Musculoskeletal science & practice · 2026
Pain-free bite force, endurance and steadiness in healthy and pain-related temporomandibular disorder populations: a reliability and cross-sectional pilot study exploring bite impairments.
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McKeon Ashleigh, Treleaven Julia, Derlin Oliver, Dinsdale Alana
Аннотация
BACKGROUND: Unilateral molar pain-free bite force (PFBF), alongside bite endurance and steadiness based on PFBF, have been proposed as useful indicators of bite function in temporomandibular disorders (TMDs). The between-session reliability and the presence of impairments in pain-related TMDs in these measures is unknown.
OBJECTIVES: To establish the (1) between-session test-retest reliability of PFBF, bite endurance and steadiness in a healthy population; (2) presence of impairments in these measures in a pain-related TMD population.
METHODS: In phase one, 26 healthy participants completed two trials 1-7 days apart comprising of three PFBF trials, and a sustained hold at 50% of PFBF to determine bite endurance and steadiness. Left and right sides were treated separately for between-session reliability analysis, determined using intra-class coefficients (ICCs). In phase two, 40 pain-related TMD participants and 56 controls (including data from the 26 controls in phase one) completed the same measures once, and between-group data was compared.
RESULTS: Between-session reliability was good to excellent for PFBF (ICC [95% CI] = 0.77 [0.64-0.87]), but poor for bite endurance (ICC = 0.58) and steadiness (ICC = 0.44). PFBF was significantly impaired in the TMD group (-79.58N, p = 0.003, d = 0.64), as was bite endurance (50% PFBF × time) (-1712.65N, p = 0.047, d = 0.42). No group differences were observed in bite steadiness.
CONCLUSION: PFBF is a reliable measure of bite function and is impaired in pain-related TMDs so should be considered within management. Future research should explore alternative tests to measure bite endurance and bite steadiness.
OBJECTIVES: To establish the (1) between-session test-retest reliability of PFBF, bite endurance and steadiness in a healthy population; (2) presence of impairments in these measures in a pain-related TMD population.
METHODS: In phase one, 26 healthy participants completed two trials 1-7 days apart comprising of three PFBF trials, and a sustained hold at 50% of PFBF to determine bite endurance and steadiness. Left and right sides were treated separately for between-session reliability analysis, determined using intra-class coefficients (ICCs). In phase two, 40 pain-related TMD participants and 56 controls (including data from the 26 controls in phase one) completed the same measures once, and between-group data was compared.
RESULTS: Between-session reliability was good to excellent for PFBF (ICC [95% CI] = 0.77 [0.64-0.87]), but poor for bite endurance (ICC = 0.58) and steadiness (ICC = 0.44). PFBF was significantly impaired in the TMD group (-79.58N, p = 0.003, d = 0.64), as was bite endurance (50% PFBF × time) (-1712.65N, p = 0.047, d = 0.42). No group differences were observed in bite steadiness.
CONCLUSION: PFBF is a reliable measure of bite function and is impaired in pain-related TMDs so should be considered within management. Future research should explore alternative tests to measure bite endurance and bite steadiness.