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Quintessence Publishing: Journals: OFPH
Journal of Oral & Facial Pain and Headache

Edited by Barry J. Sessle, BDS, MDS, BSc, PhD, FRSC

Official Journal of the American Academy of Orofacial Pain,
the European, Asian, and Ibero-Latin Academies of Craniomandibular
Disorders, and the Australian Academy of Orofacial Pain

ISSN 2333-0384 (print) • ISSN 2333-0376 (online)

Publication:
Winter 2007
Volume 21 , Issue 1

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A Reliability Study of Dynamic and Static Pain Tests in Temporomandibular Disorder Patients

Corine M. Visscher, PT, PhD / Frank Lobbezoo, DDS, PhD / Machiel Naeije, PhD

Pages: 39–45
PMID: 17312640


Aim: To determine the interexaminer reliability of dynamic and static pain tests in patients with temporomandibular disorders (TMD).
Methods: One hundred fifteen consecutive TMD patients participated in the study. At intake, pain on dynamic and static pain tests was scored on a 4-point ordinal scale by 1 of 5 dentists. Pressure was applied to the mandible during mandibular opening, closing, and protrusive movements (dynamic tests) and while the mandible was kept motionless by the patient in an open, closed, or protrusive position (static tests). After this examination, the dynamic and static pain tests were performed a second time by 1 of 2 physical therapists blinded to the outcome of the first examination. Prior to the study, all examiners took part in a yearly training session, while 3 examiners (2 dentists and 1 physical therapist) were trained on a more regular basis.
Results: The interexaminer reliability of dynamic and static pain tests ranged from “poor” to “fair to good” (intraclass correlation coefficient [ICC]: 0.29–0.54) but reached the “excellent” level (ICC: 0.34–0.92) when only the data gathered by the more extensively trained examiners were considered. The reliability was higher when the data were analyzed on the 4-point scale as compared to a dichotomized pain scale.
Conclusion: The reliability of dynamic and static pain tests for the temporomandibular region is fair to good when rated on an ordinal pain scale. Thorough training of examiners can improve the reliability considerably. J Orofac Pain 2007;21:39–45

Key words: dynamic and static pain tests, interexaminer reliability, temporomandibular disorders

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