Reliability of pressure pain threshold on myofascial trigger points in the trapezius muscle of women with chronic neck pain

Abstract

OBJECTIVE:The aim of this study was to evaluate the intra-and inter-rater reliability of pressure pain threshold measurement on myofascial trigger points in the trapezius muscle in women with chronic neck pain.METHODS: This reliability study involved 30 volunteers with neck pain for more than 90 days. The assessment procedures were performed by blinded researchers. Two examiners, who were previously trained in the use of algometry, independently performed two assessments of the pressure pain threshold at two time intervals, one week apart. RESULTS:The study sample consisted of 30 young adult women. Excellent intra-and inter-rater reliability were found for the pressure pain threshold on myofascial trigger points, with intraclass correlation coefficient values ranging between 0.752 and 0.874, standard error of measurement ranging between 0.18 and 0.22 kg/cm 2 , and minimum detectable change ranging between 0.45 and 0.62 kg/cm 2 .CONCLUSION: The present study showed that the assessment of pressure pain threshold through algometry presents satisfactory intraclass correlation coefficient values, considering different time and examiners, contributing to the spread of the use of this tool as a quantitative method of pain evaluation in myofascial trigger points.

Current Concept of Quantitative Sensory Testing and Pressure Pain Threshold in Neck/Shoulder and Low Back Pain

“…Previously published articles revealed that the individuals with higher scores in the pain-related questionnaire and with a higher score of central sensitization showed lower values on PPT; in addition, previous studies consistently demonstrated that there was a moderate to strong correlation between PPT value and disability/pain intensity [ 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 ]. Although valid reference values indicative of a normal and abnormal PPT would aid in the clinical diagnosis of pain, no such reliable values and no published review articles currently exist for neck/shoulder and back pain [ 17 ].…”

“…The PPT values collected from several studies were obtained from varying parts of the body and thus may not be directly comparable [ 22 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ]. However, using these values, we propose a database of PPTs that could serve as a benchmark for future research with pressure algometers on healthy subjects and subjects with some disease or pain.…”

“…Forty-nine studies, in which the PPT of the neck–shoulder area was measured in patients with neck/shoulder pain and/or healthy volunteers, are listed in Table 2 [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 ]. The subjects of studies of healthy volunteers, workers, children, and young adults without pain were also reported in 10 articles, shown at the bottom of Table 2 [ …”

“…There were 39 studies that measured PPT in the neck–shoulder area of patients with neck/shoulder pain ( Table 2 ) [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 ]. Algometers made by Somedic AB (units in kPa) and Wagner Instruments (units in kg/cm 2 ) were mainly used for PPT measurements, but more than 10 different devices were used in the articles.…”

Effect of ischemic compressions versus extracorporeal shockwave therapy on myofascial trigger points: A protocol of a randomized controlled trial

“…The value will be fixed on the equipment screen and noted. Three tests will be performed at each point and the average will be calculated [ 30 ].…”