Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
J Oral Rehabil. 2012 Oct;39(10):744-53. doi: 10.1111/j.1365-2842.2012.02336.x. Epub 2012 Aug 1.
The aims of this study were to analyse the validity, sensitivity and specificity of the protocol of oro-facial myofunctional evaluation with scores (OMES) for oro-facial myofunctional disorder (OMD) diagnosis in young and adult subjects. Eighty subjects were examined. The OMES was validated against the Nordic orofacial test-screening (NOT-S) protocol (criterion validity) (Spearman correlation test). The construct validity was tested by analysis of the ability of the OMES (i) to differentiate healthy subjects (n = 22) from temporomandibular disorder (TMD) patients (n = 22), which frequently have OMD (Mann-Whitney test) and (ii) to measure the changes that occurred in a subgroup with TMD between the period before and after oro-facial myofunctional therapy (T group, n = 15) (Wilcoxon test). Two speech therapists trained with the OMES participated as examiners (E). There was a statistically significant correlation between the OMES and NOT-S protocols, which was negative because the two scales are inverse (r = -0·86, P < 0·01). There was a significant difference between the healthy and TMD subjects regarding the oro-facial myofunctional status (OMES total score, P = 0·003). After therapy, the T group showed improvement in the oro-facial myofunctional status (OMES total score, P = 0·001). Inter- and intra-examiner agreement was moderate, and the reliability coefficients ranged from good to excellent. The OMES protocol presented mean sensitivity and specificity = 0·80, positive predictive value = 0·76 and negative predictive value = 0·84.
The OMES protocol is valid and reliable for clinical evaluation of young and adult subjects, among them patients with TMD.
本研究旨在分析口面肌功能评估与评分（OMES）方案对年轻和成年患者口面肌功能障碍（OMD）诊断的有效性、敏感性和特异性。方法：共 80 例患者纳入本研究。采用 Spearman 相关分析检验 OMES 与北欧口面功能筛选测试（NOT-S）协议（标准效度）之间的相关性，采用 Mann-Whitney 检验分析 OMES 区分健康受试者（n=22）和颞下颌关节紊乱（TMD）患者（n=22）的能力，采用 Wilcoxon 检验分析 TMD 患者口面肌功能治疗前后（T 组，n=15）OMES 评分的变化。两名接受 OMES 培训的言语治疗师作为评估员（E）参与评估。结果：OMES 与 NOT-S 协议之间呈显著负相关（r=-0.86，P<0.01）。健康受试者和 TMD 患者的口面肌功能状态（OMES 总分）存在显著差异（P=0.003）。治疗后，T 组的口面肌功能状态（OMES 总分）得到改善（P=0.001）。评估员间和评估员内的一致性为中度，可靠性系数范围为 0.63~0.91。OMES 方案的平均敏感性和特异性为 0.80，阳性预测值为 0.76，阴性预测值为 0.84。结论：OMES 方案对年轻和成年患者（包括 TMD 患者）的临床评估具有有效性和可靠性。
