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This study highlights a newer direction of balance intervention that aims to utilize pre-emptive clenching behaviors as part of a dynamic balance training routine. Typical balance improvements are correlated with a decrease in EMG activity of lower extremity muscles [LEM] during the balance task pre- and post-treatment [theoretically correlated with improved muscular efficiency and coordination]. This study demonstrated greater improvements in post-intervention dynamic balance in the clenching group as compared to the non-clenching group, but without the typical reduction of LEM-iEMG. For consideration for those treating TMD’s, it is an important consideration that this type of approach may inadvertently contribute to iatrogenic TMD’s [especially in those patient’s already dealing with habitual parafunctional behaviors].

Persisting effects of jaw clenching on dynamic steady-state balance

Cagla Fadillioglu ¹, Lisa Kanus ², Felix Möhler ¹, Steffen Ringhof ^3 4, Marc Schmitter ², Daniel Hellmann ^2 5, Thorsten Stein ¹

PLoS One. 2024 Feb 22;19(2).

Abstract

The effects of jaw clenching on balance has been shown under static steady-state conditions but the effects on dynamic steady-state balance have not yet been investigated. On this basis, the research questions were: 1) if jaw clenching improves dynamic steady-state balance; 2) if the effects persist when the jaw clenching task loses its novelty and the increased attention associated with it; 3) if the improved dynamic steady-state balance performance is associated with decreased muscle activity. A total of 48 physically active healthy adults were assigned to three groups differing in intervention (Jaw clenching and balance training (JBT), only balance training (OBT) or the no-training control group (CON)) and attending two measurement points separated by two weeks. A stabilometer was used to assess the dynamic steady-state balance performance in a jaw clenching and non-clenching condition. Dynamic steady-state balance performance was measured by the time at equilibrium (TAE). The activities of tibialis anterior (TA), gastrocnemius medialis (GM), rectus femoris (RF), biceps femoris (BF) and masseter (MA) muscles were recorded by a wireless EMG system. Integrated EMG (iEMG) was calculated to quantify the muscle activities. All groups had better dynamic steady-state balance performance in the jaw clenching condition than non-clenching at T1, and the positive effects persisted at T2 even though the jaw clenching task lost its novelty and attention associated with it after balance training with simultaneous jaw clenching. Independent of the intervention, all groups had better dynamic steady-state balance performances at T2. Moreover, reductions in muscle activities were observed at T2 parallel to the dynamic steady-state balance performance improvement. Previous studies showed that jaw clenching alters balance during upright standing, predictable perturbations when standing on the ground and unpredictable perturbations when standing on an oscillating platform. This study complemented the previous findings by showing positive effects of jaw clenching on dynamic steady-state balance performance.