Effects of Different Graston Technique Application Speeds on Trapezius Muscle Stiffness, Pressure Pain Threshold, Pain, and Muscle Oxygenation in Patients With Bruxism

This randomized crossover study aims to address an important gap in manual therapy by examining the acute physiological effects of different Graston Technique application speeds (60 BPM vs. 120 BPM) on the dominant upper trapezius muscle in patients with bruxism. Although the Graston Technique is widely used, the specific impact of application speed on parameters such as muscle stiffness, muscle oxygenation, pressure pain threshold, and pain intensity remains under-investigated. By utilizing a crossover design with a 1-week washout period, this study allows for a precise within-subject comparison of the two speeds. The findings will clarify the optimal application frequency, providing objective data to guide the development of more effective, evidence-based manual therapy protocols for bruxism management.

Inclusion Criteria: * Diagnosed with bruxism. * Aged 18-55 years. * Presence of trigger points in the trapezius muscle, according to the criteria defined by Travell and Simons. Exclusion Criteria: * Acute tears, tendon ruptures, or severe muscle injuries. * Conditions that prevent the application of the Graston Technique (e.g., skin lesions, open wounds, infections). * Having received botox injections in the temporomandibular joint (TMJ) region within the last 6 months. * Psychological disorders that may affect participation or measurements.