School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Brisbane, QLD, 4072, Australia; School of Health, Medical and Applied Sciences, Central Queensland University, Norman Gardens, Rockhampton, QLD, 4701, Australia.
School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Brisbane, QLD, 4072, Australia.
Musculoskelet Sci Pract. 2023 Jun;65:102756. doi: 10.1016/j.msksp.2023.102756. Epub 2023 Apr 13.
Little is known about the impact of intra-articular temporomandibular disorders (TMDs) on bite function, or how bite impairments in this subgroup relate to self-perceived bite limitation or kinesiophobia. This presents a challenge to practitioners involved in delivering care.
To determine what bite impairments are associated with intra-articular TMDs, and explore how these impairments relate to self-perceived bite limitations and kinesiophobia.
Observational, case-control study.
Sixty participants (n = 30 intra-articular TMDs, n = 30 healthy controls) were recruited via convenience sampling. Bite function was explored using pain-free bite force and bite endurance/steadiness (submaximal bite hold) measures. Self-perceived bite function and kinesiophobia were evaluated via the Patient specific functional scale (PSFS) and the Tampa Scale for kinesiophobia of Temporomandibular disorders (TSK-TMD) respectively. Between-group data were compared and associations between physical bite impairments, self-perceived bite limitation and kinesiophobia were explored in the intra-articular TMD group.
Pain-free bite force was significantly impaired in the intra-articular TMD group (-108N, p < 0.01, d = 0.9), and this impairment demonstrated moderate association with degree of kinesiophobia (p < 0.01, r = -0.4). No significant between-group difference was observed for bite endurance or force steadiness (p > 0.05). No association was observed between pain-free bite force and self-perceived bite limitation, or self-perceived bite limitation and kinesiophobia (p > 0.05).
Impaired pain-free bite force appears to be an important feature of intra-articular TMDs which should be considered within management. Kinesiophobia may be important to consider when assessing bite function in this subgroup. Future research is needed to guide optimal interventions and inform subsequent management guidelines.
对于关节内颞下颌紊乱（TMD）对咬合功能的影响，以及该亚组中的咬合障碍与自我感知的咬合限制或运动恐惧症之间的关系，我们知之甚少。这给参与护理的从业者带来了挑战。
确定与关节内 TMD 相关的咬合障碍，并探讨这些障碍与自我感知的咬合限制和运动恐惧症之间的关系。
观察性、病例对照研究。
通过方便抽样招募了 60 名参与者（n=30 例关节内 TMD，n=30 例健康对照组）。使用无痛咬合力和咬合力耐力/稳定性（亚最大咬合力保持）测量来探索咬合功能。通过患者特定功能量表（PSFS）和 Tampa 量表评估自我感知的咬合功能和运动恐惧症，用于颞下颌关节紊乱的运动恐惧症（TSK-TMD）。比较组间数据，并在关节内 TMD 组中探讨物理咬合障碍、自我感知的咬合限制和运动恐惧症之间的关联。
关节内 TMD 组的无痛咬合力显著受损（-108N，p<0.01，d=0.9），且与运动恐惧症的程度呈中度相关（p<0.01，r=-0.4）。在咬合耐力或力稳定性方面，两组之间没有观察到显著差异（p>0.05）。无痛咬合力与自我感知的咬合限制之间没有观察到关联，也没有观察到自我感知的咬合限制与运动恐惧症之间的关联（p>0.05）。
无痛咬合力受损似乎是关节内 TMD 的一个重要特征，在管理中应加以考虑。在评估该亚组的咬合功能时，运动恐惧症可能是需要考虑的重要因素。需要进一步的研究来指导最佳干预措施，并为后续的管理指南提供信息。
