{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T18:08:03Z","timestamp":1763748483390,"version":"build-2065373602"},"reference-count":39,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,10,12]],"date-time":"2021-10-12T00:00:00Z","timestamp":1633996800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>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\u20130.90) 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 &gt;1, a sensitivity of 90.48 (95% CI 80.4\u201396.4) and a specificity of 85.71 (95% CI 73.8\u201393.6) 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.<\/jats:p>","DOI":"10.3390\/diagnostics11101876","type":"journal-article","created":{"date-parts":[[2021,10,12]],"date-time":"2021-10-12T08:09:32Z","timestamp":1634026172000},"page":"1876","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Psychometric Evaluation of the Krogh-Poulsen Test for the Diagnosis of the Temporomandibular Disorders"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9103-9696","authenticated-orcid":false,"given":"Alfonso Javier","family":"Ib\u00e1\u00f1ez-Vera","sequence":"first","affiliation":[{"name":"Department of Health Sciences, Campus de las Lagunillas, University of Ja\u00e9n, 23071 Ja\u00e9n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger","family":"Alonso-Royo","sequence":"additional","affiliation":[{"name":"FisioMedic Clinic, Dos Hermanas, 41701 Sevilla, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen Mar\u00eda","family":"S\u00e1nchez-Torrelo","sequence":"additional","affiliation":[{"name":"FisioMedic Clinic, Dos Hermanas, 41701 Sevilla, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7105-9865","authenticated-orcid":false,"given":"Noelia","family":"Zagalaz-Anula","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Campus de las Lagunillas, University of Ja\u00e9n, 23071 Ja\u00e9n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jes\u00fas","family":"L\u00f3pez-Collantes","sequence":"additional","affiliation":[{"name":"Dental Medical Center Drs. L\u00f3pez Collantes, Dos Hermanas, 41701 Sevilla, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2546-6301","authenticated-orcid":false,"given":"Rafael","family":"Lomas-Vega","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Campus de las Lagunillas, University of Ja\u00e9n, 23071 Ja\u00e9n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,12]]},"reference":[{"key":"ref_1","first-page":"378","article-title":"Diagnosis and Treatment of Temporomandibular Disorders","volume":"91","author":"Gauer","year":"2015","journal-title":"Am. Fam. Physician"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1007\/s11916-006-0070-7","article-title":"Temporomandibular joint pain and dysfunction","volume":"10","author":"Herb","year":"2006","journal-title":"Curr. Pain Headache Rep."},{"unstructured":"International Association of the Study of Pain (2021, May 03). Orofacial Pain [Internet]. Available online: https:\/\/www.iasp-pain.org\/GlobalYear\/OrofacialPain2013.","key":"ref_3"},{"key":"ref_4","first-page":"14","article-title":"Temporomandibular Disorders, Sleep Bruxism, and Primary Headaches Are Mutually Associated","volume":"27","author":"Fernandes","year":"2013","journal-title":"J. OROFAC PAIN"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1016\/j.bjorl.2017.07.010","article-title":"Temporomandibular disorder: Otologic implications and its relationship to sleep bruxism","volume":"84","author":"Rosenblatt","year":"2018","journal-title":"Braz. J. Otorhinolaryngol."},{"unstructured":"National Institute of Dental and Craniofacial Research (2021, May 03). Prevalence of TMJD and Its Sings and Symptoms, Available online: https:\/\/www.nidcr.nih.gov\/research\/data-statistics\/facial-pain\/prevalence.","key":"ref_6"},{"key":"ref_7","first-page":"25","article-title":"Racial\/Ethnic and gender prevalences in reported common pains in a national sample","volume":"25","author":"Plesh","year":"2011","journal-title":"J. Orofac. Pain"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"6","DOI":"10.11607\/jop.1151","article-title":"Diagnostic Criteria for Temporomandibular Disorders (DC\/TMD) for Clinical and Research Applications: Recommendations of the International RDC\/TMD Consortium Network* and Orofacial Pain Special Interest Group","volume":"28","author":"Schiffman","year":"2014","journal-title":"J. Oral. Fac. Pain Headache"},{"doi-asserted-by":"crossref","unstructured":"Krogh-Poulsen, W., and Olsson, A. (1966). Occlusal disharmonies and dysfunction of the stomatognathic system. Dent. Clin. N. Am., 627\u2013635.","key":"ref_9","DOI":"10.1016\/S0011-8532(22)03290-6"},{"unstructured":"Farf\u00e1n-Ver\u00e1stegui, L.G., and Aguirre-Aguilar, A.A. (2014). Asociaci\u00f3n Entre Sintomatolog\u00eda Cl\u00ednica de Trastornos Temporomandibulares y Posici\u00f3n Condilar Seg\u00fan el \u00cdndice de Krogh Poulsen en Escolares de 15 a 17 A\u00f1os de Edad en el Distrito de Moche, 2014, Universidad Nacional de Trujillo.","key":"ref_10"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"255","DOI":"10.3109\/00016357409026342","article-title":"Studies on function and dysfunction of the masticatory system: IV. Age and sex distribution of symptoms of dysfunction of the masticatory system in lapps in the north of Finland","volume":"32","author":"Helkimo","year":"1974","journal-title":"Acta Odontol. Scand."},{"doi-asserted-by":"crossref","unstructured":"Alonso-Royo, R., S\u00e1nchez-Torrelo, C.M., Ib\u00e1\u00f1ez-Vera, A.J., Zagalaz-Anula, N., Castellote-Caballero, Y., Obrero-Gait\u00e1n, E., Rodr\u00edguez-Almagro, D., and Lomas-Vega, R. (2021). Validity and Reliability of the Helkimo Clinical Dysfunction Index for the Diagnosis of Temporomandibular Disorders. Diagnostics, 11.","key":"ref_12","DOI":"10.3390\/diagnostics11030472"},{"key":"ref_13","first-page":"16","article-title":"Sensibilidad y especificiad del \u00edndice de Krogh Poulsen en el Diagn\u00f3stico de los Transtornos Temporomandibulares","volume":"1","author":"Salazar","year":"1999","journal-title":"Odontol. Sanmarquina"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2681","DOI":"10.1007\/s00415-012-6570-y","article-title":"What sample sizes for reliability and validity studies in neurology?","volume":"259","author":"Hobart","year":"2012","journal-title":"J. Neurol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"15156","DOI":"10.1136\/bmjopen-2016-015156","article-title":"Risk factor modifications and depression incidence: A 4-year longitudinal Canadian cohort of the Montreal Catchment Area Study","volume":"7","author":"Meng","year":"2017","journal-title":"BMJ Open"},{"key":"ref_16","first-page":"436","article-title":"Smoking. Prevalence and Attitudes Among Health Science Students","volume":"18","year":"1996","journal-title":"Aten Primaria"},{"unstructured":"World Health Organization (2013). 2013\u20132020 Global Action Plan for the Prevention and Control of Noncommunicable Diseases, WHO.","key":"ref_17"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/S1808-8694(15)31117-4","article-title":"Analysis of helkimo and craniomandibular indexes for temporomandibular disorder diagnosis on rheumatoid arthritis patients","volume":"73","year":"2007","journal-title":"Braz. J. Otorhinolaryngol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.bjpt.2017.03.007","article-title":"Factor and Rasch analysis of the Fonseca anamnestic index for the diagnosis of myogenous temporomandibular disorder","volume":"21","author":"Pires","year":"2017","journal-title":"Braz. J. Phys. Ther."},{"doi-asserted-by":"crossref","unstructured":"S\u00e1nchez-Torrelo, C., Zagalaz-Anula, N., Alonso-Royo, R., Ib\u00e1\u00f1ez-Vera, A., L\u00f3pez-Collantes, J., Rodr\u00edguez-Almagro, D., Obrero-Gait\u00e1n, E., and Lomas-Vega, R. (2020). Transcultural Adaptation and Validation of the Fonseca Anamnestic Index in a Spanish Population with Temporomandibular Disorders. J. Clin. Med., 9.","key":"ref_20","DOI":"10.21203\/rs.3.rs-21592\/v1"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.bjpt.2018.02.003","article-title":"Analysis of the accuracy and reliability of the Short-Form Fonseca Anamnestic Index in the diagnosis of myogenous temporomandibular disorder in women","volume":"22","author":"Pires","year":"2018","journal-title":"Braz. J. Phys. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2411","DOI":"10.1093\/pm\/pny319","article-title":"The Utility and Construct Validity of Four Measures of Pain Intensity: Results from a University-Based Study in Spain","volume":"20","author":"Jensen","year":"2019","journal-title":"Pain Med."},{"key":"ref_23","first-page":"85","article-title":"Validation of a Spanish version of the Neck Disability Index","volume":"35","year":"2010","journal-title":"Spine"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1016\/j.jclinepi.2004.05.004","article-title":"The Short-Form Headache Impact Test (HIT-6) was psychometrically equivalent in nine languages","volume":"57","author":"Martin","year":"2004","journal-title":"J. Clin. Epidemiol."},{"key":"ref_25","first-page":"572","article-title":"Cultural adaptation of 2 questionnaires for health measurement in patients with vertigo","volume":"51","author":"Garmendia","year":"2000","journal-title":"Acta Otorrinolaringol. Esp."},{"key":"ref_26","first-page":"425","article-title":"The Development of the Dizziness Handicap Inventory lected to ensure that the scale had both content and face validity. An example of a probe question for functional aspects of dizziness would be: \u201cBecause of your prob\u00ac lem, do you restrict your travel fo","volume":"116","author":"Jacobson","year":"1990","journal-title":"Arch. Otolaryngol. Head. Neck Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1157\/13121076","article-title":"Interpretation of SF-36 and SF-12 questionnaires in Spain: Physical and mental components","volume":"130","author":"Vilagut","year":"2008","journal-title":"Med. Clin."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1177\/0013164417719308","article-title":"Assessing the quality and appropiateness of factor solutions and factor score estimates in exploratory item factor analysis","volume":"78","author":"Ferrando","year":"2018","journal-title":"Educ. Psychol. Meas."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1007\/s11336-018-9621-1","article-title":"An Alternative Interpretation of the Linearly Weighted Kappa Coefficients for Ordinal Data","volume":"83","year":"2018","journal-title":"Psychometrika"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2307\/2529310","article-title":"The Measurement of the Observer Agreement for Categorial Data","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics"},{"unstructured":"Hillsdale, N.J. (1998). Statistical Power Analysis for the Behavioral Sciencies, Lawrence Erlbaum Associates. [2nd ed.].","key":"ref_31"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/clinchem\/39.4.561","article-title":"Receiver-operating characteristic (ROC) plots: A fundamental evaluation tool in clinical medicine","volume":"39","author":"Zweig","year":"1993","journal-title":"Clin. Chem."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1126\/science.3287615","article-title":"Measuring the accuracy of diagnostic systems","volume":"240","author":"Swets","year":"1988","journal-title":"Science"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"48","DOI":"10.4103\/0972-4052.194941","article-title":"Analysis of Helkimo index for temporomandibular disorder diagnosis in the dental students of Faridabad city: A cross-sectional study","volume":"17","author":"Rani","year":"2016","journal-title":"J. Indian Prosthodont Soc."},{"key":"ref_35","first-page":"182","article-title":"Examiner agreement with the Krogh-Poulsen method of clinical functional analysis","volume":"40","author":"Bergholz","year":"1985","journal-title":"Dtsch. Zahnarztl. Z."},{"key":"ref_36","first-page":"189","article-title":"Teaching of functional occlusion according to Krogh-Poulsen","volume":"2","author":"Pangidis","year":"1974","journal-title":"Zahnarztebl Bad. Wurttemb"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"25","DOI":"10.14219\/jada.archive.1979.0008","article-title":"Prevalence of mandibular dysfunction in young adults","volume":"98","author":"Solberg","year":"1979","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_38","first-page":"439","article-title":"Statistical considerations on the evaluation of the Krogh-Poulsen clinical functional analysis","volume":"33","author":"Kerschbaum","year":"1978","journal-title":"Dtsch. Zahnarztl. Z."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1148\/radiology.219.1.r01ap0695","article-title":"Early prediction of irreversible brain damage after ischemic stroke at CT","volume":"219","author":"Bourquain","year":"2001","journal-title":"Radiology"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/10\/1876\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:11:55Z","timestamp":1760166715000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/10\/1876"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,12]]},"references-count":39,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,10]]}},"alternative-id":["diagnostics11101876"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics11101876","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2021,10,12]]}}}