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. 2022 Apr;49(4):381-390.
doi: 10.1111/joor.13309. Epub 2022 Feb 12.

Tongue and mouth imagery questionnaire (TMIQ) for assessing motor imagery vividness of the temporomandibular region: A reliability and validity case-control study

Caroline Alvarado  1 , Audrey Arminjon  1 , Clovis Damieux-Verdeaux  1 , Claire Lhotte  1 , Chloé Condemine  1 , Sébastien Mateo  2   3
Affiliations

Tongue and mouth imagery questionnaire (TMIQ) for assessing motor imagery vividness of the temporomandibular region: A reliability and validity case-control study

Caroline Alvarado et al. J Oral Rehabil. 2022 Apr.

Abstract

Background: To date, no validated assessment of motor imagery (MI) ability with temporomandibular disorders (TMD) exists preventing identification of good imagers and appropriate MI use during TMD rehabilitation.

Objective: To assess the reliability and construct validity of the previously developed Tongue and Mouth Imagery Questionnaire (TMIQ) compared with the gold-standard Kinaesthetic and Visual Imagery Questionnaire (KVIQ-10).

Methods: Both KVIQ-10 and TMIQ assess MI ability using vividness (i.e. clarity/brightness for visual MI, V MI; or intensity for kinesthetic MI, K MI) of MI using a 5-point Likert scale (1: no image/sensation, 5: clear/intense image/sensation). The KVIQ-10 was administered once (test) and the TMIQ twice (test-retest) to heathy participants and patients with TMD. Questionnaire validity was investigated using concurrent validity (Pearson correlation and paired t test); TMIQ-test-retest reliability (intraclass correlation coefficients, ICCs); internal consistency (Cronbach ⍺) and the factorial structure (principal factor extraction).

Results: A total of 94 participants were included (n = 47 per group). The mean vividness scores of the KVIQ-10 and the TMIQ were significantly correlated, and not significantly different for both groups indicating concurrent validity. ICCs in the control group (range: 0.82-0.90), and in the TMD group (range: 0.75-0.82) indicated good reproducibility. The Cronbach ⍺ values were all above 0.94, indicating excellent reliability. Two factors were extracted corresponding to V MI and K MI, and explained 66% of total variance.

Conclusion: The TMIQ is a valid and reproducible MI questionnaire showing excellent internal consistency and, therefore, can be used to assess imagined movements of the TM region in healthy individuals and patients with TMD.

Keywords: Physiotherapy; cronbach ⍺; factorial analysis; intraclass correlation coefficient; temporomandibular disorders.

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Conflict of interest statement

None declared.

Figures

FIGURE 1
FIGURE 1
Illustration of the Tongue and Mouth Imagery Questionnaire (TMIQ). R: right, L: Left. Item 1. Pointing to mouth commissure, Participant was instructed to point with the tip of the tongue to the mouth commissures a total of 6 pointing (e.g. left, right, left, right, left, right); Item 2: Licking lip and teeth, Participant was instructed to lick (2A) the lower lip, then the upper lip, (2B) the anterior part of the mandible teeth then the anterior part of the maxilla teeth, (2C) the posterior part of the mandible teeth then the posterior part of the maxilla teeth (hence a total of 6 licking); Item 3: Drawing an ‘m’ on the palate with the tongue without touching the teeth; Item 4: Lateral shift of the mandible, Participant, maintaining the mouth slightly open, was instructed to laterally shift the mandible a total of 6 time (e.g. left, right, left, right, left, right); Item 5: Maximal opening of the tongue then closing 3 consecutive times
FIGURE 2
FIGURE 2
Flow chart detailing the enrolment, allocation, test, retest and analysis of the TMIQ study. n: number of participants
FIGURE 3
FIGURE 3
Concurrent validity of the TMIQ against the KVIQ‐10 for participants with TMD (upper panel) and healthy participants (lower panel) separating visual and kinaesthetic motor imagery (left and right panels respectively)
FIGURE 4
FIGURE 4
Motor imagery (MI) dominance evidenced by correlation between total vividness score of visual and Kinaesthetic MI for participants with TMD (upper panel) and healthy control participants (lower panel) for respectively KVIQ‐10 (left), TMIQ‐test (centre) and TMIQ‐retest (right)
See this image and copyright information in PMC

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