Inter and intraexaminer reliability in identifying and classifying myofascial trigger points in shoulder muscles

Publication date: Available online 24 July 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): José Diego Sales do Nascimento, Francisco Alburquerque-Sendín, Lorena Passos Vigolvino, Wandemberg Fortunato de Oliveira, Catarina de Oliveira Sousa
ObjectiveTo determine inter and intraexaminer reliability of examiners without clinical experience in identifying and classifying MTPs in the shoulder muscles of subjects asymptomatic and symptomatic for unilateral SIS.DesignWithin-day inter and intraexaminer reliability study.SettingPhysical Therapy Department of a University.ParticipantsFifty-two subjects participated in the study, 26 symptomatic (SG) and 26 asymptomatic (AG) for unilateral SIS.InterventionsTwo examiners, without experience for assessment MTPs, independent and blind to the clinical conditions of the subjects, assessed bilaterally the presence of MTPs (present or absent) in six shoulder muscles and classified them (latent or active) on the affected side of the SG. Each examiner performed the same assessment twice in the same day.Main Outcome MeasuresThe reliability was calculated through Percentage Agreement (PA), Prevalence and Bias Adjusted Kappa Statistics (PABAK), and weighted Kappa (IKw).ResultsIntraexaminer reliability in identifying MTPs for the SG and AG was moderate to perfect (PABAK: 0.46-1 and 0.60-1, respectively). Interexaminer reliability was between moderate and almost perfect in the two groups (PABAK: 0.46-0.92), except for the muscles of the SG, which were below these values. With respect to MTP classification, intraexaminer reliability was moderate to high for the most muscles, but interexaminer reliability was moderate for only one muscle (IKw=0.45), and between weak and reasonable for the rest (IKw: 0.06 -0.31).ConclusionsIntraexaminer reliability is acceptable in clinical practice to identify and classify MTPs. However, interexaminer reliability proved to be reliable only to identify MTPs, with the symptomatic side exhibiting lower values of reliability.



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