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Additional effects of aerobic training to neck exercises for women with chronic temporomandibular disorders: a randomized controlled clinical trial.

Luiz Felipe Tavares,L. B. Calixtre,Suelen Debora Fontana Vieira,Mayra Quintanilha Souza,Ana Beatriz Oliveira,S. Armijo-Olivo

Published 2026 in Musculoskeletal Science and Practice

ABSTRACT

BACKGROUND Neck-specific exercises are commonly used in the management of temporomandibular disorders (TMD); however, the additional role of aerobic training remains unclear. Given the involvement of central pain mechanisms in TMD and the effects of aerobic exercise on pain modulation, its potential adjunctive value warrants further investigation. OBJECTIVE To evaluate the additional effects of aerobic training to neck exercises on pain intensity, neck disability, and related outcomes in women with chronic TMD. DESIGN Randomized controlled trial. METHODS Fifty-eight women with chronic TMD were randomized into: (1) neck exercises (CG; n = 30); or (2) neck exercises plus aerobic training (EG; n = 28). Primary outcomes were orofacial pain intensity (VAS) and neck disability (NDI). Secondary outcomes were pressure pain thresholds (PPTs), jaw function (MFIQ), self-efficacy (CPSS), and oral health-related quality of life (OHIP-14). Repeated-measures ANOVA and multilevel mixed modelling (MLM) were used for analysis. RESULTS Both groups improved over time in pain intensity, neck disability, and secondary outcomes, with no statistically significant differences between groups. Within-group effect sizes for pain intensity were large in the EG (g = 1.43) and in the CG (g = 1.08) after treatment. The MLM models indicated that NDI, CPSS and OHIP-14 explained part of the variation in pain intensity, and central sensitization, OHIP-14, and CPSS explained part of the variation for neck disability. CONCLUSION Moderate-intensity aerobic exercise did not yield statistically significant additional benefits compared with performing neck exercises alone. However, it remains important to explore other types of aerobic exercise for managing TMD.

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