Nice D A, Riddle D L, Lamb R L, Mayhew T P, Rucker K
Virginia Commonwealth University Sports Medicine Center, Richmond.
Arch Phys Med Rehabil. 1992 Oct;73(10):893-8.
The purpose of this study was to determine the intertester reliability of assessments of the presence of trigger points in the region of the lumbar spine of patients with low back pain (LBP). A total of six trigger points described by Travell and Simons were studied. The trigger point examination procedures described by Travell and Simons were used by 12 physical therapists. Randomly paired therapists examined 50 patients for 197 trigger points. The Kappa coefficient, percent agreement, the observed proportion of positive agreement (Ppos), and the observed proportion of negative agreement (Pneg) were used to describe reliability. Kappa values ranged from .29 to .38. Percent agreement ranged from 76% to 79%. Ppos ranged from .43 to .52. The low Kappa and Ppos values suggest different therapists are unable to reliably determine when a trigger point is present in a patient with LBP. This study suggests the usefulness of examining for the presence of trigger points in patients with LBP should be questioned.
本研究的目的是确定对下腰痛（LBP）患者腰椎区域触发点存在情况评估的检查者间可靠性。共研究了特拉维尔和西蒙斯描述的六个触发点。12名物理治疗师采用了特拉维尔和西蒙斯描述的触发点检查程序。随机配对的治疗师对50名患者的197个触发点进行了检查。使用卡帕系数、一致率、观察到的阳性一致比例（Ppos）和观察到的阴性一致比例（Pneg）来描述可靠性。卡帕值范围为0.29至0.38。一致率范围为76%至79%。Ppos范围为0.43至0.52。较低的卡帕值和Ppos值表明，不同的治疗师无法可靠地确定LBP患者何时存在触发点。本研究表明，对LBP患者检查触发点存在情况的实用性值得质疑。
