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.