Nascimento José Diego Sales do, Alburquerque-Sendín Francisco, Vigolvino Lorena Passos, Oliveira Wandemberg Fortunato de, Sousa Catarina de Oliveira
Neuromuscular Performance Analysis Laboratory-Department of Physiotherapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil.
Department of Sociosanitary Sciences, Radiology and Physical Medicine, University of Córdoba, Córdoba, Spain.
Arch Phys Med Rehabil. 2018 Jan;99(1):49-56. doi: 10.1016/j.apmr.2017.06.020. Epub 2017 Jul 24.
To determine inter- and intraexaminer reliability of examiners without clinical experience in identifying and classifying myofascial trigger points (MTPs) in the shoulder muscles of subjects asymptomatic and symptomatic for unilateral subacromial impact syndrome (SIS).
Within-day inter- and intraexaminer reliability study.
Physical therapy department of a university.
Fifty-two subjects participated in the study, 26 symptomatic and 26 asymptomatic for unilateral SIS.
Two examiners, without experience for assessing MTPs, independent and blind to the clinical conditions of the subjects, assessed bilaterally the presence of MTPs (present or absent) in 6 shoulder muscles and classified them (latent or active) on the affected side of the symptomatic group. Each examiner performed the same assessment twice in the same day.
Reliability was calculated through percentage agreement, prevalence- and bias-adjusted kappa (PABAK) statistics, and weighted kappa.
Intraexaminer reliability in identifying MTPs for the symptomatic and asymptomatic groups was moderate to perfect (PABAK, .46-1 and .60-1, respectively). Interexaminer reliability was between moderate and almost perfect in the 2 groups (PABAK, .46-.92), except for the muscles of the symptomatic group, which were below these values. With respect to MTP classification, intraexaminer reliability was moderate to high for most muscles, but interexaminer reliability was moderate for only 1 muscle (weighted κ=.45), and between weak and reasonable for the rest (weighted κ=.06-.31).
Intraexaminer 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.
确定在识别和分类单侧肩峰下撞击综合征（SIS）无症状和有症状受试者肩部肌肉中的肌筋膜触发点（MTP）方面，无临床经验的检查者之间以及检查者内部的可靠性。
日内检查者之间以及检查者内部的可靠性研究。
一所大学的物理治疗科。
52名受试者参与了该研究，其中26名有单侧SIS症状，26名无症状。
两名无评估MTP经验的检查者，独立且对受试者的临床状况不知情，双侧评估6块肩部肌肉中MTP的存在情况（存在或不存在），并对有症状组受影响一侧的MTP进行分类（潜伏性或活动性）。每位检查者在同一天进行两次相同的评估。
通过百分比一致性、患病率和偏差调整的kappa（PABAK）统计以及加权kappa计算可靠性。
有症状组和无症状组在识别MTP方面的检查者内部可靠性为中等至完美（PABAK分别为0.46 - 1和0.60 - 1）。两组检查者之间的可靠性在中等至几乎完美之间（PABAK为0.46 - 0.92），有症状组的肌肉除外，其低于这些值。关于MTP分类，大多数肌肉的检查者内部可靠性为中等至高，但检查者之间的可靠性仅对1块肌肉为中等（加权κ = 0.45），其余肌肉为弱至合理之间（加权κ = 0.06 - 0.31）。
在临床实践中，检查者内部在识别和分类MTP方面的可靠性是可以接受的。然而，检查者之间的可靠性仅在识别MTP方面可靠，有症状一侧的可靠性值较低。
