RESUMEN
OBJECTIVES: The aim of this study was to empirically derive subgroups according to pain-related fear of movement beliefs using cluster analysis within a sample of TMD patients and asymptomatic volunteers. METHODS: 129 volunteers participated in this cross-sectional study (34.78, standard deviation [SD]: 12.49 years; 92 TMD patients and 37 symptom-free volunteers). Mechanical pain sensitivity through pressure pain threshold (PPT) on orofacial and remote sites, kinesiophobia, pain catastrophizing, anxiety and depression were assessed. A cluster analysis was used to derive subgroups according to kinesiophobia scores (TSK/TMD). RESULTS: Three subgroups were derived: cluster 1 (high kinesiophobia [nâ¯=â¯53], TSK score: 33, SD[standard deviation]â¯=â¯2.9), cluster 2 (moderate kinesiophobia [nâ¯=â¯50], TSK score: 26.2, SDâ¯=â¯2.14) and cluster 3 (no/low kinesiophobia [nâ¯=â¯26], TSK score 12.12, SDâ¯=â¯2.08) which included patients with higher overall PPT and lower scores on psychosocial variables. The group with high kinesiophobia showed high levels of pain catastrophizing, anxiety, and orofacial pain-related disability compared to the other subgroups and mechanical pain hyperalgesia in remote site compared to the low-kinesiophobia group. Also, we found a greater prevalence of triple diagnosis for the high-kinesiophobia subgroup compared to the moderate kinesiophobia group - odds ratio: 12.6 (95% confidence interval [CI]: 3.31-43.52, pâ¯<â¯0.01). CONCLUSION: These results suggested that patients with TMD and higher levels of kinesiophobia beliefs may show a more complex clinical feature, with high psychosocial distress, widespread mechanical pain sensitivity, and a more complex TMD disorder. In this way, we suggest a relationship between the number of TMD diagnoses and kinesiophobia severity.