EFFECTS OF PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION VS ROCABADO EXERCISE ON PAIN AND MAXIMAL MOUTH OPENING IN TEMPOROMANDIBULAR DYSFUNCTION

Temporal mandibular joint disorders (TMDs) are a multifaceted group of excruciating disorders which impact masticatory muscles along with temporomandibular joint. TMD symptoms include jaw pain or tenderness, aching in and around the ear, discomfort or difficulty chewing, agonizing facial pain, joint locking, and trouble opening and closing the mouth. Females aged 18 years and older reported higher prevalence of TMD signs and symptoms than males.

Aim and objective:. The aim is to evaluate the effectiveness of Proprioceptive neuromuscular facilitation Vs Rocabado exercise on pain and maximal mouth opening in muscular temporomandibular joint disorders.

Procedure:

For experimental group, Exercises was given 30 minutes per day for 7 days a week for 8 weeks. First diagonal movement is flexion with right side rotation and right side lateral flexion. Then do extension with left rotation and left lateral flexion. The second Diagonal flexion with left side rotation and left side lateral flexion and extension with right side rotation and right side lateral flexion of the head and neck patterns of PNF were applied. In both diagonals, the following movements were performed: mouth opening, mandibular Retrusion, tongue elevation with neck flexion, and mouth closing, mandibular protraction, tongue depression with neck extension. All of these patterns were applied using techniques of RS and CI. Individuals with TMD were initially taught exercises with rhythmic initiation and 15 repetitions were applied as warm-up period before techniques were applied.

for control group, Exercises was given for 6 reps - 3 sets per day for 7 days a week for 8 weeks

Rest position of the tongue.Make a clucking sound with the tongue for 6 times. To find your normal resting position gently place the one third of tongue against the roof of the mouth behind front teeth. Breathe diaphragmatically through your nose while keeping your tongue in this resting position for six breaths.

Controlled temporomandibular joint rotation. Tongue on roof of mouth and open for 15 repetition.

Mandibular rhythmic stabilization. Apply slight resistance to opening, closing and lateral deviation with the jaw in a resting position holding for 6 seconds.

Stabilized head flexion: Nodding facilitates upper cervical flexion, as most of these patients have forward head posture resulting in upper cervical extension deviation. Nod head for 15 degree back and forth for 6 repetitions

Lower cervical retraction: Chin tuck for 6 seconds and hold.

Shoulder girdle retraction. : Pull shoulder back and down, hold for 6 seconds.

Exercises was given for 6 reps - 3 sets per day for 7 days a week for 8 weeks

Rest position of the tongue.Make a clucking sound with the tongue for 6 times. To find your normal resting position gently place the one third of tongue against the roof of the mouth behind front teeth. Breathe diaphragmatically through your nose while keeping your tongue in this resting position for six breaths.

Controlled temporomandibular joint rotation. Tongue on roof of mouth and open for 15 repetition.

Mandibular rhythmic stabilization. Apply slight resistance to opening, closing and lateral deviation with the jaw in a resting position holding for 6 seconds.

Stabilized head flexion: Nodding facilitates upper cervical flexion, as most of these patients have forward head posture resulting in upper cervical extension deviation. Nod head for 15 degree back and forth for 6 repetitions

Lower cervical retraction: Chin tuck for 6 seconds and hold.

Shoulder girdle retraction. : Pull shoulder back and down, hold for 6 seconds.