Effects of Core Strengthening Exercises for Treating TMD

Part of paid clinical trials in Maywood, Illinois.

Sponsor
Loyola University
Study ID
NCT07226505
Status
Not Yet Recruiting

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Conditions

  • Myofascial Pain
  • TMD
  • TMJ Internal Derangement
  • Temporomandibular Joint Dysfunction

Eligibility Criteria

Sex
ALL
Age
18 Years - 80 Years
Healthy Volunteers
Not accepted

Interventions

  • Experimental: Group 1: Core Strengthening — BEHAVIORAL
    Participants perform Shirley Sahrmann core exercises (5 progressive levels maintaining neutral spine and deep core activation), possibly adding upper extremity movements. Standard TMD PT includes jaw exercises, manual therapy, soft tissue mobilization, neuromuscular re-education, and patient education. A home exercise program (\~20 min/day) is provided with printed and video instructions.
  • Group 2: Standard TMD PT — BEHAVIORAL
    Participants receive standard TMD PT including jaw exercises (Rocabado 6x6), manual therapy for TMJ and cervical spine, soft tissue mobilization, neuromuscular re-education to improve jaw mechanics, and education on jaw positioning, diet/chewing modifications, and parafunctional habits. A home exercise program is provided as part of treatment.

Study Details

Temporomandibular disorders (TMD) are commonly managed with non-invasive interventions such as manual therapy, therapeutic exercise, relaxation techniques, and patient education. Core strengthening (also known as abdominal strengthening) is a fundamental element of physical therapy that engages deep and superficial trunk musculature to enhance postural control and functional performance. Protocols such as the Shirley Sahrmann progression have demonstrated increased activation of key core stabilizing muscles. Emerging evidence suggests a potential relationship between core stability training and reductions in TMD-related pain, though improvements in functional outcomes remain inconclusive. Biomechanical links between the pelvic floor, spine, and temporomandibular joint further support the rationale for core-focused interventions. Nevertheless, few studies have isolated the effects of core strengthening on TMD symptomatology. This study seeks to determine whether the integration of core stability exercises into TMD management can reduce pain, improve function, and enhance quality of life.

Key Dates

Start date
Nov 1, 2025
Status verified
Oct 2025
Primary completion
Dec 1, 2026
Completion
Jan 31, 2027

Study Design

Enrollment
50 participants (estimated)
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT

Arms

  • Experimental: Group 1: Core Strengthening + Standard TMD Physical Therapy
    Participants in this group will receive the Shirley Sahrmann core strengthening protocol, which involves progressive levels of dynamic movements designed to maintain a neutral spine and activate deep core muscles. Exercises begin in hook-lying or supine positions, with gradual progression through five levels, and may include upper extremity movements once core control is achieved. In addition, participants will follow a structured home exercise program with daily exercises (approximately 20 minutes), supported with printed instructions and video demonstrations through the MedBridge platform.
  • Active Comparator: Group 2: Standard TMD Physical Therapy
    Participants in this group will receive standard physical therapy for TMD, including: Therapeutic exercises (e.g., Rocabado 6x6) for jaw mobility and posture. Manual therapy to restore normal TMJ and cervical spine joint mechanics. Soft tissue mobilization targeting masticatory and cervical muscles as clinically indicated. Education on jaw rest position, diet/chewing modifications, and avoidance of parafunctional habits. Neuromuscular re-education to improve TMJ opening mechanics, including deep neck flexor activation and mirror training.

Primary Outcome Measure

TMD Pain (e.g., Visual Analog Scale/Numeric Pain Rating) [ Time Frame: Baseline and post-intervention (6 PT sessions), assessed up to 6 weeks ]

Locations (1)

FacilityCityStateZIPSite coordinators
Loyola University Medical CenterMaywoodIllinois60153
Dr. Margaret Miller, MD
[email protected]
(888) 584-7888
Dr. Margaret Miller, MD
[email protected]

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By research site
Loyola University Medical Center· Maywood, IL

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