Effects of a Thermoformable Mouthguard on Cervical Posture and Running Performance in Non-professional Runners

A prospective within-subject pilot study was conducted in nine non-professional runners. Each participant was assessed under two conditions : natural occlusion and thermoformable mouthguard. Static cervical posture was evaluated using the craniovertebral angle. Running performance was assessed recording heart rate, respiratory rate and running pace.

• Thermoformable mouthguard (Other): The intervention consisted of a thermoformable mouthguard individually adapted to each participant. The device used was the Domyos Adult Bi-Material Mouthguard (Decathlon, France), composed of high-density ethylene-vinyl acetate and styrene-ethylene-butadiene-styrene.

Primary outcomes

• Effects on cervical posture (CVA) [Measurements were taken during the training sessions (Day 1)]: The CVA served as the primary postural variable, reflecting head and cervical alignment. It was calculated from standardized photographs using the APECS system, based on the angle between a horizontal cervical reference line and a line extending from the tragion to the same point. Lower CVA values indicate a forward head posture.

Secondary outcomes

• Heart Rate [Measurements were taken during the training sessions (Day 1)]: It was recorded during the running test to evaluate the cardiovascular response under each occlusal condition.

Other outcomes

• Respiratory rate [Measurements were taken during the training sessions (Day 1)]: It was measured to assess whether the mouthguard influenced ventilatory patterns during running.
• Running Speed [Measurementes were taken during the training sessions (Day 1)]: Speed was monitored to quantify running performance and compare both occlusal conditions

Sex: All, ages: 18 Years to 25 Years, accepts healthy volunteers

Inclusion criteria:

* Students from Universidad Europea de Valencia enrolled in dentistry and physiotherapy programs, aged between 18 and 25 years
* Regularly engaged in running training, with at least one year of experience
* Already participated in an official half marathon
* Good general health status
* Willingness to comply with the study protocol and provision of written informed consent prior to participation

Exclusion criteria:

* Subjects reporting a history of muscular injuries, active inflammatory or infectious processes in the last 6 months
* Known cardiovascular diseases
* Pregnancy
* Use of orthopedic shoe insoles
* Use of mouthguard during running

As I am unable to upload the flow chart image, I have provided its content in text format below.

1. Recruitment

   * Participants assessed for eligibility (n = 17)
   * Excluded (n = 8):
   * Declined participation due to lack of time (n = 3)
   * Did not meet the inclusion criteria (n = 5)
2. Allocation and follow-up

   * Participants included in the study (n = 9)
   * Assigned to both conditions (within-subject design):
   * Natural occlusion condition (n = 9)
   * Thermoformable mouthguard condition (n = 9)
   * Completed follow-up (n = 9)
3. Analysis - Participants included in the final analysis (n = 9)

• Maria del Carmen Ferrer Serena, Study director, Universidad Europea de Valencia