Interexaminer reliability of the palpation of trigger points in the trunk and lower limb muscles

Hsieh, Chang-Yu J.; Hong, Chang‐Zern; Adams, Alan H.; Platt, Katherine J.; Danielson, Clark D.; Hoehler, Fred K.; Tobis, Jerome S.

doi:10.1016/s0003-9993(00)90068-6

Cited by 162 publications

(71 citation statements)

References 19 publications

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“…3 Several studies have shown that experienced physicians, physical therapists, and chiropractors can reach acceptable degrees of inter-and intrarater reliability. [42][43][44][45][46][47][48][49] In a recent study, experienced clinicians reached good agreement, but inexperienced clinicians did not reach acceptable levels of agreement in spite of having completed a brief training program to improve standardization of the research protocol. 48 Trigger points can be verified objectively using magnetic resonance or ultrasound elastography [50][51][52] …”

Section: Introductionmentioning

confidence: 99%

Dry needling — peripheral and central considerations

Dommerholt¹

2011

Journal of Manual & Manipulative Therapy

220

140

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Dry needling is a common treatment technique in orthopedic manual physical therapy. Although various dry needling approaches exist, the more common and best supported approach targets myofascial trigger points. This article aims to place trigger point dry needling within the context of pain sciences. From a pain science perspective, trigger points are constant sources of peripheral nociceptive input leading to peripheral and central sensitization. Dry needling cannot only reverse some aspects of central sensitization, it reduces local and referred pain, improves range of motion and muscle activation pattern, and alters the chemical environment of trigger points. Trigger point dry needling should be based on a thorough understanding of the scientific background of trigger points, the differences and similarities between active and latent trigger points, motor adaptation, and central sensitize application. Several outcome studies are included, as well as comments on dry needling and acupuncture.

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Section: Introductionmentioning

confidence: 99%

Dry needling — peripheral and central considerations

Dommerholt¹

2011

Journal of Manual & Manipulative Therapy

220

140

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“…12 Numerous research studies and two systematic reviews 13,14 have been conducted to investigate the reproducibility of the MTrPs examination for several muscles. [15][16][17][18][19][20][21][22] These studies have focused on the reliability of the MTrPs diagnostic criteria and no attention given to the reliability of palpation protocols in identifying the MTrPs exact location. The best reproducibility of the MTrP diagnostic criteria has been reported in the upper trapezius, which is frequently affected by MTrPs, as observed in patients with neck pain and chronic tension-type headaches.…”

Section: Introductionmentioning

confidence: 99%

Intra-rater reliability of an experienced physiotherapist in locating myofascial trigger points in upper trapezius muscle

Barbero

Bertoli

Cescon

et al. 2012

Journal of Manual & Manipulative Therapy

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Objectives: Myofascial trigger points (MTrPs) are considered the principal clinical feature of myofascial pain syndrome (MPS). An MTrP consists of spot tenderness within a taut band of muscle fibers and its stimulation can produce both local and referred pain. The clinical diagnosis of MPS depends on correct history taking and a physical examination aimed at identifying the presence of MTrP. The purpose of this study was to investigate the intra-rater reliability of a palpation protocol used for locating an MTrP in the upper trapezius muscle. Methods: Twenty-four subjects with MTrP in the upper trapezius muscle were examined by an experienced physiotherapist. During each of eight experimental sessions, subjects were examined twice in randomized order using a palpation protocol. An anatomical landmark system was defined and the MTrP location established using X and Y values.

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“…-Respecto al diagnóstico: no existe una estandarización y accesibilidad de test específicos de laboratorio o estudios de imagen que permitan el diagnóstico del SDM de manera accesible para el clínico, siendo necesarios un exhaustivo examen físico y una minuciosa anamnesis e historia clínica del paciente, realizada por un profesional adiestrado en esta técnica y patología, ya que los estudios sobre evaluación de trp determinan que hay una pobre fiabilidad entre los examinadores no entrenados y algo mejor en los entrenados (13,14). -Respecto al tratamiento: se basa en el diagnóstico, un mal diagnóstico conlleva un tratamiento erróneo y aumenta la tendencia a la cronicidad, incluso un buen diagnóstico no asegura un tratamiento óptimo sino resuelve el problema etiológico lo cual nos conduciría a la cronicidad.…”

Section: El Dolor Tiene Múltiples Definiciones Dolor Agudo Versus Dounclassified

Aproximación antropológica al síndrome de dolor miofascial: una propuesta de intervención

Gómez

González²

2013

Rev. Soc. Esp. Dolor

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Objectives: -Study the myofascial pain syndrome (MPS) from a different perspective to the clinical one. -Approach chronic MPS by means of an interdisciplinary point of view. -Develop a proposal for intervention in patients with chronic MPS considering anthropological aspects of pain. Methods: Work has been divided into two parts: the first one in which you conduct a search of scientific literature related to the object of study and a second one in which, from the results obtained, conclusions are drawn up to propose intervention.Results: Anthropological aspects of MPS have not been a regular subject of study. Therefore it has been necessary to use studies on pain in general:-Pain goes beyond the personal and subjective experience of those who suffer, the expression, and validation by social environment respond to socio-cultural factors -Acute and chronic pain have a different socio-cultural connotations, scientific literature indicates the importance of finding causality for a more positive experience of pain. -The attitude of the therapist and patient information are key elements in the process of recovery. Conclusions: -Understand the pain not only as a natural and subjective fact but also as a socially learned and culturally transmitted behaviour, influenced by many external factors.-Need to integrate empathy and "estrangement" in addressing the patient with MPS. -Inform the patient clearly and concisely about his recovery process to become an active part of treatment. -Need to develop lines of research so that the study of MPS interacts with social sciences in order to obtain a greater interdisciplinarity which results in a holistic conception of the patient.Key works: Anthropology. Myofascial pain. Physical therapy. RESUMENObjetivos: -Estudiar el síndrome de dolor miofascial (SDM) desde una perspectiva distinta a la clínica. -Abordar mediante un enfoque interdisciplinar el SDM cró-nico. -Elaborar una propuesta de intervención sobre el paciente con SDM crónico considerando aspectos antropológicos del dolor. Métodos: Se ha dividido el trabajo en dos partes; una primera en la que se ha realizado una búsqueda de literatura científica relacionada con el objeto de estudio y una segunda en la que, a partir de los resultados obtenidos, se han elaborado las conclusiones a modo de propuesta de intervención.Resultados: Los aspectos antropológicos del SDM no han sido un objeto de estudio habitual por lo que ha sido necesario recurrir a los trabajos sobre el dolor en general:-El dolor va más allá de la experiencia personal y subjetiva del que lo padece, la expresión del mismo y la validación por parte del entorno social responde a factores socioculturales. -El dolor agudo y el dolor crónico tienen unas connotaciones socio-culturales distintas, la literatura científica señala la importancia de encontrar la causalidad para una vivencia más positiva del dolor. -La actitud del terapeuta y la información al paciente son elementos claves en el proceso recuperador.

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Interexaminer reliability of the palpation of trigger points in the trunk and lower limb muscles

Cited by 162 publications

References 19 publications

Dry needling — peripheral and central considerations

Dry needling — peripheral and central considerations

Intra-rater reliability of an experienced physiotherapist in locating myofascial trigger points in upper trapezius muscle

Aproximación antropológica al síndrome de dolor miofascial: una propuesta de intervención

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