{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T22:55:26Z","timestamp":1777416926651,"version":"3.51.4"},"reference-count":54,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,1,13]],"date-time":"2023-01-13T00:00:00Z","timestamp":1673568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Temporomandibular disorders are craniofacial disorders characterized by the presence of chronic pain in masticatory muscles, with higher incidence in the women population. There is little research that has studied tongue force related to temporomandibular disorders, but there are a lot of studies that have demonstrated the impact of tongue force in vital functions, such as chewing, swallowing, phonation, or breathing. According to this, the aim of this study was to compare the maximum force of the tongue between females with chronic temporomandibular disorders and asymptomatic females. We also wanted to establish whether any relationship existed between the pain and fatigue versus the maximum force developed in females with chronic temporomandibular disorders. Material and methods: A cross-sectional study of 67 women between the ages of 18 and 65 years old was performed. The included women were assigned to one of two groups, according to whether they had chronic temporomandibular disorders or not. The procedure was the same for both groups. Outcome measures included the maximum tongue force, intensity of perceived orofacial pain, and intensity of perceived orofacial fatigue. Results: The results showed significant statistical differences for the maximum tongue force measurement between the chronic temporomandibular disorders group and the control group (p &lt; 0.05) for all the movements, except the lip pressure measurement. Furthermore, the analysis revealed significant statistical differences between the intensity of perceived orofacial fatigue between the groups (p &lt; 0.05). Moreover, the data showed no significant correlations between variables. Conclusion: The study found significant differences in maximum tongue force when comparing women with chronic temporomandibular disorders and asymptomatic women (being superior in these). Likewise, we found that the intensity of perceived orofacial fatigue after tongue exercises showed significant differences between groups. However, this study reveals no correlations between the intensity of perceived orofacial pain and fatigue and the maximum tongue force.<\/jats:p>","DOI":"10.3390\/life13010229","type":"journal-article","created":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T03:10:34Z","timestamp":1673838634000},"page":"229","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Differences between Maximum Tongue Force in Women Suffering from Chronic and Asymptomatic Temporomandibular Disorders\u2014An Observational Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Marta Carlota","family":"Diaz-Saez","sequence":"first","affiliation":[{"name":"Physiotherapy Department, Centro Superior de Estudios Universitarios La Salle, Universidad Aut\u00f3noma de Madrid, 28023 Madrid, Spain"},{"name":"CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Aut\u00f3noma de Madrid, 28023 Madrid, Spain"},{"name":"Programa de Doctorado en Medicina y Cirug\u00eda, Universidad Aut\u00f3noma de Madrid, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1971-1510","authenticated-orcid":false,"given":"Hector","family":"Beltran-Alacreu","sequence":"additional","affiliation":[{"name":"CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Aut\u00f3noma de Madrid, 28023 Madrid, Spain"},{"name":"Toledo Physiotherapy Research Group (GIFTO), Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, 45071 Toledo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9311-5506","authenticated-orcid":false,"given":"Javier","family":"Gil-Castillo","sequence":"additional","affiliation":[{"name":"Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Av. Doctor Arce, 37, 28002 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0115-088X","authenticated-orcid":false,"given":"Alfonso","family":"Gil-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Physiotherapy Department, Centro Superior de Estudios Universitarios La Salle, Universidad Aut\u00f3noma de Madrid, 28023 Madrid, Spain"},{"name":"CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Aut\u00f3noma de Madrid, 28023 Madrid, Spain"},{"name":"Unit of Physiotherapy, Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1177\/10454411970080030401","article-title":"Epidemiology of temporomandibular disorders: Implications for the investigation of etiologic factors","volume":"8","author":"LeResche","year":"1997","journal-title":"Crit. Rev. Oral Biol. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.cden.2013.04.006","article-title":"Epidemiology, diagnosis, and treatment of temporomandibular disorders","volume":"57","author":"Liu","year":"2013","journal-title":"Dent. Clin. North Am."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1111\/joor.12661","article-title":"Gender differences in temporomandibular disorders in adult populational studies: A systematic review and meta-analysis","volume":"45","author":"Bueno","year":"2018","journal-title":"J. Oral Rehabil."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"42","DOI":"10.11607\/jop.970","article-title":"Sex-specific differences in patients with temporomandibular disorders","volume":"27","author":"Bristela","year":"2013","journal-title":"J. Orofac. Pain"},{"key":"ref_5","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 Facial Pain Headache"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1097\/j.pain.0000000000000160","article-title":"A classification of chronic pain for ICD-11","volume":"156","author":"Treede","year":"2015","journal-title":"Pain"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"309","DOI":"10.11607\/ofph.1968","article-title":"Pain catastrophizing and pain persistence in temporomandibular disorder patients","volume":"32","author":"Reiter","year":"2018","journal-title":"J. Oral Facial Pain Headache"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1097\/SCS.0000000000000667","article-title":"Temporomandibular synovial chondromatosis with numerous nodules","volume":"25","author":"Cascone","year":"2014","journal-title":"J. Craniofacial Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1016\/j.jpain.2009.04.017","article-title":"Bilateral widespread mechanical pain sensitivity in women with myofascial temporomandibular disorder: Evidence of impairment in central nociceptive processing","volume":"10","author":"Pesquera","year":"2009","journal-title":"J. Pain"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1016\/j.pain.2010.09.030","article-title":"Central sensitization: Implications for the diagnosis and treatment of pain","volume":"152","author":"Woolf","year":"2011","journal-title":"Pain"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1046\/j.1365-2842.2000.00526.x","article-title":"The diagnostic value of pressure algometry in myofascial pain of the jaw muscles","volume":"27","author":"Farella","year":"2000","journal-title":"J. Oral Rehabil."},{"key":"ref_12","first-page":"258","article-title":"The influence of time, facial side, and location on pain-pressure thresholds in chronic myogenous temporomandibular disorder","volume":"8","author":"Reid","year":"1994","journal-title":"J. Orofac. Pain"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1016\/S1044-7431(03)00236-7","article-title":"Removal of GABAergic inhibition facilitates polysynaptic A fiber-mediated excitatory transmission to the superficial spinal dorsal horn","volume":"24","author":"Baba","year":"2003","journal-title":"Mol. Cell. Neurosci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.1523\/JNEUROSCI.4584-05.2006","article-title":"Disinhibition opens the gate to pathological pain signaling in superficial neurokinin 1 receptor-expressing neurons in rat spinal cord","volume":"26","author":"Torsney","year":"2006","journal-title":"J. Neurosci."},{"key":"ref_15","first-page":"146","article-title":"Prevalence of temporomandibular dysfunction and its association with malocclusion in children and adolescents: An epidemiologic study related to specified stages of dental development","volume":"72","author":"Thilander","year":"2002","journal-title":"Angle Orthod."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1784","DOI":"10.7150\/ijms.6327","article-title":"Temporomandibular disorders in burning mouth syndrome patients: An observational study","volume":"10","author":"Corsalini","year":"2013","journal-title":"Int. J. Med. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"6363","DOI":"10.4081\/ejtm.2017.6363","article-title":"The tongue, mandible, hyoid system","volume":"27","author":"Messina","year":"2017","journal-title":"Eur. J. Transl. Myol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1177\/0333102416681570","article-title":"Neck-Tongue syndrome: A systematic review","volume":"38","author":"Gelfand","year":"2018","journal-title":"Cephalalgia"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.jelekin.2014.04.005","article-title":"Impaired orofacial motor functions on chronic temporomandibular disorders","volume":"24","author":"Ferreira","year":"2014","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1080\/00016357.2018.1424936","article-title":"The prevalence of oral stage dysphagia in adults presenting with temporomandibular disorders: A systematic review and meta-analysis","volume":"76","author":"Gilheaney","year":"2018","journal-title":"Acta Odontol. Scand."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3499","DOI":"10.1152\/jn.00051.2015","article-title":"Crossed motor innervation of the base of human tongue","volume":"113","author":"Kubin","year":"2015","journal-title":"J. Neurophysiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1589\/jpts.28.854","article-title":"Differences in maximal isometric tongue strength and endurance of healthy young vs. older adults","volume":"28","author":"Oh","year":"2016","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"112616","DOI":"10.1016\/j.physbeh.2019.112616","article-title":"Tongue strength, masticatory and swallowing dysfunction in patients with chronic temporomandibular disorder","volume":"210","author":"Marim","year":"2019","journal-title":"Physiol. Behav."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/s10072-013-1507-5","article-title":"Neck\u2013tongue syndrome precipitated by prolonged poor sitting posture","volume":"35","author":"Kim","year":"2014","journal-title":"Neurol. Sci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1590\/2317-1782\/20162015256","article-title":"Rela\u00e7\u00e3o entre a percep\u00e7\u00e3o da posi\u00e7\u00e3o de l\u00edngua pelo indiv\u00edduo e medidas de for\u00e7a da l\u00edngua nos dentes","volume":"28","author":"Valentim","year":"2016","journal-title":"Codas"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2245","DOI":"10.1002\/lary.27044","article-title":"Differential impact of tongue exercise on intrinsic lingual muscles","volume":"128","author":"Cullins","year":"2017","journal-title":"Laryngoscope"},{"key":"ref_27","first-page":"158","article-title":"Strengthening the reporting of observational studies in epidemiology (STROBE): Explanation and elaboration","volume":"23","author":"Vandenbroucke","year":"2009","journal-title":"Gac. Sanit."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Diaz-Saez, M.C., and Beltran-Alacreu, H. (2022). Validity and intra rater reliability of a new device for tongue force measurement. Int. J. Interact. Multimed. Artif. Intell., in press.","DOI":"10.9781\/ijimai.2022.02.001"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1016\/j.jpainsymman.2010.08.016","article-title":"Studies comparing numerical rating scales, verbal rating scales, and visual analogue scales for assessment of pain intensity in adults: A systematic literature review","volume":"41","author":"Hjermstad","year":"2011","journal-title":"J. Pain Symptom. Manag."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"851","DOI":"10.2147\/JPR.S158847","article-title":"Test-retest reliability, validity, and minimum detectable change of visual analog, numerical rating, and verbal rating scales for measurement of osteoarthritic knee pain","volume":"11","author":"Alghadir","year":"2018","journal-title":"J. Pain Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/S0304-3959(01)00349-9","article-title":"Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale","volume":"94","author":"Farrar","year":"2001","journal-title":"Pain"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.jpain.2009.06.007","article-title":"The clinical importance of changes in the 0 to 10 numeric rating scale for worst, least, and average pain intensity: Analyses of data from clinical trials of duloxetine in pain disorders","volume":"11","author":"Farrar","year":"2010","journal-title":"J. Pain"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.nec.2016.02.003","article-title":"Measurement of trigeminal neuralgia pain","volume":"27","author":"Lee","year":"2016","journal-title":"Neurosurg. Clin. North Am."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"389","DOI":"10.3109\/09638288.2014.921245","article-title":"Reliability of measurements of tongue and hand strength and endurance using the Iowa Oral Performance Instrument with elderly adults","volume":"37","author":"Adams","year":"2015","journal-title":"Disabil. Rehabil."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/s00455-012-9425-x","article-title":"The influence of age, sex, bulb position, visual feedback, and the order of testing on maximum anterior and posterior tongue strength and endurance in healthy Belgian adults","volume":"28","author":"Vanderwegen","year":"2013","journal-title":"Dysphagia"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"042124","DOI":"10.1103\/PhysRevE.88.042124","article-title":"Log-normal distribution from a process that is not multiplicative but is additive","volume":"88","author":"Mouri","year":"2013","journal-title":"Phys. Rev. E Stat. Nonlinear Soft Matter Phys."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1002\/hec.1477","article-title":"Non-parametric methods for cost-effectiveness analysis: The central limit theorem and the bootstrap compared","volume":"19","author":"Nixon","year":"2010","journal-title":"Health Econ."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Cohen, J. (2013). Statistical Power Analysis for the Behavioral Sciences, Routledge. [2nd ed.].","DOI":"10.4324\/9780203771587"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e20190355","DOI":"10.1590\/1678-7757-2019-0355","article-title":"Tongue function and swallowing in individuals with temporomandibular disorders","volume":"28","author":"Rosa","year":"2020","journal-title":"J. Appl. Oral Sci."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1590\/S2317-17822013005000005","article-title":"Chewing and swallowing in young women with temporomandibular disorder","volume":"25","author":"Weber","year":"2013","journal-title":"Codas"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1152\/japplphysiol.01370.2012","article-title":"Differential effects of targeted tongue exercise and treadmill running on aging tongue muscle structure and contractile properties","volume":"114","author":"Kletzien","year":"2013","journal-title":"J. Appl. Physiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1007\/s00455-013-9451-3","article-title":"A systematic review and meta-analysis of measurements of tongue and hand strength and endurance using the Iowa Oral Performance Instrument (IOPI)","volume":"28","author":"Adams","year":"2013","journal-title":"Dysphagia"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1044\/2016_AJSLP-15-0051","article-title":"A systematic review of isometric lingual strength-training programs in adults with and without dysphagia","volume":"26","author":"McKenna","year":"2017","journal-title":"Am. J. Speech Lang. Pathol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"3287","DOI":"10.1007\/s00784-018-2760-z","article-title":"Swallowing changes related to chronic temporomandibular disorders","volume":"23","author":"Fassicollo","year":"2019","journal-title":"Clin. Oral. Investig."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.resp.2014.11.017","article-title":"Effects of tongue position and lung volume on voluntary maximal tongue protrusion force in humans","volume":"206","author":"Saboisky","year":"2015","journal-title":"Respir. Physiol. Neurobiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1037\/a0030150","article-title":"Pain acceptance, psychological functioning, and self-regulatory fatigue in temporomandibular disorder","volume":"32","author":"Burris","year":"2013","journal-title":"Health Psychol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1590\/2176-9451.20.1.127-133.sar","article-title":"TMD and chronic pain: A current view","volume":"20","author":"Furquim","year":"2015","journal-title":"Dent. Press J. Orthod."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/0003-9969(94)90016-7","article-title":"Characteristics of muscle fatigue in patients with myofascial pain-dysfunction syndrome","volume":"39","author":"Gay","year":"1994","journal-title":"Arch. Oral Biol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"255","DOI":"10.3109\/03009742.2015.1095943","article-title":"Correlations between fatigue and disease duration, disease activity, and pain in patients with rheumatoid arthritis: A systematic review","volume":"45","author":"Madsen","year":"2016","journal-title":"Scand. J. Rheumatol."},{"key":"ref_50","first-page":"269734","article-title":"Muscle fatigue in the temporal and masseter muscles in patients with temporomandibular dysfunction","volume":"2015","author":"Lipski","year":"2015","journal-title":"Biomed Res. Int."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1093\/ptj\/73.12.902","article-title":"Muscle fatigue: Clinical implications for fatigue assessment and neuromuscular electrical stimulation","volume":"73","year":"1993","journal-title":"Phys. Ther."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1177\/1049909113494748","article-title":"Fatigue in healthy and diseased individuals","volume":"31","author":"Finsterer","year":"2013","journal-title":"Am. J. Hosp. Palliat. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.humov.2015.06.001","article-title":"Muscle force compensation among synergistic muscles after fatigue of a single muscle","volume":"42","author":"Stutzig","year":"2015","journal-title":"Hum. Mov. Sci."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1044\/1092-4388(2004\/045)","article-title":"The effect of jaw position on measures of tongue strength and endurance","volume":"47","author":"Solomon","year":"2004","journal-title":"J. Speech Lang. Hear. Res."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/1\/229\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:05:31Z","timestamp":1760119531000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/1\/229"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,13]]},"references-count":54,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["life13010229"],"URL":"https:\/\/doi.org\/10.3390\/life13010229","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,13]]}}}