pISSN 2288-6982
eISSN 2288-7105




Phys. Ther. Korea 2020; 27(2): 102-110

Published online May 20, 2020

© Korean Research Society of Physical Therapy

턱관절장애 환자의 목뼈 뒤굽음 각과 통증 및 기능장애 수준 간에 상관성 연구

이인수1, 김선엽2

1대전대학교 보건의료대학원 물리치료학과, 2대전대학교 보건의료과학대학 물리치료학과

Correlation Among the Cervical Kyphotic Angle, Pain, and Disability Level in Patients With Temporomandibular Disorders

In-su Lee1, BHSc, PT, Suhn-yeop Kim2 , PhD, PT

1Department of Physical Therapy, Graduate School of Health and Medicine, Daejeon University, 2Department of Physical Therapy, College of
Health and Medical Science, Daejeon University, Daejeon, Korea

Correspondence to: Suhn-yeop Kim

Received: March 16, 2020; Revised: April 8, 2020; Accepted: April 28, 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background: There is an opinion that improper postures of the head and cervical spine are associated with temporomandibular joint (TMJ) disorders (TMDs).
Objects: The aim of this study was to investigate the proportions among the cervical kyphotic angle, physical symptoms including the pain intensity level of the TMJ, and severity of TMD disability in patients diagnosed with TMD.
Methods: Sixty-two subjects participated in the study. The evaluation tools included measurements of the cervical kyphotic angle based on the Ishihara index, pressure pain threshold (PPT) on the TMJ, maximal mouth opening (MMO) without pain, current pain intensity level of the TMJ measured using the Quadruple Visual Analogue Scale (QVAS), Korean TMD (KTMD) disability index, KTMD Symptom Frequency/Intensity Scales (SFS/SIS), and Korean Headache Impact Test-6. Correlation analysis was conducted to investigate the correlations between the cervical kyphotic angle and parameters related to TMJ symptoms.
Results: Variables that were significantly correlated with the cervical kyphotic angle were the PPT around the TMJ (r = 0.259, p < 0.05), current pain intensity level of the TMJ based on the QVAS (r = –0.601, p< 0.01), and usual pain intensity level based on the SIS (r = –0.379, p < 0.01). The level of TMD functional disability was significantly correlated with the degree of headache (r = 0.551, p < 0.01), level of PPT of the TMJ (r = –0.383, p < 0.01), pain-free MMO (r = –0.515, p < 0.01), pain intensity level of the TMJ based on the QVAS (r = 0.393, p < 0.01), TMD symptom frequency (r = 0.739, p < 0.01), usual pain intensity of the TMJ (r = 0.624, p < 0.01), and most severe pain intensity of the TMJ (r = 0.757, p < 0.01).
Conclusion: There is a positive correlation between the cervical kyphotic angle and PPT and a negative correlation between the current and usual pain intensity levels of the TMJ. The cervical kyphotic angle was a predictor of the pain level, tenderness threshold, and intensity of pain in the TMJ.

Keywords: Cervical kyphotic angle, Disability, Pain, Pressure pain threshold, Temporomandibular joint disorders