Validity and Reliability of the Helkimo Clinical Dysfunction Index for the Diagnosis of Temporomandibular Disorders

Abstract

The Helkimo Clinical Dysfunction Index (HCDI) is a simple and quick test used to evaluate subjects affected by temporomandibular disorders (TMDs), and its psychometric properties have not been tested. The test evaluates movement, joint function, pain and musculature, providing a quick general overview that could be very useful at different levels of care. For this reason, the aim of this study was to validate the use of the HCDI in a sample of patients with TMD. Methods: The sample consisted of 107 subjects, 60 TMD patients and 47 healthy controls. The study evaluated concurrent validity, inter-rater concordance and predictive values. Results: The HCDI showed moderate to substantial inter-rater concordance among the items and excellent concordance for the total scores. The correlation with other TMD assessment tests was high, the correlation with dizziness was moderate and the correlation with neck pain, headache and overall quality of life was poor. The prediction of TMD showed a sensitivity of 86.67%, a specificity of 68.09% and an area under the curve (AUC) of 0.841. Conclusions: The HCDI is a valid and reliable assessment instrument; its clinimetric properties are adequate, and it has a good ability to discriminate between TMD-affected and TMD-unaffected subjects.

Psychometric Evaluation of the Krogh-Poulsen Test for the Diagnosis of the Temporomandibular Disorders

“…Our study used the Krogh-Poulsen Test on 119 participants divided into 2 comparable groups: one group with 63 affected by TMD and another group with 56 healthy controls. The only difference between groups was the higher proportion of females, a common observation in TMD studies [12,18,34].…”

“…For concurrent validity analysis, other validated tests were used, such as the Helkimo Index, a tool composed of five items with different responses that score 0, 1, or 5. The sum of the items is categorized as unaffected (0 points), slight (1-9 points), moderate (10-19 points), and severe (20-25 points) [12,18]. The Fonseca Anamnestic Index (FAI) and its short version (SFAI) were also used.…”

“…This test consists of nine items and assesses the masticatory muscles, TMJ, and dental occlusion [10]. In 1999, Cornejo-Salazar evaluated the sensitivity and specificity of the Krogh-Poulsen Test, using the Helkimo Index [11,12] as the gold standard, for TMD diagnostic procedures. The results indicated a sensitivity of 78% and a specificity of 100%, providing evidence for the diagnostic value of the Krogh-Poulsen Test and of its greater utility in the diagnosis of truly healthy individuals [13].…”

Validade e reprodutibilidade do Teste Avaliativo de DTM: um estudo de acurácia diagnóstica

“…Em contrapartida, um estudo realizado em 2021, no qual foi realizada a validação e reprodutibilidade do Índice de Helkimo para o diagnóstico da disfunção temporomandibular, obteve reprodutibilidade inter-examinadores classificada entre moderada e substancial. 18 Porém, apesar desse estudo apresentar um Kappa elevado, o Índice de Helkimo, além de não avaliar postura, foi validado para avaliação de severidade de sinais e sintomas, não fornecendo classificação diagnóstica. 9 Em um trabalho realizado em 2004, é dado ênfase à importância da avaliação da postura nos pacientes com DTM.…”

Treatment protocol for temporomandibular joint derangement using an anterior repositioning splint with modification (one year prospective study).

“…3) Helkimo index (dysfunction index or Di) (67,68) . This index the anamnestic function throw grading or symptomatic evaluation for dysfunction at baseline (pre-treatment) and after treatment (posttreatment).…”