The validity and predictive value of four assessment instruments for evaluation of the cervical and stomatognathic systems.

Four assessment instruments--a 10-item cervical pain questionnaire, a 10-item TMJ pain questionnaire, the Cervical Range of Motion (CROM) instrument, and the Craniomandibular Index--were used to evaluate 25 consecutive patients presenting to a physical therapy clinic for evaluation and treatment of cervical hyperextension-hyperflexion injuries. The assessment tools were tested for internal consistency between the cervical and stomatognathic measures as well as between the two sets of measures. The cervical questionnaire was strongly correlated to the CROM measurements. Tenderness to palpation of the superficial neck muscles was not correlated to the cervical questionnaire nor to measures of cervical flexion-extension or lateral flexion. It was, however, correlated to cervical rotation. The TMJ questionnaire was a useful predictor of muscular tenderness and self-reported symptoms in the stomatognathic system, but it was not related to the intra-articular signs of TMD. The flexion-extension and rotation measures of cervical mobility were useful predictors of masticatory muscle tenderness. These assessment tools are valid indicators of cervical or stomatognathic status and, when used together, provide a comprehensive description of jaw and neck status.