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Effects of integrating jaw opening and closing movements with active neck exercises in the management of chronic non-specific neck pain: a randomized controlled trial
Department of Physiotherapy, Sindh Institute of Physical Medicine & Rehabilitation, Chand Bibi Road, Karachi, Pakistan; University Institute of Physical Therapy, The University of Lahore, Lahore, Pakistan.
Umeå University, Faculty of Medicine, Department of Odontology. University Institute of Physical Therapy, The University of Lahore, Lahore, Pakistan; Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
University Institute of Physical Therapy, The University of Lahore, Lahore, Pakistan.
School of Public Health, Dow University of Health Sciences, Karachi, Pakistan.
2024 (English)In: Medicina, ISSN 1010-660X, E-ISSN 1648-9144, Vol. 60, no 9, article id 1437Article in journal (Refereed) Published
Abstract [en]

Background and Objectives: It has been seen that jaw opening is associated with neck extension and jaw closing is associated with neck flexion. This natural association between the jaw and neck can be used as a novel approach to treat chronic non-specific neck pain, although the effects of this concept have never been previously evaluated as a treatment strategy. This article intends to study the effects of integrating jaw opening and closing movements along with active neck exercises versus active neck exercises alone in the management of chronic non-specific neck pain.

Materials and Methods: A total of 80 patients, aged 20 to 50, with chronic non-specific neck pain were included in a double-blind randomized controlled trial, conducted at the Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Pakistan from 2018 to 2022. The patients were divided into two groups: Group A patients were assigned jaw movements with active neck exercises, while Group B patients were assigned only active neck exercises. Both groups were assigned isometric strengthening exercises and self-resisted strengthening exercises for cervical spine muscles as a home plan. The study used various outcome measures, including the numerical pain rating scale (NPRS), neck disability index (NDI), neck flexion endurance (NFE), neck extension endurance (NEE), the neck proprioception error (NPE): neck flexion proprioception error (NFPE), neck extension proprioception error (NEPE), neck right rotation proprioception error (NRRPE), and neck left rotation proprioception error (NLRPE), with measurements taken at week 1 and week 6, respectively; the mean differences between the groups were measured using a two-way repeated ANOVA.

Results: The experimental group showed better improvements compared to the control group, NPRS (73%), NDI (57%), NFE (152%), NEE (83%), NFPE (58%), NEPE (65%), NRRPE (65%), and NLRPE (62%), with a significant difference (p < 0.05). Conclusions: Active neck extension and flexion movements combined with jaw opening and closing are more effective in reducing pain and disability, improving neck muscles endurance and normalizing neck proprioception in patients with chronic neck pain.

Place, publisher, year, edition, pages
MDPI, 2024. Vol. 60, no 9, article id 1437
Keywords [en]
exercise, intervention, neck pain, physiotherapy, temporomandibular joint
National Category
Physiotherapy
Identifiers
URN: urn:nbn:se:umu:diva-230582DOI: 10.3390/medicina60091437ISI: 001326168300001PubMedID: 39336478Scopus ID: 2-s2.0-85205096241OAI: oai:DiVA.org:umu-230582DiVA, id: diva2:1904207
Available from: 2024-10-08 Created: 2024-10-08 Last updated: 2025-04-24Bibliographically approved

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Zafar, Hamayun

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