At home yoga treatment for adult students with jaw muscle pain

INTERVENTION: Participants were blinded and randomly assigned into one of two interventions, either a ‘yoga inclusive management program’ ‐ Group A or an ‘active control standard care program’ ‐ Group B. All participants were offered Standard self‐care management for myofascial pain. This was done by a discussion on self‐care management strategies and by providing an email copy of ‘Immediate management of Temporomandibular disorders’ document (Table 1). Participants in Group A were provided a yoga mat and taught in groups (no more than 5) simple yoga activities to be performed daily for 30 minutes. The group then demonstrated to the instructor standardised activities which included 15 minutes of active physical yoga exercises, 15 minutes of breathing exercises and meditation. The activities included an initial warm‐up exercise; a short sequence of 9 to 12 movements (sun salutation); 4 sustained yoga postures; breathing exercises; and a brief period of focused attention. A summary of exercise routines for each yoga session is presented in tables 2, 3 and 4. Further details and particulars of the yoga exercises are presented in appendi X1. Yoga sessions were conducted by a trained yoga instructor (with minimum 3 years’ experience) in a lecture room at 3 locations in Sydney: at the Westmead Centre for Oral Health (WCOH), at the Sydney Dental Hospital (SDH), and at The University of Sydney Camperdown Campus (USYD). Each participant was seen twice weekly by a researcher for 30 minutes and were instructed and reviewed on the daily activities. Participant adherence with the treatment was assessed with a self‐report daily diary (appendi X3). Participants were emailed a copy of the session routines outlining the sequence of yoga exercises after they attended the sessions for weeks 1, 2, 3 CONDITION: Alternative and Complementary Medicine ‐ Other alternative and complementary medicine Musculoskeletal ‐ Other muscular and skeletal disorders Oral and Gastrointestinal ‐ Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon Orofacial myofascial pain ; ; Orofacial myofascial pain PRIMARY OUTCOME: Change in jaw function limitation assessed using Jaw function limitation scale ‐20 (JFLS‐20)[Baseline, 14 days post‐intervention commencement, 28 days post‐intervention commencement (primary end point)] Change in pain intensity on an 11 point numerical rating scale (NRS) assessed using Graded Chronic Pain Scale (GCPS)[Baseline, 14 days post‐intervention commencement, 28 days post ‐intervention commencement (primary endpoint).] Change in pain palpation scores assessed clinically as per Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD)[Baseline, 28 days post‐intervention commencement (primary end point)] INCLUSION CRITERIA: ‐ Participants diagnosed with myofascial pain of the masticatory (jaw) muscles were invited to participate for the study. ‐ Volunteers who could participate for the entire duration (28 days) of the study were informed about the details of the study ‐ Able to give informed consent. SECONDARY OUTCOME: Change in anxiety symptoms assessed using Depression, Anxiety and Stress Scale (DASS)[Baseline, 14 days post‐intervention commencement, 28 days post‐intervention commencement ] Change in depressive symptoms assessed using Depression, Anxiety and Stress Scale (DASS)[Baseline, 14 days post‐intervention commencement, 28 days post‐intervention commencement ] Change in oral health‐related quality of life assessed using Oral health impact profile (OHIP‐14) ; [Baseline, 14 days post‐intervention commencement, 28 days post‐intervention commencement ] Change in pain catastrophizing assessed using Pain catastrophizing scale (PCS)[Baseline, 14 days post‐intervention commencement, 28 days post‐intervention commencement ] Change in pain related disability assessed using Graded Chronic Pain Scale (GCPS) [Baseline, 14 days post‐intervention commencement, 28 days post‐intervention commencement ] Change in pain self‐efficacy assessed using Pain self‐efficacy questionnaire (PSEQ)[Baseline, 14 days post‐intervention commencement, 28 days post‐intervention commencement ] Change in pain‐mapping area assessed using Digital pain map of head and neck. [Baseline, 14 days post‐intervention commencement, 28 days post‐intervention commencement ] Change in stress symptoms assessed using Depression, Anxiety and Stress Scale (DASS)[Baseline, 14 days post‐intervention commencement, 28 days post‐intervention commencement ] Change in the measurements of assisted vertical jaw opening clinically assessed as per RDC/TMD. [Baseline, 28 days post‐intervention commencement ] Change in the measurements of pain‐free jaw mobility clinically assessed as per RDC/TMD. This is an additional primary outcome.[Baseline, 28 days post‐intervention commencement (primary end point)] Change in the measurements of unassisted vertical jaw opening clinically assessed as per RDC/TMD. [Baseline, 28 days post‐intervention commencement ] Participants attitude in response to "Which group you think you were in?" assessed using post study feedback form. The post study feedback form was designed specifically for this study (Appendi X2).[28 days post intervention commencement ] Participants indicating their willingness to continue the assigned activity after completion of the study assessed using post study feedback form. The post study feedback form was designed specifically for this study (Appendi X2).[28 days post‐intervention commencement] Participants response on level of benefit assessed using Post study feedback form. The post study feedback form was designed specifically for this study (Appendi X2).[28 days post‐intervention commencement ]