The inter-examiner reliability of standardized manual palpation for the identification of clinically relevant myofascial triggerpoints

Research output: Contribution to conference without publisher/journalPosterResearch

Abstract

A clinical diagnosis of Myofascial Pain Syndrome (MPS) requires manual palpation for the identification of at least one clinically relevant trigger point (TP). However, few comparable, high quality studies exist regarding the robustness of TP examination. Our aim was to determine the inter-observer agreement of TP examination among four examiners and whether reproducibility is influenced by examiner clinical experience. Two experienced and two inexperienced clinicians each performed a standardized palpation of the upper Trapezius musculature. Each observer was asked to judge the presents/absence of clinically relevant TP(s) using clinician global assessment (GA). A random case mix of 81 female participants was examined, 14 being asymptomatic and the remainder suffering from neck/shoulder pain. Examiners received psychomotor training and video analysis feedback provided prior to and during the study in order to improve protocol standardization. Kappa co-efficients were calculated for all possible examiner pairings. Good agreement was noted between the experienced pairing (κ= 0.63). Moderate levels of agreement were observed among the two mixed pairings (κ=0.35 and 0.47 respectively). However, poor agreement was observed for the inexperienced pairing (κ=0.22). Inter-observer agreement was not stable with the experienced pairing in particular, exhibiting a sharp decline in agreement during the latter portion of the study. Identification of clinically relevant TPs of the upper Trapezius musculature is a reproducible procedure when performed by two experienced clinicians. However, an experienced-inexperienced observer pairing can yield acceptable levels of agreement. A protracted period of data collection may be detrimental to inter-observer agreement.
Original languageEnglish
Publication date2010
Publication statusPublished - 2010
EventThe Society for Back Pain Research - Annual General Meeting: The life course of back pain - are we making a difference? - Odense, Denmark
Duration: 9. Jun 201011. Jun 2010

Conference

ConferenceThe Society for Back Pain Research - Annual General Meeting: The life course of back pain - are we making a difference?
CountryDenmark
CityOdense
Period09/06/201011/06/2010

Cite this

Myburgh, C., Lauridsen, H. H., Larsen, A. H., & Hartvigsen, J. (2010). The inter-examiner reliability of standardized manual palpation for the identification of clinically relevant myofascial triggerpoints. Poster session presented at The Society for Back Pain Research - Annual General Meeting: The life course of back pain - are we making a difference?, Odense, Denmark.
Myburgh, Corrie ; Lauridsen, Henrik Hein ; Larsen, Anders Holsgaard ; Hartvigsen, Jan. / The inter-examiner reliability of standardized manual palpation for the identification of clinically relevant myofascial triggerpoints. Poster session presented at The Society for Back Pain Research - Annual General Meeting: The life course of back pain - are we making a difference?, Odense, Denmark.
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abstract = "A clinical diagnosis of Myofascial Pain Syndrome (MPS) requires manual palpation for the identification of at least one clinically relevant trigger point (TP). However, few comparable, high quality studies exist regarding the robustness of TP examination. Our aim was to determine the inter-observer agreement of TP examination among four examiners and whether reproducibility is influenced by examiner clinical experience. Two experienced and two inexperienced clinicians each performed a standardized palpation of the upper Trapezius musculature. Each observer was asked to judge the presents/absence of clinically relevant TP(s) using clinician global assessment (GA). A random case mix of 81 female participants was examined, 14 being asymptomatic and the remainder suffering from neck/shoulder pain. Examiners received psychomotor training and video analysis feedback provided prior to and during the study in order to improve protocol standardization. Kappa co-efficients were calculated for all possible examiner pairings. Good agreement was noted between the experienced pairing (κ= 0.63). Moderate levels of agreement were observed among the two mixed pairings (κ=0.35 and 0.47 respectively). However, poor agreement was observed for the inexperienced pairing (κ=0.22). Inter-observer agreement was not stable with the experienced pairing in particular, exhibiting a sharp decline in agreement during the latter portion of the study. Identification of clinically relevant TPs of the upper Trapezius musculature is a reproducible procedure when performed by two experienced clinicians. However, an experienced-inexperienced observer pairing can yield acceptable levels of agreement. A protracted period of data collection may be detrimental to inter-observer agreement.",
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Myburgh, C, Lauridsen, HH, Larsen, AH & Hartvigsen, J 2010, 'The inter-examiner reliability of standardized manual palpation for the identification of clinically relevant myofascial triggerpoints', The Society for Back Pain Research - Annual General Meeting: The life course of back pain - are we making a difference?, Odense, Denmark, 09/06/2010 - 11/06/2010.

The inter-examiner reliability of standardized manual palpation for the identification of clinically relevant myofascial triggerpoints. / Myburgh, Corrie; Lauridsen, Henrik Hein; Larsen, Anders Holsgaard; Hartvigsen, Jan.

2010. Poster session presented at The Society for Back Pain Research - Annual General Meeting: The life course of back pain - are we making a difference?, Odense, Denmark.

Research output: Contribution to conference without publisher/journalPosterResearch

TY - CONF

T1 - The inter-examiner reliability of standardized manual palpation for the identification of clinically relevant myofascial triggerpoints

AU - Myburgh, Corrie

AU - Lauridsen, Henrik Hein

AU - Larsen, Anders Holsgaard

AU - Hartvigsen, Jan

PY - 2010

Y1 - 2010

N2 - A clinical diagnosis of Myofascial Pain Syndrome (MPS) requires manual palpation for the identification of at least one clinically relevant trigger point (TP). However, few comparable, high quality studies exist regarding the robustness of TP examination. Our aim was to determine the inter-observer agreement of TP examination among four examiners and whether reproducibility is influenced by examiner clinical experience. Two experienced and two inexperienced clinicians each performed a standardized palpation of the upper Trapezius musculature. Each observer was asked to judge the presents/absence of clinically relevant TP(s) using clinician global assessment (GA). A random case mix of 81 female participants was examined, 14 being asymptomatic and the remainder suffering from neck/shoulder pain. Examiners received psychomotor training and video analysis feedback provided prior to and during the study in order to improve protocol standardization. Kappa co-efficients were calculated for all possible examiner pairings. Good agreement was noted between the experienced pairing (κ= 0.63). Moderate levels of agreement were observed among the two mixed pairings (κ=0.35 and 0.47 respectively). However, poor agreement was observed for the inexperienced pairing (κ=0.22). Inter-observer agreement was not stable with the experienced pairing in particular, exhibiting a sharp decline in agreement during the latter portion of the study. Identification of clinically relevant TPs of the upper Trapezius musculature is a reproducible procedure when performed by two experienced clinicians. However, an experienced-inexperienced observer pairing can yield acceptable levels of agreement. A protracted period of data collection may be detrimental to inter-observer agreement.

AB - A clinical diagnosis of Myofascial Pain Syndrome (MPS) requires manual palpation for the identification of at least one clinically relevant trigger point (TP). However, few comparable, high quality studies exist regarding the robustness of TP examination. Our aim was to determine the inter-observer agreement of TP examination among four examiners and whether reproducibility is influenced by examiner clinical experience. Two experienced and two inexperienced clinicians each performed a standardized palpation of the upper Trapezius musculature. Each observer was asked to judge the presents/absence of clinically relevant TP(s) using clinician global assessment (GA). A random case mix of 81 female participants was examined, 14 being asymptomatic and the remainder suffering from neck/shoulder pain. Examiners received psychomotor training and video analysis feedback provided prior to and during the study in order to improve protocol standardization. Kappa co-efficients were calculated for all possible examiner pairings. Good agreement was noted between the experienced pairing (κ= 0.63). Moderate levels of agreement were observed among the two mixed pairings (κ=0.35 and 0.47 respectively). However, poor agreement was observed for the inexperienced pairing (κ=0.22). Inter-observer agreement was not stable with the experienced pairing in particular, exhibiting a sharp decline in agreement during the latter portion of the study. Identification of clinically relevant TPs of the upper Trapezius musculature is a reproducible procedure when performed by two experienced clinicians. However, an experienced-inexperienced observer pairing can yield acceptable levels of agreement. A protracted period of data collection may be detrimental to inter-observer agreement.

M3 - Poster

ER -

Myburgh C, Lauridsen HH, Larsen AH, Hartvigsen J. The inter-examiner reliability of standardized manual palpation for the identification of clinically relevant myofascial triggerpoints. 2010. Poster session presented at The Society for Back Pain Research - Annual General Meeting: The life course of back pain - are we making a difference?, Odense, Denmark.