Interrater Reliability of Palpation of Myofascial Trigger Points in Three Shoulder Muscles
Interrater Reliability of Palpation of Myofascial Trigger Points in Three Shoulder Muscles
复制标题
DOI：
10.1179/106698107790819477
复制
发表时间：
2007-01-01
影响因子：
2
通讯作者：
Oostendorp, Rob
中科院分区：
文献类型：
--
作者：
Bron, Carel;Franssen, Jo;Oostendorp, Rob
这项观察性研究包括无症状受试者（n=8）和单侧或双侧肩痛患者（n=32）。转诊医生提供的患者诊断包括肩峰下撞击、肩袖疾病、肌腱炎、肌腱病和慢性三角肌下-肩峰下滑囊炎。3名评定者双侧触诊冈下肌、三角肌前部和肱二头肌，以获得Simons等人描述的总共12个肌筋膜触发点（MTrP）的临床特征。评定者对受试者的肩部是否疼痛不知情。在这项研究中，触发点最可靠的特征是牵涉痛感觉和跳跃征。除3例外，所有涉及疼痛感觉的配对一致率（PA）均≥ 70%（范围63-93%）。对于跳跃征，21例中PA =70%（范围67-77%）。在绷紧带中发现结节（PA=45-90%）和引起局部抽搐反应（PA=33-100%）被证明是最不可靠的。关于MTrPs的存在或不存在的最佳协议被发现为冈下肌（PA=69-80%）。这项研究提供了初步证据，证明肌筋膜触诊是一种可靠的诊断工具，因此在诊断非创伤性肩痛患者的肌筋膜疼痛方面可能有用。
This observational study included both asymptomatic subjects (n=8) and patients with unilateral or bilateral shoulder pain (n=32). Patient diagnoses provided by the referring medical physicians included subacromial impingement, rotator cuff disease, tendonitis, tendinopathy, and chronic subdeltoid- subacromial bursitis. Three raters bilaterally palpated the infraspinatus, the anterior deltoid, and the biceps brachii muscles for clinical characteristics of a total of 12 myofascial trigger points (MTrPs) as described by Simons et al. The raters were blinded to whether the shoulder of the subject was painful. In this study, the most reliable features of trigger points were the referred pain sensation and the jump sign. Percentage of pair-wise agreement (PA) was=70% (range 63-93%) in all but 3 instances for the referred pain sensation. For the jump sign, PA was=70% (range 67-77%) in 21 instances. Finding a nodule in a taut band (PA=45-90%) and eliciting a local twitch response (PA=33-100%) were shown to be least reliable. The best agreement about the presence or absence of MTrPs was found for the infraspinatus muscle (PA=69-80%). This study provides preliminary evidence that MTrP palpation is a reliable and, therefore, potentially useful diagnostic tool in the diagnosis of myofascial pain in patients with non-traumatic shoulder pain.