# Craniofacial Pain and Disability Inventory and Tampa Scale for Kinesiophobia for Temporomandibular Disorders: A Study of Responsiveness and Minimal Important Change

## TL;DR

This study evaluates how well two questionnaires measure changes in disability and fear of movement in patients with chronic temporomandibular disorders.

## Contribution

The study provides evidence of the responsiveness and minimal important change thresholds for two TMD-specific questionnaires.

## Key findings

- CF-PDI/Br and TSK/TMD-Br showed strong responsiveness in chronic TMD patients.
- MIC values of -5.3 and -4 for CF-PDI and TSK/TMD scores indicate clinically meaningful improvement.
- Over 75% of expected correlations between change scores were confirmed.

## Abstract

Craniofacial Pain and Disability Inventory (CF‐PDI/Brazil [Br]) assesses Temporomandibular Disorders (TMD)‐related disability, and the Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK/TMD‐Br) assesses kinesiophobia in patients with TMD.

To evaluate the responsiveness and interpretability of CF‐PDI/Br and TSK/TMD‐Br scores in chronic TMD patients.

A total of 148 participants of both sexes (38, SD = 10.9 years) were included. Participants were reassessed after undergoing a 6‐week rehabilitation treatment. Spearman correlations between change scores of the CF‐PDI/Br and TSK/TMD‐Br were compared with pain intensity and pain self‐efficacy (responsiveness‐construct approach). Accuracy (Area Under the Curve = AUC) was assessed by considering patients who improved or not, using the perceived global effect of improvement scale as an external anchor (responsiveness‐construct approach). Interpretability assessed by minimal important change (MIC) estimate was also calculated using three methods: MICROC, MICmean and MICpredict.

CF‐PDI and TSK/TMD exhibited suitable responsiveness. More than 75% of the hypothesized correlations between change scores for CF‐PDI and TSK/TMD were confirmed, and both measures showed AUC > 0.70 to distinguish patients who improved from patients who did not improve. We found MICpredict of −5.3 and −4, respectively, for the CF‐PDI and TSK/TMD scores.

CF‐PDI/Br and TSK/TMD‐Br demonstrated appropriate responsiveness and interpretability for patients with chronic TMD. The MIC values presented can be used to evaluate whether improvements in TMD‐related disability and kinesiophobia are clinically meaningful. A change score decrease of at least −5.3 and −4 points in the total CF‐PDI/Br and TSK/TMD‐Br scores, respectively, indicates clinically significant improvement.

Graphical abstract of the manuscript published at the Journal of Oral Rehabilitation, showing the responsiveness and interpretability (Minimal Important Change [MIC]) scores for two questionnaires designed to assess patients with Temporomandibular Disorders: Craniofacial Pain and Disability Inventory (CF‐PDI) and Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK‐TMD).