Objectives: To investigate the test-retest reliability of the following clinical diagnostic characteristics of myofascial trigger points: taut band, spot tenderness, jump sign, pain recognition, referred pain and local twitch responses (LTRs).
Design: Test-retest reliability study.
Setting: This study was undertaken in an outpatient physiotherapy department.
Subjects: Fifty-eight patients (31 males and 27 females) with rotator cuff tendonitis were recruited into this study.
Intervention: Rotator cuff muscles were assessed by an expert for the presence or absence of the main clinical diagnostic characteristics of trigger point assessment. The process was then repeated three days later by the same expert.
Main measures: Outcomes included the presence or absence of: a taut band, spot tenderness, jump sign, pain recognition, referred pain and LTRs.
Results: Kappa values between testing situations for the taut band, spot tenderness, jump sign and pain recognition were 1. Kappa scores for referred pain ranged between 0.79 and 0.88 and for the local twitch response between 0.75 and 1 depending on the muscles under investigation.
Conclusions: The presence or absence of the taut band, spot tenderness, jump sign and pain recognition was highly reliable between sessions. Referred pain and local twitch response reliability varied depending on the muscle being studied.
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References
1.
1 Sola A, Rodenberger M, Gettys B. Incidence of hypersensitive areas in posterior shoulder muscles. Am J Phys Med1955; 34: 585-590.
2.
2 Fricton J, Award E. Advances in pain research and therapy. Raven Press: New York, 1990.
3.
3 Skootsky S, Jaeger B, Oye R. Prevalence of myofascial pain in general internal medicine practice. West J Med1989; 151: 157-160.
4.
4 Sola A, Bonica J. Myofascial pain syndromes. In: Bonica J, Loeser J, Chapman C eds. The management of pain. Philadelphia: Lea & Febiger, 1990: 352-367.
5.
5 Gower W. Lumbago: its lessons and analogues. BMJ1994; 1: 117-121.
6.
6 Kelley M. The treatment of fibrositis and allied disorders by local anesthesia. Med J Aust1941; 1: 294-298.
7.
7 Kelley M. The relief of facial pain by procaine (novocain) injections. J Am Geriatr Soc1963; 11: 586-596.
8.
8 Simons D. Myofascial trigger points: the critical experiment. J Musculoskeletal Pain1997; 5: 113-118.
9.
9 Baldry P. Trigger point acupuncture. In: Filshie J, White A eds. Medical acupuncture, a western scientific approach. London: Churchill Livingstone, 1998: 33-60.
10.
10 Baldry P. Acupuncture, trigger points and musculoskeletal pain, second edition. Edinburgh: Churchill Livingstone, 1993.
11.
11 Bohr T. Problems with myofascial pain syndrome and fibromyalgia syndrome. Neurology1996; 46: 593-597.
12.
12 Nice D, Riddle D, Lamb R, Mayhew T, Rucker K. Inter-tester reliability of judgments of the presence of trigger points in patients. Arch Phys Med Rehabil1992; 73: 893-898.
13.
13 Njoo K, Van der Does E. The occurrence and inter-rater reliability of myofascial trigger points in Myofascial trigger point detection 487 the quaderatus lumborum and gluteus medius: a prospective study in non-specific low back pain patients and controls in general practice. Pain1994; 58: 317-323.
14.
14 Gerwin R, Shannon S, Hong C, Hubbard D, Gevirtz R. Interrater reliability in myofascial trigger point examination. Pain1997; 69:65-73.
15.
15 Simons D, Travell J, Simons L. Travell & Simons's myofascial pain and dysfunction: the trigger point manual, Volume 1, second edition. William & Wilkins, Baltimore; 1999.
16.
16 Cyriax JH, Cyriax PJ. Cyriax's illustrated manual of orthopaedic medicine, second edition. London: Butterworth Heinemann, 1993.
17.
17 Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Meas1960; 20:37-46.
18.
18 Wolfe F, Simons D, Fricton J et al. The fibromyalgia and myofascial pain syndromes: a preliminary study of tender points and trigger points in persons with fibromyalgia, myofascial pain syndrome and no disease. J Rheumatol1992; 19: 944-951.
