ADAPTACIÓN TRANSCULTURAL Y VALIDACIÓN DE LAS VERSIONES ESTANDAR Y CORTA DEL ÍNDICE ANAMNÉSICO DE FONSECA PARA LA EVALUACIÓN Y EL DIAGNÓSTICO DE LOS TRASTORNOS TEMPOROMANDIBULARES

Los Trastornos Temporomandibulares (TTMs) son un subgrupo de problemas de dolor craneofacial que afectan a la articulación temporomandibular, la musculatura masticatoria y las estructuras musculoesqueléticas de la cabeza y el cuello asociadas. Debido a la falta de herramientas en español para realizar un diagnóstico rápido y simplificado, resulta conveniente la adaptación transcultural y el análisis de las propiedades psicométricas de la versión estándar y la versión corta de Índice Anamnésico de Fonseca. Dichos cuestionarios se utilizan para la valoración de los TTMs, son test sencillos y rápidos de implementar. Esto cuestionarios, han reportado buenos resultados en sus validaciones y anteriores adaptaciones transculturales en diversos entornos geográficos. Por lo tanto, el objetivo de esta tesis doctoral fue adaptar transculturalmente y obtener las versiones españolas estándar y corta del Índice Anamnésico de Fonseca. Los resultados fueron satisfactorios, cumpliendo con el objetivo principal de la investigación.Temporomandibular Disorders (TMDs) are a subgroup of craniofacial pain problems that affect the temporomandibular joint, the chewing muscles, and associated musculoskeletal structures of the head and neck. Due to the lack of tools in Spanish to carry out a quick and simplified diagnosis, the cross- cultural adaptation and analysis of the psychometric properties of the standard version and the short version of the Fonseca Anamnestic Index is convenient. These questionnaires are used to assess TMDs, they are simple and quick tests to implement. These questionnaires have reported good results in their validations and previous cross-cultural adaptations in various geographical settings. Therefore, the objective of this doctoral thesis was to cross-culturally adapt and obtain the standard and short Spanish versions of the Fonseca Anamnestic Index. The results were satisfactory, fulfilling the main objective of the investigation.Tesis Univ. Jaén. Departamento de Ciencias de la Salu

The Short Form of the Fonseca Anamnestic Index for the Screening of Temporomandibular Disorders: Validity and Reliability in a Spanish-Speaking Population

The Short Form of the Fonseca Anamnestic Index (SFAI) is a simple and quick questionnaire used for screening temporomandibular disorders (TMDs). The present study aimed to validate the Spanish version of the SFAI in patients with TMDs. The study sample comprised 112 subjects (50 TMDs and 52 controls). Test–retest reliability, factorial validity, internal consistency, concurrent validity, and the SFAI’s ability to discriminate between TMDs subjects and healthy controls were analyzed using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD protocol) as the reference. Factor analysis showed a single factor that explained 63% of the total variance. Cronbach’s alpha was 0.849. The reliability of the items measured with the Kappa index showed values from 0.767 to 0.888. Test–retest reliability was substantial (intraclass correlation coefficient = 0.837). The total SFAI score showed a significant correlation with orofacial pain, vertigo, and neck disability measurements. For a cut-off point of >10 points, the SFAI showed a sensitivity of 78% and specificity of 78.85% at differentiating between TMDs patients and healthy subjects, with an area under the curve (AUC) of 0.852. The Spanish version of the SFAI is a valid and reliable instrument for diagnosing people with TMDs and shows generally good psychometric properties

Transcultural Adaptation and Validation of the Fonseca Anamnestic Index in a Spanish Population with Temporomandibular Disorders

Background: The Fonseca Anamnestic Index (FAI) offers a simple method to screen temporomandibular disorders (TMD). This study aimed to validate the Spanish version of the FAI in patients with TMD. Methods: The sample consisted of 125 subjects (66 TMD and 59 controls) aged over 18 years. Construct validity, internal consistency, test-retest reliability, concurrent validity and capacity to discriminate between TMD and healthy subjects were analyzed. Results: The Spanish version of the FAI showed a structure formed by three factors. Cronbach’s alpha was 0.826. The reliability of the items varied between substantial to almost perfect and was excellent for the total score (intraclass correlation coefficient = 0.937). The standard error of measurement (SEM) was 6.52, with a minimum detectable change (MDC) of 12.78. FAI score showed a significant correlation with headache, neck pain and vertigo measurements. A cut-off point >35 showed a sensitivity = 83.33% and a specificity = 77.97% in differentiating between healthy and TMD patients, with an area under the curve (AUC) = 0.865. Conclusions: The Spanish version of the FAI is a valid and reliable instrument for diagnosing people with TMD, with appropriate general clinimetric properties. Discrimination between patients with and without TMD is excellent

Psychometric Evaluation of the Krogh-Poulsen Test for the Diagnosis of the Temporomandibular Disorders

The Krogh-Poulsen Test is a classic instrument to measure dysfunction of the stomatognathic system whose psychometric properties are unknown. This study aimed to evaluate the psychometric properties of the Krogh-Poulsen Test for the diagnosis of temporomandibular disorders (TMDs). A cross-sectional study was designed, including 119 patients (63 patients with TMD and 56 healthy controls). Factorial validity, inter-rater reliability, error of measurement, diagnostic validity of the Krogh-Poulsen Test, and concurrent validity were analyzed. The Krogh-Poulsen Test showed a three-factor structure. The inter-rater agreement could be considered very good with a kappa index of 0.87 (95% CI 0.83–0.90) and Standard Error of Measurement of 0.79. Correlations were strong with other orofacial instruments, moderate with instruments measuring TMD-related disorders such as neck pain, headache, or dizziness, and poor with generic quality of life instruments. The Area Under the Curve ROC was 0.928 showing, for a cut-off point >1, a sensitivity of 90.48 (95% CI 80.4–96.4) and a specificity of 85.71 (95% CI 73.8–93.6) for the diagnosis of TMD disorders. The Krogh-Poulsen Test showed a three-factor structure, very good inter-rater reliability, a strong correlation with other orofacial instruments, and an excellent capacity to discriminate between patients with or without TMD

Validity and Reliability of the Helkimo Clinical Dysfunction Index for the Diagnosis of Temporomandibular Disorders

The Helkimo Clinical Dysfunction Index (HCDI) is a simple and quick test used to evaluate subjects affected by temporomandibular disorders (TMDs), and its psychometric properties have not been tested. The test evaluates movement, joint function, pain and musculature, providing a quick general overview that could be very useful at different levels of care. For this reason, the aim of this study was to validate the use of the HCDI in a sample of patients with TMD. Methods: The sample consisted of 107 subjects, 60 TMD patients and 47 healthy controls. The study evaluated concurrent validity, inter-rater concordance and predictive values. Results: The HCDI showed moderate to substantial inter-rater concordance among the items and excellent concordance for the total scores. The correlation with other TMD assessment tests was high, the correlation with dizziness was moderate and the correlation with neck pain, headache and overall quality of life was poor. The prediction of TMD showed a sensitivity of 86.67%, a specificity of 68.09% and an area under the curve (AUC) of 0.841. Conclusions: The HCDI is a valid and reliable assessment instrument; its clinimetric properties are adequate, and it has a good ability to discriminate between TMD-affected and TMD-unaffected subjects