An evaluation tool for myofascial adhesions in patients after breast cancer (MAP-BC evaluation tool): Development and interrater reliability

Abstract

PurposeTo develop a tool to evaluate myofascial adhesions objectively in patients with breast cancer and to investigate its interrater reliability.Methods1) Development of the evaluation tool. Literature was searched, experts in the field of myofascial therapy were consulted and pilot testing was performed. 2) Thirty patients (63% had a mastectomy, 37% breast-conserving surgery and 97% radiotherapy) with myofascial adhesions were evaluated using the developed tool by 2 independent raters. The Weighted Kappa (WK) and the intra-class correlation coefficient (ICC) were calculated.Results1) The evaluation tool for Myofascial Adhesions in Patients with Breast Cancer (MAP-BC evaluation tool) consisted of the assessment of myofascial adhesions at 7 locations: axillary and breast region scars, musculi pectorales region, axilla, frontal chest wall, lateral chest wall and the inframammary fold. At each location the degree of the myofascial adhesion was scored at three levels (skin, superficial and deep) on a 4-points scale (between no adhesions and very stiff adhesions). Additionally, a total score (0–9) was calculated, i.e. the sum of the different levels of each location. 2) Interrater agreement of the different levels separately was moderate for the axillary and mastectomy scar (WK 0.62–0.73) and good for the scar on the breast (WK >0.75). Moderate agreement was reached for almost all levels of the non-scar locations. Interrater reliability of the total scores was the highest for the scars (ICC 0.82–0.99). At non-scar locations good interrater reliability was reached, except for the inframammary fold (ICC = 0.71).ConclusionsThe total scores of all locations of the MAP-BC evaluation tool had good to excellent interrater reliability, except for the inframammary fold which only reached moderate reliability.

Effect of myofascial techniques for treatment of persistent arm pain after breast cancer treatment: randomized controlled trial

“…Inter-rater reliability for palpation for myofascial adhesions in breast cancer patients has been found to be good to excellent. 13 Reliability of the palpation for myofascial trigger points in this population has been investigated by the authors as well. Excellent inter-rater reliability has been found for the upper trapezius muscle and moderate reliability for other upper body muscles ( not published ).…”

An evaluation tool for Myofascial Adhesions in Patients after Breast Cancer (MAP-BC evaluation tool): Concurrent, face and content validity

“…More details and instructions on how to use the MAP-BC evaluation tool are reported elsewhere. [ 10 ]…”

“…For myofascial trigger points, several criteria to determine their presence have already been postulated. [ 3 , 8 , 9 ] For the evaluation of myofascial adhesions, the Myofascial Adhesions in Patients after Breast Cancer (MAP-BC) evaluation tool has been developed by De Groef et al[ 10 ] This tool evaluates the degree of myofascial adhesions at 7 anatomical locations (axillary and breast region scars, pectoral muscles region, axilla, frontal chest wall, lateral chest wall and inframammary fold) in breast cancer patients. At each location, the degree of myofascial adhesions is scored at three levels of depth (skin, superficial and deep level) on a 4-points scale (between no adhesions and very strong adhesions).…”

“…[ 11 ] The reliability of the MAP-BC evaluation tool has already been investigated. [ 10 ] Interrater agreement of the different levels separately was moderate to good (Weighted Kappa (WK) 0.62 to 0.90) for the scars. For almost all levels of the non-scar locations moderate agreement was reached (Weighed Kappa > 0.50), except for 2 levels (superficial level of the lateral chest wall and skin level of the inframammary fold) were only poor agreement was found (WK 0.41 to 0.44).…”

Early Physical Rehabilitation after Sentinel Lymph Node Biopsy in Breast Cancer: Is It Feasible and Safe?

“…The evaluation of myofascial adhesions was measured with the Myofascial Adhesions in Patients after Breast Cancer (MAP-BC) tool [ 32 ], which evaluates the degree of myofascial adhesions at seven anatomical locations in breast cancer patients. At each location, the degree of myofascial adhesions is scored at three levels of depth (skin, superficial, and deep) on a 4-point scale (between no adhesions and very strong adhesions), with 0 for no restriction in tissue gliding and 3 for when tissue gliding is virtually impossible.…”