A Randomized Clinical Trial Assessing the Efficacy of 6 X 6 Exercises with Self-care for the Treatment of Masticatory Myofascial Pain

Aims: To determine whether Rocabado's 6 x 6 exercise program has an added benefit to self-care alone in reducing myofascial jaw pain and improving forward head posture (FHP) in subjects with myofascial pain and FHP at the end of 4 weeks. Methods: In this double-blinded trial, 45 subjects (43 female and 2 male, mean age 24 years) were randomly assigned to self-care or self-care + 6 x 6 exercises. The primary outcome measure was intensity of jaw pain on a numerical graphic rating scale (NGRS). Secondary outcome measures were jaw pain on a verbal rating scale (VRS), neck pain (NGRS and VRS), and change in head posture. Twenty-one subjects per group resulted in 80% power to detect a difference of 2 in the NGRS for intensity of jaw pain. Alpha was set at .05 for statistical significance. Results: Both groups showed significant statistical (P = .001) and clinical (> 2 on NGRS) improvement in jaw pain intensity. Jaw pain and neck pain improved significantly (P .01) in both groups. There were no differences between groups for any of the measures. A significant change in head posture was not detected in either group. Conclusion: The 6 x 6 exercises were not significantly more beneficial in reducing the intensity of jaw and neck pain than self-care alone. Furthermore, they were not beneficial in improving head posture within the 4-week duration of this study. Keywords: exercises, myofascial pain, posture, randomized clinical trial, self-care, temporomandibular disorders