FULL DETAILS (Read-only)  -> Click Here to Create PDF for Current Dataset of Trial
CTRI Number  CTRI/2026/02/103314 [Registered on: 09/02/2026] Trial Registered Prospectively
Last Modified On: 25/03/2026
Post Graduate Thesis  No 
Type of Trial  Interventional 
Type of Study   Physiotherapy (Not Including YOGA) 
Study Design  Randomized, Parallel Group Trial 
Public Title of Study   Comparison of Two Physiotherapy Treatments for Jaw Joint Pain and Movement Problems 
Scientific Title of Study   Effect of Maitland Mobilization Versus Muscle Energy Technique in Patients with Temporomandibular Joint Dysfunction: A Randomized Controlled Trial 
Trial Acronym  NIL 
Secondary IDs if Any  
Secondary ID  Identifier 
not applicable  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Dr Neeraj Athavale PT 
Designation  Professor 
Affiliation  School of Physiotherapy, Pune Bharati vidyapeeth (Deemed to be University) 
Address  School of Physiotherapy, Pune Bharati Vidyapeeth (Deemed to be University) Dhankawadi, Pune- Satara Road, Pune

Pune
MAHARASHTRA
411043
India 
Phone  9960097409  
Fax    
Email  drneeraj86@gmail.com  
 
Details of Contact Person
Scientific Query  
Name  Dr Neeraj Athavale PT 
Designation  Professor 
Affiliation  School of Physiotherapy, Pune Bharati vidyapeeth (Deemed to be University) 
Address  School of Physiotherapy, Pune Bharati Vidyapeeth (Deemed to be University) Dhankawadi, Pune- Satara Road, Pune

Pune
MAHARASHTRA
411043
India 
Phone  9960097409  
Fax    
Email  drneeraj86@gmail.com  
 
Details of Contact Person
Public Query  
Name  Rachana Dabadghav 
Designation  Assistant Professor 
Affiliation  School of Physiotherapy Pune, Bharati Vidyapeeth Deemed to be University 
Address  School of Physiotherapy, Pune, Bharati Vidyapeeth (Deemed to be University) Dhankawadi, Pune- Satara Road, Pune

Pune
MAHARASHTRA
411043
India 
Phone  9923173525  
Fax    
Email  rachanadabadghav@gmail.com  
 
Source of Monetary or Material Support  
Bharati Vidyapeeth (Deemed to be University) Dhankawadi, Pune- Satara Road, Pune 411043 
 
Primary Sponsor  
Name  School of Physiotherapy Pune, Bharati Vidyapeeth (Deemed to be University) 
Address  Bharati Vidyapeeth (Deemed to be University) Dhankawadi, Pune- Satara Road, Pune 411043 
Type of Sponsor  Other [Physiotherapy College] 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Neeraj Athavale   Physiotherapy OPD   Physiotherapy OPD, Ground floor, Bharati Hospital and Research centre, Dhankawadi, Pune- Satara road, Pune-411043
Pune
MAHARASHTRA 		 9960097409

dr.neeraj86@gmail.com 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
Bharati Vidyapeeth ( Deemed to be University) Medical College Institutional Ethics Committee  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: M278||Other specified diseases of jaws,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Intervention  Group A: Maitland mobilization in addition to TENS and exercises  The patient will be positioned in a supine position with the arms and legs adequately supported. The therapist will stand opposite the joint to be treated. The technique will be performed by placing the thumbs over the lower molars while the remaining fingers will be comfortably clasped around the patient’s mandible. An oscillatory Grade IV TMJ Maitland mobilization will be administered. The following glides will be applied based on the identified restriction: Distraction Distraction with anterior glide Distraction with anterior glide and lateral glide (right/left) Lateral glide without distraction Each glide will be performed three times. Each procedure will last 60 seconds and will be separated by a 10-second interval. 
Intervention  Group B: MET in addition to TENS and exercises  Group B will receive the post-isometric relaxation muscle energy technique. The subject will be positioned in a supine lying position. The therapist will place the thumbs on the lower molars bilaterally while stabilizing the mandible. The subject will be instructed to close the jaw using approximately 30% of maximal voluntary effort while the therapist will apply equal counter-resistance to ensure that no joint movement occurs. After a 7-second isometric contraction, the subject will be asked to relax the jaw, following which the therapist will gently open the jaw to the maximum pain-free range possible. This procedure will be repeated five times. 
Comparator Agent  Group C: TENS and exercises only  Group C will receive TENS therapy along with therapeutic exercises. Before the application of TENS, the therapist will thoroughly evaluate the patient for any contraindications. Patients will be positioned in a side-lying position with the arms and legs adequately supported. Carbon electrodes (40 mm × 54 mm) will be placed over the affected side of the masseter muscle. TENS will be administered at a frequency of 50 Hz with a pulse width of 0.5 milliseconds. The intensity will be adjusted according to the patient’s tolerance. The treatment will be given for 10 for 6 days. TMD Exercise Protocol: All patients will also undergo a temporomandibular disorder exercise protocol. Each exercise will be performed six times. 1. The resting position of the tongue will be achieved by placing the tip of the tongue on the upper palate just behind the front teeth. The patient will perform diaphragmatic breathing through the nose while producing a clicking sound with the tongue, ensuring no movement of accessory respiratory muscles. 2. The mouth will be opened slowly to facilitate TMJ rotation, with the tongue maintained in the resting position to prevent anterior translation of the condyle. 3. While maintaining the tongue in the resting position, resistance will be applied using the index finger to left lateral deviation of the chin as well as during opening and closing movements of the jaw. 4. With the body maintained in an upright position and the hand placed over the C2–C7 region at the posterior aspect of the neck, the patient will be trained to perform craniocervical flexion. 5. With the body in an upright position and the eyes and ears maintained at the same horizontal level, upper cervical flexion and lower cervical extension will be performed, followed by cervical retraction through backward head movement. 6. With the body maintained in an upright position, shoulder girdle retraction and depression will be performed without altering the position of the cervical spine.  
 
Inclusion Criteria  
Age From  19.00 Year(s)
Age To  60.00 Year(s)
Gender  Both 
Details  Both males and females with pain in the TMJ, reduced mouth opening for more than one month due to conditions like trismus, fibromyalgia, bruxism, patients having undergone maxillofacial surgeries after submaxillary space infection, post-operative cases of zygomatic arch fracture, or mandible fracture  
 
ExclusionCriteria 
Details  Patients with Degenerative TMJ arthritis, malignant tumours of the face and jaw, a history of TMJ dislocation, hypermobile TMJ, and missing lower premolar or molar teeth  
 
Method of Generating Random Sequence   Computer generated randomization 
Method of Concealment   Sequentially numbered, sealed, opaque envelopes 
Blinding/Masking   Outcome Assessor Blinded 
Primary Outcome  
Outcome  TimePoints 
pain using the visual analogue scale (VAS)   before the treatment and reassessed after 2 weeks, i.e., 6 sessions  
 
Secondary Outcome  
Outcome  TimePoints 
maximal mouth opening (MMO)  before the treatment and reassessed after 2 weeks, i.e., 6 sessions 
Functional disability was measured by the Fonesca Anamnestic Index (FAI)   before the treatment and reassessed after 2 weeks, i.e., 6 sessions  
 
Target Sample Size   Total Sample Size="45"
Sample Size from India="45" 
Final Enrollment numbers achieved (Total)= "0"
Final Enrollment numbers achieved (India)="45" 
Phase of Trial   N/A 
Date of First Enrollment (India)   17/02/2026 
Date of Study Completion (India) 30/05/2026 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Date Missing 
Estimated Duration of Trial   Years="0"
Months="4"
Days="0" 
Recruitment Status of Trial (Global)
Modification(s)  		 Not Applicable 
Recruitment Status of Trial (India)  Completed 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary  

Temporomandibular joint dysfunction (TMD) is a common musculoskeletal disorder characterized by jaw pain, restricted mouth opening, joint sounds, and functional limitations. Owing to its multifactorial etiology, conservative physiotherapy management—particularly manual therapy—is considered the first line of treatment. Maitland mobilization and Muscle Energy Technique (MET) are frequently used techniques, but evidence directly comparing their effectiveness in TMD is limited.

This randomized controlled trial aims to compare the effects of Maitland mobilization and MET on pain, maximal mouth opening, and functional disability in patients with TMD. A total of 45 participants (aged 19–60 years) diagnosed with TMD will be randomly allocated into three groups:

 

Group A: Maitland mobilization + TENS + exercises

 

Group B: MET + TENS + exercises

 

Group C: TENS + exercises

 

Intervention will be given for two weeks (6 sessions). Outcomes will be assessed pre- and post-intervention using the Visual Analogue Scale (VAS), Maximal Mouth Opening (MMO), and Fonseca Anamnestic Index (FAI).

Data will be analyzed using SPSS version 25.0 with appropriate parametric and non-parametric tests. The study aims to provide evidence-based guidance on the relative effectiveness of Maitland mobilization and MET in the physiotherapy management of temporomandibular joint dysfunction.

 


 
Close