Reliability of the mixing ability test testing masticatory performance in patients with head and neck cancer and healthy controls

J Oral Rehabil. 2020 Aug;47(8):961-966. doi: 10.1111/joor.13029. Epub 2020 Jun 20.


Background: Treatment of patients with head and neck cancer can result in disrupted mastication. To measure masticatory performance in people with compromised mastication, the mixing ability test (MAT) was developed.

Objective: In this study, the reliability of the MAT was evaluated in patients with head and neck cancer and healthy controls.

Methods: Thirty-four patients with head and neck cancer and 42 healthy controls performed the MAT twice on the same day. To assess reliability, the intra-class correlation coefficient (ICC2,1 ), standard error of measurement (SEM), smallest detectable change (SDC) and limits of agreement (LoA) were calculated.

Results: A good (ICC = 0.886) and moderate correlation (ICC = 0.525) were found for patients and healthy controls, respectively. Patients had a worse mixing ability (mean = 19.12, SD = 4.56) in comparison with healthy controls (mean = 16.42, SD = 2.04). The SEM was 0.76 in patients and 1.45 in healthy controls, with a SDC of 2.12 and 4.02, respectively. The LoA was -4.46 to 4.42 in patients and -3.65 to 4.59 in healthy controls.

Conclusion: The MAT has a good reliability in patients with head and neck cancer and a moderate reliability in healthy controls.

Keywords: chewing; head and neck cancer; mastication; mixing ability test; oral health; reliability.

MeSH terms

  • Algorithms
  • Head and Neck Neoplasms*
  • Humans
  • Mastication*
  • Reproducibility of Results