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乳腺癌幸存者上肢疼痛中肌筋膜触发点的识别:评估者间可靠性。

Identification of Myofascial Trigger Points in Breast Cancer Survivors with Upper Limb Pain: Interrater Reliability.

机构信息

Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium.

Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium.

出版信息

Pain Med. 2018 Aug 1;19(8):1650-1656. doi: 10.1093/pm/pnx299.

Abstract

OBJECTIVE

Despite the increasing awareness of the contribution of myofascial dysfunctions to upper limb pain in breast cancer survivors, reliability of the identification of myofascial trigger points (MTPs) in this population has not yet been investigated. Therefore, the aim of the present study was to investigate the interrater reliability of the identification of MTPs by palpation at the upper limb region in breast cancer survivors with upper limb pain.

DESIGN

Interrater reliability study.

SETTING

University Hospitals Leuven, Belgium.

SUBJECTS

Thirty breast cancer survivors with pain at the upper limb region.

METHODS

Nine muscles (upper trapezius, levator scapulae, infraspinatus, supraspinatus, teres major and minor, subscapularis, pectoralis major, and scalene muscles) at the operated side were examined. The weighted kappa (WK) coefficient and Absolute Agreement with 95% confidence intervals were calculated.

RESULTS

Moderate agreement was found for all examined upper limb muscles (WK = 0.41-0.60), except for the trapezius muscle, for which the agreement was almost perfect (WK = 0.83), and the supraspinatus muscle (WK = 0.23), for which the agreement was only fair.

CONCLUSIONS

For most muscles, moderate interrater reliability for the identification of MTPs by palpation in breast cancer survivors with upper limb pain was found. Therefore, we concluded that the identification of MTPs by palpation may add to the diagnosis of the myofascial pain syndrome in breast cancer survivors.

摘要

目的

尽管人们越来越意识到筋膜功能障碍对上臂疼痛乳腺癌幸存者的贡献,但尚未研究该人群中肌筋膜触发点(MTP)的识别的可靠性。因此,本研究旨在调查在上臂疼痛的乳腺癌幸存者上肢区域触诊识别 MTP 的组间可靠性。

设计

组间可靠性研究。

地点

比利时鲁汶大学医院。

受试者

30 名上肢疼痛的乳腺癌幸存者。

方法

检查 9 块肌肉(上斜方肌、肩胛提肌、冈下肌、冈上肌、大圆肌和小圆肌、肩胛下肌、胸大肌和斜角肌)。计算加权 Kappa(WK)系数和 95%置信区间的绝对一致性。

结果

除斜方肌(WK=0.83)和冈上肌(WK=0.23)外,所有检查的上肢肌肉均显示出中度一致(WK=0.41-0.60),而斜方肌的一致性几乎为完美(WK=0.83),而冈上肌的一致性仅为适度(WK=0.23)。

结论

在上臂疼痛的乳腺癌幸存者中,触诊识别 MTP 的组间可靠性对于大多数肌肉为中度。因此,我们得出结论,触诊识别 MTP 可能有助于诊断乳腺癌幸存者的肌筋膜疼痛综合征。

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