The 6-minute mastication test: a unique test to assess endurance of continuous chewing; normal values, reliability, reproducibility and usability in patients with mitochondrial disease

Abstract

In patients with mitochondrial disease, fatigue and muscle problems are the most common complaints. They also experience these complaints during mastication. To measure endurance in continuous mastication in patients with mitochondrial diseases the 6-minute mastication test (6MMT) was developed. This study included the collection of normal data for the 6MMT in a healthy population (children and adults). During 6 minutes of continuous mastication on a chew tube chewing cycles per minute, total amount of chewing cycles and the difference between minute 1 (M₁) and minute 6 (M₂) were collected in 271 healthy participants (5 - 80 years old). These results were compared with those of 9 pediatric and 25 adult patients with a mitochondrial disease. Visual Analogue Scale (VAS) scores were collected directly after the test and after 5 minutes. A qualitative rating was made on masticatory movements. The reproducibility of the 6MMT in the healthy population with an interval of approximately two weeks was good. The interrater reliability for the observations was excellent. The patient group demonstrated lower total amount of chewing cycles or had greater differences between M₁ and M₆. The 6MMT is a reliable and objective test to assess endurance in continuous chewing. It demonstrates the ability of healthy children and adults to chew during 6 minutes with a highly stable frequency of mastication movements. The test may give an explanation for the masticatory problems in patient groups, who are complaining of pain and fatigue during mastication.

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