Effects of a Self-management Program for Temporomandibular Myalgia in Subjects With Fibromyalgia: a Single Arm Study

Assessed with the Spanish version of Tampa Scale for Temporomandibular Joint Disorder, an 11-item scale. The score for each item ranges from 0 (totally disagree) to 4 (totally agree), the higher the score, the greater the degree of kinesiophobia. The optimal cut-off point for considering kinesiophobia is 23 points.

Assessed with the Spanish version of Pain Catastrophizing Scale. It is a self-administered scale of 13 items. It comprises 3 dimensions: rumination; magnification and despair. Each item is valued from 0 to 4, with the maximum score being 52 points. The higher the score, the higher degree of catastrophizing.

Assessed with the Spanish version of Central Sensitization Inventory. It is divided in 2 parts. Part A contains a list of 25 items about how often the person experiences each symptom ("never, rarely, sometimes, often, or always"). Individual items are scored from "0" (never) to "4" (always), resulting in a total score range for all 25 items from "0" to "100." Part B is about if the person has been previously diagnosed with seven common central sensitization diagnoses (tension headaches/migraines, fibromyalgia, irritable bowel syndrome, restless leg syndrome, temporomandibular joint disorder, chronic fatigue syndrome, and multiple chemical sensitivities) and three central sensitization-related diagnoses (depression, anxiety/panic attacks, and neck injury). This part is for information only and is not scored. A score of 40 or higher has been recommended as a reasonable cutoff.

Assessed with the Spanish version of Chronic Self-efficacy Scale. It is a scale of 19 questions divided into 3 parts. The first part (8 questions) refers to whether the subject believes they are capable of carrying out different activities. The second part (6 questions) refers to whether the subject believes they are capable of carrying out a series of activities without help. The third part (5 questions) refers to the ability that the subject believes he has, at this time, to carry out a series of activities. The subject responds using an 11-point Likert-type scale (0=I do not think I am capable at all, 10=I think I am totally capable). The maximum score is 190 points. The higher the score, the higher the degree of self-efficacy.

Assessed with Reduced Chronic Pain Coping Strategies Questionnaire. It is a scale of 24 items. It is answered on a 5-point Likert scale (never = 1, always = 5). The first-order scales are religion (use of religious beliefs), catharsis (seeking social emotional support), distraction (avoidance by paying attention to pain), self-affirmation (not fainting, encouraging oneself), mental self-control (mental control of pain) and search for information (advice, queries about what to do). The second-order scales are called active strategies (distraction, mental self-control, self-affirmation, and information seeking) and passive strategies (religion and catharsis).

Evaluated with the numerical rating scale for pain. It's An 11-point numeric scale with 0 representing one pain extreme ("no pain") and 10 representing the other pain extreme ("pain as bad as you can imagine" and "worst pain imaginable"). The subject is asked to indicate the numeric value on the segmented scale that best describes their pain intensity. Higher scores indicate greater pain intensity. A reduction of approximately two points or a reduction of approximately 30% represented a clinically important difference.

Assessed with the Spanish version of Jaw Functional Limitation Scale-8 (JFLS8). A scale that evaluates 8 items on a scale from 0 (no limitation) to 10 (severe limitation). The higher the score, the greater the limitation.

Assessed with Athens Insomnia Scale. It is an 8-item scale. Participants are asked to score each item from 0 (no problem at all) to 3 (very serious problem). The total score ranges from 0 to 24.

Assessed with the Spanish version of Hospital Anxiety and Depression Scale. 14-item questionnaire. Two subscales of 7 items each, on a 0-3 Likert scale. Odd items assess anxiety, even items assess depression, with a score range in each subscale of 0-21. Higher score, greater anxiety and depression. For both subscales, the authors suggest that scores greater than eleven would indicate "case" and greater than eight would be considered "probable case".

Assessed with the Spanish version of Oral Behaviors Checklist. It's a self-reported questionnaire (diagnostic criteria for temporomandibular disorder, axis II assessment) used to identify and quantify the frequency of different oral habits. It is conformed by 21 questions, with each having 5 possible answers: none of the time=0; a little of the time=1; some of the time=2; most of the time=3; and all of the time=4. For the first 2 questions, which are about oral habits that occur at night, the possible answers are: none of the time=0; <1 night per month=1; 1 to 3 nights per month=2; 1 to 3 nights per week=3; and 4 to 7 nights per week=4. A score of 3 or 4 indicated that the patient had that particular oral habit.

Assessed with the Spanish version of Neurophysiology of Pain Questionnaire. It contains 12 items relating to the neurophysiology of pain. Each item has three response options: true, false, undecided. It is scored out of 12 with 1 point awarded for each correct response. A score of 0 is attributed to incorrect responses and those marked as undecided. The higher the score, the greater the knowledge about the neurophysiology of pain.

Assessed with a questionnaire proposed by Puentedura et al (Development of a Clinical Prediction Rule to Identify Patients With Neck Pain Likely to Benefit From Thrust Joint Manipulation to the Cervical Spine). In this proposal, the subject is asked if he thinks that the treatment can help him. There are 5 possible responses: completely disagree, slightly disagree, neutral, somewhat agree, completely agree. The treatments they ask about are: education in the physiology of pain, jaw mobility exercises, jaw strength exercises, sleep hygiene, relaxation techniques, rest, avoiding bad oral habits, medication, surgery.

Assessed with the Spanish version of Consumer Reports Effectiveness Scale (CRES-4). It consists of 4 items: a satisfaction question, a question to rate the degree of resolution of the main problem, a question about the emotional state before starting treatment and, finally, a question about the emotional state at the time of answering. To obtain the global score of the CRES-4, the results of the previous components are added together as represented by the following formula: CRES-4 = (20 x satisfaction) + (20 x problem solution) + [12.5 x (4 + current emotional state - pre-treatment emotional state)] Therefore, to interpret the CRES-4 globally, a score on a scale ranging from 0 to 300 points is considered. The higher the total score, the more effective the treatment according to the patient.

Questionnaire in which you will be asked if you have had adverse effects. If so, the subject will be asked to specify what it consists of.