Prevalence and Interplay of Hypervigilance and Kinesiophobia in TMD Patients: Implications in Clinical Outcomes.

BACKGROUND

Behavioural cognitive factors, like kinesiophobia and coping skills like hypervigilance, may contribute to a worse prognosis of TMD symptoms. However, there is a lack of evidence about the prevalence and relationship of hypervigilance and kinesiophobia with TMD.

OBJECTIVE

This study aimed to assess the prevalence and associations of hypervigilance and kinesiophobia in TMD.

METHODS

The sample consisted of 233 participants, divided into the TMD group (133) and a control group (100). The following instruments were used: diagnostic criteria for temporomandibular disorders (DC/TMD), Pain Vigilance and Awareness Questionnaire (PVAQ), and Tampa Scale for kinesiophobia/temporomandibular joint dysfunction (TSK/TMD). Pain pressure threshold (PPT) was measured on the masticatory muscles and the temporomandibular joint. Mandibular movements were assessed with a millimetre ruler. Mann-Whitney U test was used for group comparisons and Spearman's correlation test for association analyses.

RESULTS

The TMD-group showed higher hypervigilance and kinesiophobia values,and lower PPT and mandibular movement (opening and protrusion) values compared with controls (p < 0.05). Also, a positive moderate correlation between hypervigilance and kinesiophobia (p = 0.000001), a significant negative correlation between hypervigilance and PPT (p = 0.00001) and a significant negative correlation between hypervigilance, kinesiophobia and mandibular movements (p < 0.05) in the TMD-group were found. A positive weak correlation was found just between hypervigilance and kinesiophobia in the control group (p = 0.01).

CONCLUSION

TMD patients present high levels of kinesiophobia and hypervigilance, which in turn are correlated and affect TMD symptoms.