Interrater Reliability in the Clinical Evaluation of Myofascial Trigger Points in Three Ankle Muscles

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• 作者：David Rodrí ; guez Sanz ; PhD ; MSc ; PT ; DP^a ; Cé ; sar Calvo Lobo ; PhD ; MSc ; PT^b ; ^c ; ^{cecalvo19@hotmail.com} ; Daniel Ló ; pez Ló ; pez ; PhD ; MSc ; DP^d ; Carlos Romero Morales ; PhD ; MSc ; PT^a ; Carlos Sosa Marí ; n ; MSc ; PT^a ; Irene Sanz Corbalá ; n ; MSc ; DP^e
• 关键词：Myofascial Pain Syndromes ; Trigger Points ; Musculoskeletal Pain ; Reproducibility of Results ; Ankle ; Lower Extremity
• 刊名：Journal of Manipulative and Physiological Therapeutics
• 出版年：2016
• 出版时间：November-December 2016
• 年：2016
• 卷：39
• 期：9
• 页码：623-634
• 全文大小：1051 K
• 卷排序：39

文摘

The purpose of this study was to evaluate interrater reliability in the diagnosis of myofascial trigger points (MTrPs) in the tibialis anterior, peroneus brevis, and extensor digitorum longus muscles.MethodsA reliability research study was performed. Three physical therapists with clinical experience in myofascial pain functioned as raters and randomly and bilaterally evaluated the ankles of 40 subjects in the Madrid public health care system. The absence or presence of MTrPs, nodules in taut bands, patterns of referred pain, local twitch response (LTR), and jump-sign were evaluated.ResultsWe calculated the pairwise interrater agreement and κ-value concordance of the presence or absence of trigger points (55%-85%; κ = 0.12-0.60), palpable nodules in taut bands (63%-90%; κ = 0.24-0.60), referred pain (63%-85%; κ = 0.20-0.54), and jump sign (62%-89%; κ = 0.15-0.72) in the 3 studied muscles. The LTR could only be evaluated in the tibialis anterior (43%-70%; κ = 0.05-0.21), and evaluation was not possible for the other muscles.ConclusionsThree blinded raters were able to reach acceptable pairwise interrater agreement (percentage of agreement value ≥70%) for the presence or absence of MTrPs and LTR in the tibialis anterior, as well as for nodules in taut bands, referred pain, and the jump sign for the extensor digitorum longus. The peroneus brevis showed a wide percentage of agreement value, ranging from 31% to 82%. The results of this study showed that expert raters can agree, with slight-to-moderate concordance, with regard to the clinical testing of muscle trigger points by direct palpation of the 3 muscles studied: the tibialis anterior, the extensor digitorum longus, and the peroneus brevis. Interrater reliability seems to be muscle dependent, especially with regard to the depth of the muscle.