Orthopaedic department, Central Manchester University Hospitals, Manchester, UK.
Physiotherapy Department in Sports City at English Institute of Sport, Manchester.
Pain Med. 2017 Jul 1;18(7):1382-1393. doi: 10.1093/pm/pnw326.
A previous study on shoulder pain mapping showed specific pain patterns for common shoulder disorders. This study aimed to test those patterns for accuracy, modify shoulder pain mapping as needed, and observe their reliability and validity.
This prospective study used a two-step process and was undertaken to determine its potential utility in daily practice. New shoulder pain patients marked their pain, its character and severity, on a custom-made mapping form. Then a researcher blinded to the diagnoses gave their estimations on the basis of previously established maps, and they were correlated with final diagnoses. Subsequently, a guide table was developed on how to read the maps, and intertester reliability was performed with three independent testers.
The study included 194 patients, and the overall accuracy for estimations was between 45.4% and 49.5%. The sensitivity was high, especially for instability, followed by calcific tendinitis, acromio-calvicular joint pathology, and impingement. The intertester reliability showed clinically significant agreement between testers for both disease groups (κ = 0.70) and individual disorders (κ = 0.52).
This was a unique and extensive study on shoulder pain mapping. The study concluded that pain mapping could be a useful adjunct to the clinical assessment of patients with shoulder pain and can be used in the primary care setting as well as secondary care and for research.
先前的肩部疼痛图谱研究显示了常见肩部疾病的特定疼痛模式。本研究旨在测试这些模式的准确性，根据需要修改肩部疼痛图谱，并观察其可靠性和有效性。
本前瞻性研究采用两步法进行，旨在确定其在日常实践中的潜在用途。新的肩部疼痛患者在特制的映射表上标记他们的疼痛、性质和严重程度。然后，一位对诊断结果不知情的研究人员根据先前建立的图谱进行估计，并将其与最终诊断进行相关性分析。随后，制定了如何解读图谱的指南表，并由三位独立的测试人员进行了测试者间可靠性测试。
该研究纳入了 194 名患者，总体估计准确性在 45.4%至 49.5%之间。其敏感性较高，尤其是对不稳定、钙化性肌腱炎、肩锁关节病变和撞击综合征。疾病组（κ=0.70）和个别疾病（κ=0.52）的测试者间可靠性显示出了临床显著的一致性。
这是一项针对肩部疼痛图谱的独特且广泛的研究。研究得出的结论是，疼痛图谱可以作为肩部疼痛患者临床评估的有用辅助手段，可以在初级保健环境以及二级保健和研究中使用。
