Effectiveness of Telerehabilitation in Individuals With Myofascial Pain and Temporomandibular Joint Dysfunction: A Randomized Controlled Trial

Abstract

Background: Temporomandibular disorders (TMD), particularly the myofascial subtype, are common and impair quality of life. Although conservative treatments are effective, limited access and adherence issues highlight the need for alternative approaches such as telerehabilitation. Objectives: To evaluate the effects of a supervised telerehabilitation program, comparing its physical and psychosocial outcomes with those of a standard home-based exercise program in individuals with myofascial TMD. Methods: In this randomized, single-blind trial, 50 individuals with myofascial TMD were assigned to a telerehabilitation (TeleR, n = 25) or a home-based exercise group (HomeEx, n = 25), both following the same 6-week standardized exercise protocol. Outcomes included pain intensity (NPRS, primary), palpation pain, cervical-mandibular range of motion (ROM), TMD severity (FAI), oral habits (OBC), oral health-related quality of life (OHIP-14) and neck disability (NDI); analyses used non-parametric tests and GEE with FDR correction. Results: Significant improvements were found across all outcomes within both groups (p < 0.05, r = 0.72-0.88). TeleR showed greater reductions in pain intensity (p < 0.001), cervical and mandibular ROM except for lateral excursion, and in TMD severity, OBC, OHIP-14 and NDI scores (p = 0.001-0.004). Palpation pain decreased in all muscles in both groups (p < 0.001), with greater improvements in the masseter muscles in TeleR (OR = 1.69-1.82; p < 0.001). Conclusion: Both telerehabilitation and home-based exercise programs effectively improve physical and psychosocial outcomes in myofascial TMD patients in the short term. Telerehabilitation is more effective in reducing pain scores and increasing maximum mouth opening. Long-term clinical studies are needed to confirm the efficacy of telerehabilitation.