Abstract
The Krogh-Poulsen Test is a classic instrument to measure dysfunction of the stomatognathic system whose psychometric properties are unknown. This study aimed to evaluate the psychometric properties of the Krogh-Poulsen Test for the diagnosis of temporomandibular disorders (TMDs). A cross-sectional study was designed, including 119 patients (63 patients with TMD and 56 healthy controls). Factorial validity, inter-rater reliability, error of measurement, diagnostic validity of the Krogh-Poulsen Test, and concurrent validity were analyzed. The Krogh-Poulsen Test showed a three-factor structure. The inter-rater agreement could be considered very good with a kappa index of 0.87 (95% CI 0.83–0.90) and Standard Error of Measurement of 0.79. Correlations were strong with other orofacial instruments, moderate with instruments measuring TMD-related disorders such as neck pain, headache, or dizziness, and poor with generic quality of life instruments. The Area Under the Curve ROC was 0.928 showing, for a cut-off point >1, a sensitivity of 90.48 (95% CI 80.4–96.4) and a specificity of 85.71 (95% CI 73.8–93.6) for the diagnosis of TMD disorders. The Krogh-Poulsen Test showed a three-factor structure, very good inter-rater reliability, a strong correlation with other orofacial instruments, and an excellent capacity to discriminate between patients with or without TMD.
Highlights
Temporomandibular disorder (TMD) is a dysfunction that affects the temporomandibular joint (TMJ), masticatory muscles, and associated structures [1]
International Association for the Study of Pain (IASP) defines orofacial pain as a frequent form of pain perceived in the face and/or oral cavity that may be caused by diseases or disorders of regional structures, dysfunction of the nervous system, or through referral from distant sources [3].TMD has a multifactorial etiology that is influenced by the initiation and/or perpetuation of cofactors such as bruxism [4,5]
The results indicated a sensitivity of 78% and a specificity of 100%, providing evidence for the diagnostic value of the Krogh-Poulsen Test and of its greater utility in the diagnosis of truly healthy individuals [13]
Summary
Temporomandibular disorder (TMD) is a dysfunction that affects the temporomandibular joint (TMJ), masticatory muscles, and associated structures [1]. Signs and symptoms of TMD may include impaired jaw function, malocclusion, deviation from the midline on opening or closing the jaw, joint noises, limited range of motion, locking, and pain [2]. The. International Association for the Study of Pain (IASP) defines orofacial pain as a frequent form of pain perceived in the face and/or oral cavity that may be caused by diseases or disorders of regional structures, dysfunction of the nervous system, or through referral from distant sources [3].TMD has a multifactorial etiology that is influenced by the initiation and/or perpetuation of cofactors such as bruxism [4,5]. For TMD diagnosis, which evaluates muscle and joint pain, measurements of the different movements of the TMJ, type of bite, opening pattern, headaches in the last 30 days, noises (clicks and crackles), joint blockages, pain on palpation, and TMJ and muscle pathologies.
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