Cebola Pedro Miguel Teixeira Carvas, Lourenço André Schneider, Hoppe Alexandre Mangabeira, Colombo Livia Mourão Pereira Costa, de Proença Leilane Samary, Moleirinho-Alves Paula Manuela Mendes, Christidis Nikolaos, Poluha Rodrigo Lorenzi, De la Torre Canales Giancarlo
Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Almada, Portugal.
Orofacial Pain Unit, CUF Tejo Hospital, Lisboa, Portugal.
J Oral Rehabil. 2025 Oct;52(10):1549-1558. doi: 10.1111/joor.13997. Epub 2025 May 14.
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.
This study aimed to assess the prevalence and associations of hypervigilance and kinesiophobia in TMD.
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.
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).
TMD patients present high levels of kinesiophobia and hypervigilance, which in turn are correlated and affect TMD symptoms.
行为认知因素，如运动恐惧，以及诸如过度警觉等应对技能，可能导致颞下颌关节紊乱症（TMD）症状的预后更差。然而，关于过度警觉和运动恐惧与TMD的患病率及关系，目前缺乏证据。
本研究旨在评估TMD中过度警觉和运动恐惧的患病率及相关性。
样本包括233名参与者，分为TMD组（133人）和对照组（100人）。使用了以下工具：颞下颌关节紊乱症诊断标准（DC/TMD）、疼痛警觉与意识问卷（PVAQ）以及坦帕运动恐惧/颞下颌关节功能障碍量表（TSK/TMD）。在咀嚼肌和颞下颌关节处测量疼痛压力阈值（PPT）。用毫米尺评估下颌运动。采用曼-惠特尼U检验进行组间比较，采用斯皮尔曼相关性检验进行关联分析。
与对照组相比，TMD组表现出更高的过度警觉和运动恐惧值，以及更低的PPT和下颌运动（开口和前伸）值（p < 0.05）。此外，在TMD组中发现过度警觉与运动恐惧之间存在中度正相关（p = 0.000001），过度警觉与PPT之间存在显著负相关（p = 0.00001），过度警觉、运动恐惧与下颌运动之间存在显著负相关（p < 0.05）。在对照组中仅发现过度警觉与运动恐惧之间存在弱正相关（p = 0.01）。
TMD患者表现出高水平的运动恐惧和过度警觉，而这两者相互关联并影响TMD症状。
