Comparison of the Effects of Different Manual Therapy Techniques on Mandibular Mobility, Cervical Joint Position Sense, Jaw Function and Anxiety Levels in Individuals With Rheumatoid Arthritis and Temporomandibular Disorders: A Randomized Controlled Trial.

OBJECTIVE

This study aimed to compare the effects of soft tissue mobilization (STM) and joint mobilization (JM) on mandibular mobility, cervical joint position sense (JPS), jaw function and anxiety levels in individuals with rheumatoid arthritis (RA) and temporomandibular disorders (TMD).

METHODS

This randomized controlled study included 57 patients with RA and TMD, who were allocated to three groups: STM group (n = 19), JM group (n = 19) and control group (CG; n = 19). Interventions were applied twice weekly for 6 weeks. Outcome measures included mandibular range of motion (ROM), jaw function assessed using the Jaw Functional Limitation Scale-20 (JFLS-20), cervical JPS using a CROM device, and anxiety levels using the Generalized Anxiety Disorder-7 (GAD-7) questionnaire. Statistical significance was set at p < 0.05.

RESULTS

Both intervention groups demonstrated significant improvements in mandibular mobility, jaw function, and anxiety compared to CG (p < 0.05), whereas the CG showed deterioration in mouth opening, protrusion and anxiety over time. In mandibular mobility, both STM and JM showed significant improvements across most parameters, with JM showing a more consistent pattern of improvement. Significant improvements in cervical JPS were observed in the STM group for flexion, extension, and left rotation, and in the JM group for flexion only. No significant differences were found between the intervention groups in jaw function or anxiety outcomes.

CONCLUSION

Soft tissue mobilization enhances cervical proprioception more effectively, whereas joint mobilization provides greater improvements in mandibular mobility. Both manual therapy techniques are effective, non-invasive and clinically applicable options for managing TMD in individuals with RA.

TRIAL REGISTRATION: ClinicalTrials.gov: NCT07171671.