Helkimo developed two indices for evaluating dysfunction associated with disorders of the masticatory system, include disorders of the temporomandibular joint (TMJ). The author was from the University of Goteborg in Sweden.
Indices:
(1) anamnestic (patient recall)
(2) clinical dysfunction
Subjective Symptoms of Anamnestic Dysfunction |
Index |
none (no subjective symptoms) |
Ai0 |
mild symptoms |
AiI |
severe symptoms |
AiII |
where:
• Mild symptoms include (a) TMJ clicks or crepitation (b) feeling of stiffness or fatigue in the jaws
• Severe symptoms include difficulty in opening the mouth wide, locking, luxation, pain on movement, facial pain, jaw pain.
Parameters for the clinical dysfunction score:
(1) range of movement or mobility
(2) TMJ function
(3) muscle pain (tenderness on palpation of the masticatory muscles)
(4) TMJ pain (tenderness on palpation of the TMJ)
(5) pain on movement of the mandible
Parameter |
Finding |
Points |
range of motion or mobility |
normal range of motion |
0 |
|
slightly impaired mobility |
1 |
|
severely impaired mobility |
5 |
TMJ function |
smooth movement without TMJ joint sounds and deviation on opening or closing < 2 mm |
0 |
|
TMJ sounds in one or both joints and/or deviation >= 2 mm on opening or closing movements |
1 |
|
locking and/or luxation of the TMJ |
5 |
muscle pain |
no tenderness on palpation |
0 |
|
tenderness at 1 to 3 palpation sites |
1 |
|
tenderness at 4 or more palpation sites |
5 |
TMJ pain |
no tenderness to palpation |
0 |
|
tenderness on palpation laterally |
1 |
|
tenderness on palpation posteriorly |
5 |
pain on movement of the mandible |
none |
0 |
|
pain on one movement |
1 |
|
pain on two or more movements |
5 |
where:
• It would be simple to modify the table to include moderate findings scored at 3 points.
dysfunction score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 25
• The higher the score, the greater the dysfunction.
Dysfunction Score |
Dysfunction Group |
0 |
0 |
1 to 4 |
1 |
5 to 9 |
2 |
10 to 13 |
3 |
15 to 17 |
4 |
20 to 25 |
5 |
Dysfunction Index |
Dysfunction Groups |
Dysfunction Level |
Di0 |
0 |
symptom free (none) |
DiI |
1 |
mild |
DiII |
2 |
moderate |
DiIII |
3, 4 or 5 |
severe |
Purpose: To determine dysfunction from a disorder of the masticatory system including the temperomandibular joint (TMJ) using the indices of Helkimo.
Specialty: Sports Medicine & Rehabilitation, Otolaryngology
Objective: complications, disability and performance
ICD-10: K07.6,