutes, 2-3 times per week for 6 weeks. |
| Rocabado Only | Active comparator | Other: Rocabado ExerciseParticipants will receive Rocabado exercises only. A hot pack will be applied for 15 minutes, followed by Rocabado 6×6 exercises. Sessions will be 45 minutes, 2-3 times per week for 6 weeks. |
Who may qualify
- Ages
- 20 to 50 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (1 listed)
- Diagnosed patient of muscular TMJ ;According to Fonseca Questionnaire, ranging in the age group of 20 to 50 years, with both male and female were included in the study; Maximum mouth opening (MMO) 40-60mm for diagnosis of muscular TMJ ; Mild to moderate TMJ pain ; Unilateral TMJ ; Diagnostic features of muscular TMJ dysfunction: Pain location: Jaw, temple and masseter region ; Pain Behavior: Increase with chewing, talking and clenching ; Palpation findings: tenderness at masseter and temporal region ; ROM findings: limited and painful mouth opening (<40mm) when measured with maximum mouth opening test ; MMO Test: The test involves measuring the maximum distance between the incisal edges of the upper and lower central incisors when the mouth is opened as wide as possible. This measurement is typically performed using a calibrated ruler, Vernier calipers, or a fiber ruler, with the subject positioned upright and instructed to open their mouth maximally.
Key exclusion criteria (1 listed)
- Who do not fall into the mentioned age group, with severe TMJ dysfunction according to Fonseca Questionnaire ; Recent oral surgeries; Spondyloarthropathies ;Recent oral trauma ; Systemic disease(hypothyroidism, hypercalcemia) ; Pregnant females ;Metal implants in the oral cavity ; Patient on TMJ drugs use ; Lactating females ; Neurological deficit (MS, Parkinson diseases) that effects the fascial muscles ; Any other inflammatory diseases
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 |
|---|---|---|
| Rocabado ExerciseRocabado exercises constitute a standardized 6×6 therapeutic protocol aimed at restoring normal temporomandibular joint (TMJ) biomechanics and craniocervical alignment. The intervention incorporates neuromuscular re-education techniques including tongue resting position, controlled mandibular rotation, rhythmic stabilization, axial extension of the cervical spine, and scapular postural correction. These exercises are designed to optimize joint kinematics, enhance proprioceptive control, reduce abnormal muscle activity, and improve functional jaw mobility while minimizing pain. | Other | Rocabado Exercises + Strain Counterstrain Technique, Rocabado Only |
| Strain Counterstrain TechniqueThe Strain Counterstrain (SCS) technique is a passive, indirect manual therapy approach targeting myofascial tender points. It involves precise positioning of the involved muscle in a shortened, position of maximal comfort to reduce aberrant muscle spindle activity and nociceptive input. Sustained positioning (typically 60-90 seconds) facilitates neuromuscular reset, decreases localized hypertonicity, and alleviates pain. In this study, SCS will be applied to the masticatory muscles, including the masseter, temporalis, and pterygoid muscles, to improve muscle function and reduce pain sensitivity. | Other | Rocabado Exercises + Strain Counterstrain Technique |
Primary outcome
Numeric Pain Rating Scale for pain (NPRS)
Time frame: 6 weeks
Measures the intensity of pain. The NPRS is an 11-point scale, ranging from 0 (no pain) to 10 (worst imaginable pain). Patients are asked to rate their current pain, average pain, or worst pain over a specific period (e.g., past 24 hours or week). Interpretation as No pain, 1-3 = Mild pain, 46 weeks-6 = Moderate pain 7-10 = Severe pain
Jaw Functional Limitation Scale for jaw function (JFLS-8)
Time frame: 6 weeks
Assesses limitations in jaw function in patients with temporomandibular disorders. The JFLS-8 is a short version with 8 items, each rated on a 5-point Likert scale from 0 (no limitation) to 4 (severe limitation). Domains assessed mastication (chewing), jaw mobility (opening/closing), verbal communication (speaking) Scoring as higher scores indicate greater functional limitation. Total score is usually calculated as the sum or average of the 8 items. 0= No jaw functional limitation, 1-3 =Mild functional limitation, 4-6 = Moderate functional limitation, 7-10 = Severe functional limitation. Higher scores indicate greater jaw functional impairment.(20)
1 secondary outcome
Oral Health Impact Profile for quality of life (OHIP-14)
Time frame: 6 weeks
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 14 Jul 2026.
- 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 Rocabado Exercise and Strain Counterstrain Technique in people with Temporal Mandibular Joint Dysfunction, run by Lahore University of Biological and Applied Sciences at 1 site in Pakistan.
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 1 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 14 Jul 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 Pakistan. 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 Nimra khalil (03090505681, nimrakhalil887@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Numeric Pain Rating Scale for pain (NPRS) (time frame: 6 weeks). 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?
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 14 Jul 2026.