Assessing Motor Imagery Ability of Tongue and Mouth in Subjects With and With no Temporomandibular Disorders (TMIQ)

Assessing Motor Imagery Using the Tongue and Mouth Imagery Questionnaire (TMIQ) in Patients With Temporomandibular Disorder and Healthy Control Subjects: a Reliability and Construct Validity Study

Temporomandibular disorder (TMD) is the symptomatic expression of a muscular or an articular impairment at the manducatory tract. TMD affects between 30 to 65% of the population with a higher prevalence for young women. The patients with DTM report a decrease of their personal, social and professional quality of life. Treatment usually relies on physical therapy. Among the different technics that can be used in physical therapy, there is growing evidence advocating the efficacy of using motor imagery (i.e. imagining a movement with no concomitant physical execution) during rehabilitation. It has also been shown that the benefits of practicing motor imagery depend on the ability (i.e., the higher the ability, the greater the benefits). However, there is no investigation of the motor imagery ability of the tongue and mouth movements conditioning the use of motor imagery during TMD rehabilitation. The objective of the study is to investigate the ability of imagining tongue and mouth movements using the Tongue and Mouth Imagery Questionnaire (TMIQ) as compare to the gold-standard Kinesthetic and Visual Imagery Questionnaire (KVIQ - Malouin et al., 2007).

Study Overview

• Status: Completed
• Conditions: Temporomandibular Disorder; Motor Imagery
• Intervention / Treatment: Other: reliability and validity construct of the TMIQ

Detailed Description

Principal objective:

Assess the validity construct of the Tongue and Mouth Imagery Questionnaire (TMIQ) as compare to the gold-standard Kinesthetic and Visual Imagery Questionnaire (KVIQ - Malouin et al., 2007), both measuring the motor imagery vividness.

Secondary objectives:

1. Assess the reliability of the TMIQ using a test-retest.
2. Assess the temporal coupling (i.e., the ratio between imagined and physically practiced movement) and compare these ratios for the TMIQ and KVIQ.
3. Investigate the effect of TMD by comparing the vividness scores of TMIQ for respectively subject with and with no TMD.
4. Investigate the effect of TMD by comparing the vividness scores of KVIQ for respectively subject with and with no TMD.
5. Investigate the effect of TMD by comparing the temporal coupling scores of TMIQ for respectively subject with and with no TMD.
6. Investigate the effect of TMD by comparing the temporal coupling scores of KVIQ for respectively subject with and with no TMD.

• Study Type: Observational
• Enrollment (Actual): 94

Contacts and Locations

Study Locations

• France
  • Lyon, France, 69005
    • Cabinet Saint Alexandre

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

47 participants with DTM 47 participants with no DTM (healthy control) age-matched and gender-matched to participants with DTM.

Description

Inclusion Criteria:

• age between 18 and 75 years
• A voluntary individual who has given informed consent after receiving clear, fair and appropriate information about the study.

For DTM group participants

• inclusion during the DTM rehabilitation in the physical therapy firm "Cabinet Saint Alexandre".
• beneficiary of the social security scheme

Exclusion Criteria:

• The presence of a short tongue brake (Marchesan, 2005)
• Lingual immaturity evaluated by the Tardieu test (Jouannaud et al. 1972)
• Patients who had orthognathic surgery within 6 months post- operative, or facial fractures according to the same deadlines
• The presence of peripheral facial palsy
• Current participation in another research whose objective would be the evaluation of a therapeutic, drug or not, introducing an experimental bias.

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Temporomandibular disorder group (TMD); Patients with temporomandibular disorder coming at the Cabinet Saint Alexandre for orofacial rehabilitation. Test 1: passation of the KVIQ questionnaire, followed by the passation of the TMIQ during a rehabilitation session supervised by the physical therapist (PT) Test 2: passation of the TMIQ during the next rehabilitation session supervised by the same PT(interval between PT session 1 and 2 is a maximum of 45 days). Questionnaires were performed during the course of the patient rehabilitation that was instructed not to perform imagined movement during the interval.	Other: reliability and validity construct of the TMIQ; comparison of the TMIQ to the gold-standard questionnaire (KVIQ) and test-retest
Control healthy group (CTL); Healthy individuals with no temporomandibular disorder (i.e., no orofacial medical consultation or rehabilitation) aged-matched and gender-matched to TMD group. Test 1: passation of the KVIQ questionnaire, followed by the passation of the TMIQ during a session supervised by the physical therapist (PT) Test 2: passation of the TMIQ during the next session supervised by the same PT(interval between PT session 1 and 2 is a maximum of 8 days). Questionnaires were performed with no additional rehabilitation and participants were instructed not to perform imagined movement during the interval.	Other: reliability and validity construct of the TMIQ; comparison of the TMIQ to the gold-standard questionnaire (KVIQ) and test-retest

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
vividness score of imagined movements of the TMIQ for the DTM group	Averaged vividness score (using a 5-point likert scale, 1=minimum vividness, 5=maximal vividness) for the TMIQ for the DTM group	at study inclusion, i.e day 1
vividness score of imagined movements of the TMIQ for the CTL group	Averaged vividness score (using a 5-point likert scale, 1=minimum vividness, 5=maximal vividness) for the TMIQ for the DTM group	at study inclusion, i.e day 1
vividness score of imagined movements of the KVIQ for the DTM group	Averaged vividness score (using a 5-point likert scale, 1=minimum vividness, 5=maximal vividness) for the KVIQ for the DTM group	at study inclusion, i.e day 1
vividness score of imagined movements of the KVIQ for the CTL group	Averaged vividness score (using a 5-point likert scale, 1=minimum vividness, 5=maximal vividness) for the KVIQ for the DTM group	at study inclusion, i.e day 1

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
vividness score of imagined movements of the TMIQ for the DTM group	Averaged vividness score (using a 5-point likert scale, 1=minimum vividness, 5=maximal vividness) for the TMIQ for the DTM group	at study completion, between 8 days to 45 days after inclusion
vividness score of imagined movements of the TMIQ for the CTL group	Averaged vividness score (using a 5-point likert scale, 1=minimum vividness, 5=maximal vividness) for the TMIQ for the DTM group	at study completion, between 8 days to 45 days after inclusion
Temporal coupling to imagined movements of the TMIQ for the DTM group	Computation of ratio between imagined and physically practiced movements measured during the TMIQ for the DTM group	at study completion, between 8 days to 45 days after inclusion
Temporal coupling to imagined movements of the TMIQ for the CTL group	Computation of ratio between imagined and physically practiced movements measured during the TMIQ for the DTM group	at study inclusion, i.e day 1
Temporal coupling to imagined movements of the TMIQ for the CTL group	Computation of ratio between imagined and physically practiced movements measured during the TMIQ for the DTM group	at study completion, between 8 days to 45 days after inclusion

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
mental representation of the maximal opening of the mouth for the DTM group	comparison of the score (5-point likert Scale, 1= minimal opening, 5=maximal opening) self-reported by the participant after imagination of maximal mouth opening as compared to the score of the physical therapist after the physical execution of mouth opening by the participant during the TMIQ for the DTM group	at study inclusion, i.e day 1
mental representation of the maximal opening of the mouth for the CTL group	comparison of the score (5-point likert Scale, 1= minimal opening, 5=maximal opening) self-reported by the participant after imagination of maximal mouth opening as compared to the score of the physical therapist after the physical execution of mouth opening by the participant during the TMIQ for the CTL group	at study inclusion, i.e day 1
Accuracy of tongue pointing against the wood examination stick for the DTM group	Measure the surface of the tongue print after that participant was requested to point as accurately as possible while keeping the tongue sharp against the wood examination stick for the DTM group	at study inclusion, i.e day 1
Accuracy of tongue pointing against the wood examination stick for the CTL group	Measure the surface of the tongue print after that participant was requested to point as accurately as possible while keeping the tongue sharp against the wood examination stick for the CTL group	at study inclusion, i.e day 1

Collaborators and Investigators

• Sponsor: Cabinet de Kinesitherapie SCM Saint-Alexandre
• Collaborators: Hospices Civils de Lyon; University of Lyon
• Investigators: Principal Investigator: Caroline Alvarado-Faysse, PT, Cabinet de kinésithérapie Saint Alexandre

Publications and helpful links

General Publications

• Alvarado C, Arminjon A, Damieux-Verdeaux C, Lhotte C, Condemine C, Cousin AS, Sigaux N, Bouletreau P, Mateo S. Impaired tongue motor control after temporomandibular disorder: A proof-of-concept case-control study of tongue print. Clin Exp Dent Res. 2022 Apr;8(2):529-536. doi: 10.1002/cre2.549. Epub 2022 Feb 27.

Study record dates

Study Major Dates

• Study Start (Actual): September 26, 2018
• Primary Completion (Actual): December 31, 2019
• Study Completion (Actual): December 31, 2019

Study Registration Dates

• First Submitted: September 19, 2019
• First Submitted That Met QC Criteria: September 21, 2019
• First Posted (Actual): September 25, 2019

Study Record Updates

• Last Update Posted (Actual): March 6, 2020
• Last Update Submitted That Met QC Criteria: March 4, 2020
• Last Verified: September 1, 2019

More Information

Terms related to this study

• Keywords: orofacial myotherapies;; physical therapy;; assessment;; questionnaire validation
• Additional Relevant MeSH Terms: Joint Diseases; Musculoskeletal Diseases; Muscular Diseases; Stomatognathic Diseases; Jaw Diseases; Craniomandibular Disorders; Mandibular Diseases; Myofascial Pain Syndromes; Temporomandibular Joint Disorders; Temporomandibular Joint Dysfunction Syndrome
• Other Study ID Numbers: TMIQ

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Undecided

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No