Wang-Price Sharon, Zafereo Jason, Brizzolara Kelli, Mackin Brendan, Lawson Larry, Seeger Dayna, Lawson Shannon
School of Physical Therapy, Texas Woman's University, Dallas, Texas.
Department of Physical Therapy, University of Texas Southwestern Medical Center, Dallas, Texas.
J Manipulative Physiol Ther. 2019 Jul;42(6):416-424. doi: 10.1016/j.jmpt.2018.11.021. Epub 2019 Jul 20.
The purpose of this study was to determine the psychometric properties of pressure pain threshold (PPT) testing in adults with and without neck-shoulder pain and tenderness and to compare the differences in PPT measurements between the seated and prone positions.
Thirty asymptomatic adults and 30 symptomatic patients with intermittent neck-shoulder pain and tenderness completed the study. A pressure algometer was used to assess PPTs at specific points on the middle deltoid, levator scapulae, and upper trapezius muscles of the dominant side of the asymptomatic individuals and the painful side of the patients. Four trials were performed on each muscle in both the seated and prone positions. To determine between-day reliability, a subset of the participants returned to repeat the testing.
The intraclass correlation coefficients showed good to excellent within-session reliability and fair to excellent between-day reliability of PPT measurements in both the seated and prone positions for both groups. There were significant differences between groups for all muscles in both positions (P < .05) except for the upper trapezius muscle in the prone position. In addition, significant differences were found between the 2 testing positions for the middle deltoid and upper trapezius muscles in the symptomatic group and for the middle deltoid muscle in the asymptomatic group.
The results of the study suggest that PPT testing could be useful for distinguishing individuals with and without neck-shoulder pain and tenderness. Further, the patient's position should be considered when testing PPT, specifically at the middle deltoid or upper trapezius muscles.
本研究旨在确定压力疼痛阈值（PPT）测试在有无颈肩痛及压痛的成年人中的心理测量特性，并比较坐位和俯卧位时PPT测量值的差异。
30名无症状成年人和30名有间歇性颈肩痛及压痛的有症状患者完成了本研究。使用压力痛觉计评估无症状个体优势侧以及患者疼痛侧三角肌中部、肩胛提肌和斜方肌上部特定点的PPT。在坐位和俯卧位对每块肌肉进行4次测试。为了确定日间可靠性，部分参与者返回重复测试。
组内相关系数显示，两组在坐位和俯卧位时PPT测量的组内可靠性良好至优秀，日间可靠性一般至优秀。除俯卧位的斜方肌上部外，两组在两个位置上所有肌肉的测量值均存在显著差异（P < .05）。此外，有症状组三角肌中部和斜方肌上部以及无症状组三角肌中部在两个测试位置之间存在显著差异。
研究结果表明，PPT测试有助于区分有无颈肩痛及压痛的个体。此外，在测试PPT时应考虑患者的体位，特别是在三角肌中部或斜方肌上部。
