Inter- and Intraexaminer Reliability in Identifying and Classifying Myofascial Trigger Points in Shoulder Muscles

Nascimento, José Diego Sales do; Alburquerque‐Sendín, Francisco; Vigolvino, Lorena Passos; Oliveira, Wandemberg Fortunato de; Sousa, Catarina de Oliveira

doi:10.1016/j.apmr.2017.06.020

Cited by 13 publications

(4 citation statements)

References 31 publications

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“…Perhaps, this component, which implies the individualization of pain related to diverse personal aspects, could be the cause of the greater heterogeneity of triggering pain when a muscle contraction is requested. In other words, it seems to indicate that local pain is more easily detectable by muscle contraction than myofascial pain or myofascial pain with referral, as has also been reported for the identification and classification of myofascial trigger points by manual palpation in shoulder muscles, mainly in the symptomatic side of subacromial impact syndrome [ 34 ]. The current results also confirm those obtained in DC/TMD, whereas the sensitivity and specificity values for myofascial with referral pain were lower than those for myalgia, as previously stated, where the values for local myalgia and myofascial pain were not established [ 3 ].…”

Section: Discussionmentioning

confidence: 78%

Validity of the Isometric Contraction Test of the Masticatory Muscles for Diagnosis of Muscular Temporomandibular Disorders

Iglesias-Peón

Mesa-Jiménez

Fernández‐de‐las‐Peñas

et al. 2022

Diagnostics

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In recent years, the Diagnostic Criteria for Temporomandibular Pain Disorders (DC/TMD) has been questioned, mainly because of the dependence on the muscular pressure needed to be applied during the clinical examination. Therefore, it is necessary to establish improvements in diagnostic strategies for DC/TMD of axis I. The aim of this study was to determine the validity of the Isometric Contraction Test of the masticatory muscles (ICTest) to diagnose DC/TMD of axis I. Forty (n = 40) patients with muscular TMD (myalgia in any of its subtypes), as well as forty age and sex matched controls, participated. They were diagnosed according to DC/TMD of axis I and performed the ICTest in a single session. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and positive (LR+) and negative likelihood ratios (LR−) of the ICTest compared with the DC/TMD of axis I were calculated. The ICTest showed a specificity of 95% for the diagnosis of myalgia, and between 94.9% and 96.8% for all subtypes in relation to the DC/TMD of axis I. For sensitivity, lower values were obtained, that is, 90.0% for myalgia, and losing sensitivity depending on the type of myalgia. The LR+ was over 10 for all diagnoses, with the exception of myofascial pain with referral, which was lower. When addressing the LR−, the myofascial diagnosis was the only one below 0.2. According to the results, the ICTest could be considered a valid procedure to diagnose subjects with muscular TMD in a clinical setting.

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Section: Discussionmentioning

confidence: 78%

Validity of the Isometric Contraction Test of the Masticatory Muscles for Diagnosis of Muscular Temporomandibular Disorders

Iglesias-Peón

Mesa-Jiménez

Fernández‐de‐las‐Peñas

et al. 2022

Diagnostics

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“…Based on research, reproducibility depends on the examiner's experience, muscle depth, and active or latent TrP. Manual detection only differentiates affected muscle from healthy one and does not determine the exact location of TrP [29][30][31][32][33][34][35][36][37][38][39]. Some studies have investigated the morphological characteristics and hemodynamics of TrPs with the objective ultrasound tool and shown that this method can improve the accurate diagnosis and evaluation of TrPs [40][41][42].…”

Section: Introductionmentioning

confidence: 99%

The Effects of Intramuscular Electrical Stimulation on Clinical and Sonographic Parameters in the People With Trigger Points: A Case Series Study

Hadizadeh,

Rahimi,

Javaherian

et al. 2023

jrehab

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Objective Myofascial pain syndrome (MPS) is a clinical disorder with a prevalence of 85%. It is characterized by the presence of trigger points, and all people experience it at least once in their lives. Different physiotherapy and medical methods are used to manage MPS. Intramuscular electrical stimulation (IMES) is a relatively new treatment option for MPS. This study aims to examine the effect of IMES on clinical and ultrasound imaging parameters related to trigger points in patients with MPS.Materials & Methods This is a case series clinical trial. Twelve participants with trigger points in their upper trapezius muscles participated in this study. They were treated three times per week with IMES. Before and after the intervention, pain and cervical spine range of motion (ROM) were measured with the visual analog scale and goniometry. Ultrasonic parameters (longitudinal diameter and the area of trigger points, and the thickness of the upper trapezius muscle) were assessed with B-mode ultrasound imaging technique. The pre-test and post-test values were compared using the paired t-test. The significance level was set at 0.05. Results After three sessions of IMES, pain and cervical spine ROM improved significantly (P<0.05). All ultrasound imaging parameters, including trigger points' longitudinal diameter and area and upper trapezius muscle thickness, decreased significantly compared to baseline (P<0.05). Conclusion IMES seems to have promising effects on clinical and ultrasound imaging parameters of patients with MPS. Further studies with larger sample sizes are recommended to investigate the longterm effects of IMES with the inclusion of a matched control group.

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“…20 Clinical palpation has been used as the primary modality for diagnostic compression of muscular tissue; however, it is controversial due to poor study quality and variable reliability. [23][24][25][26] The complexity of integrating various diagnostic criteria into palpation is likely to produce inconsistent findings and hence reduce palpation's reliability for MTrP detection. 27 In addition, clinical palpation can only provide subjective reporting, such as the general location and estimated pain level in contrast to measurements of the exact location, size, depth, or shape of MTrPs within the muscle.…”

mentioning

confidence: 99%

Diagnostic Applications of Ultrasonography in Myofascial Trigger Points: A Scoping Review and Critical Appraisal of Literature

Elbarbary

Sgro

Goldberg

et al. 2022

Journal of Diagnostic Medical Sonography

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Objective: Myofascial trigger points (MTrPs) are pathognomonic of myofascial pain syndrome. The detection ability of MTrPs via ultrasonography is underreported and the characteristics of MTrPs are not sufficiently standardized. The objective was to summarize the characteristics and diagnostic abilities of ultrasonography for MTrP investigations. Materials and Methods: A multi-database, and bibliography hand-search was implemented. Studies of ≥10 patients, published after 1980, appraising ultrasonography as a diagnostic aid for myofascial pain syndrome were included. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool was used to evaluate the diagnostic accuracy of the included studies. Results: Six cross-sectional studies met the inclusion criteria. The back and trapezius muscles were the most studied locations. The diagnostic studies were of low-medium risk of bias. The studies reported a large range of diagnostic metrics (accuracy 58%–100%, sensitivity 33%–91%, specificity 75%–100%, positive predictive value 91%–100%, negative predictive value 47%–97%, positive likelihood ratio 3.6, and negative likelihood ratio 0.12–0.67). Conclusion: This review found low-medium risk of bias evidence in support of ultrasonography for MTrP investigations. The clinical studies identified in the scoping review used gray-scale ultrasound equipment systems with a 5 to 14 MHz transducer to diagnose MTrPs and the local twitch response, and MTrPs were visualized mostly as hypoechoic nodules.

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Inter- and Intraexaminer Reliability in Identifying and Classifying Myofascial Trigger Points in Shoulder Muscles

Cited by 13 publications

References 31 publications

Validity of the Isometric Contraction Test of the Masticatory Muscles for Diagnosis of Muscular Temporomandibular Disorders

Validity of the Isometric Contraction Test of the Masticatory Muscles for Diagnosis of Muscular Temporomandibular Disorders

The Effects of Intramuscular Electrical Stimulation on Clinical and Sonographic Parameters in the People With Trigger Points: A Case Series Study

Diagnostic Applications of Ultrasonography in Myofascial Trigger Points: A Scoping Review and Critical Appraisal of Literature

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