EDGE Task Force on Head and Neck Cancer Outcomes: A Systematic Review of Outcome Measures for Temporomandibular-related Dysfunction

Abstract

Background: Patients with head and neck cancer (HNC) often experience significant postoperative limitations in temporomandibular joint (TMJ) function, facial pain, reduced nutritional intake, speech impairments, and compromised activities of daily living due to side effects of cancer treatment. Physical therapists treating these individuals must use valid and reliable patientreported outcome measures to quantify change related to physical therapy intervention for the TMJ. Purpose: As part of the activities of the Oncology Section EDGE Task Force on Head and Neck Cancer Outcomes, we report evidence-based recommendations for patient-reported outcome measures for individuals with HNC-related temporomandibular dysfunction (TMD). Methods: A systematic literature review of TMD-related patient-reported outcome measures that are clinically feasible and relevant to the HNC patient population was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model. Recommendations are based on the quality of psychometric properties, clinical utility, and previous use in HNC-related research. Twenty-two outcome measures were selected for review; 4 received a rating of 3, “recommended” for use in the HNC population. Conclusions: A variety of outcome measures have been reported in the literature for individuals with HNC-related TMD. Four measures, the Graded Chronic Pain Scale, 8 and 20-item Jaw Functional Limitation Scale and TMD Pain Screener, are recommended for clinical use by the researchers on this task force although it is important to note psychometric properties specific to the HNC population are lacking. Systematic Review Registration Number: PROSPERO CRD42013004898