Da Silva Alyssa Conte, Aily Jéssica Bianca, Oliveira Ana Beatriz, Mattiello Stela Marcia
Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.
Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil..
J Manipulative Physiol Ther. 2020 Nov-Dec;43(9):855-863. doi: 10.1016/j.jmpt.2020.01.003. Epub 2020 Aug 27.
We sought to investigate the interrater and intrarater reliability of ultrasound and the minimum detectable change (MDC) for the trigger points (TrPs) active in the upper trapezius (UT) muscle in individuals with shoulder pain.
Forty individuals with shoulder pain were investigated for the presence of active TrPs in the UT muscle by means of ultrasound for the parameters of gray scale, muscle thickness of UT muscle at rest, and contraction and area of TrPs. The intrarater reliability was performed on 2 days, and interrater reliability on the same day. For the gray scale, the reliability was evaluated using the kappa coefficient (κ), while the other parameters were measured by the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and MDC.
For the gray scale, the intrarater agreement was almost perfect (κ = 1.00) and the interrater agreement was substantial (κ = 0.75). The intrarater and interrater reliability were excellent for most of the parameters, except for the area of TrPs (intrarater: ICC = 0.71, substantial; interrater: ICC = 0.52, substantial). The MDC for intrarater reliability varied between 0.04 and 0.05 (SEM% between 2.4% and 38.87%), and that for interrater reliability ranged from 0.05 to 0.07 (SEM% between 3.18% and 55.10%), with a higher value for area.
Parameters such as gray scale, resting muscle thickness, and muscle contraction of the UT muscle, obtained through ultrasound, showed excellent intrarater and interrater reliability with low SEM%. The intrarater and interrater reliability for the area deserves a caveat regarding their use.
我们试图研究超声检查的观察者间和观察者内可靠性，以及肩部疼痛患者上斜方肌（UT）中活跃触发点（TrP）的最小可检测变化（MDC）。
对40名肩部疼痛患者进行超声检查，以确定UT肌肉中活跃TrP的存在情况，检查参数包括灰度、UT肌肉静息时的厚度、收缩情况以及TrP的面积。观察者内可靠性在两天内进行评估，观察者间可靠性在同一天进行评估。对于灰度，使用kappa系数（κ）评估可靠性，而其他参数则通过组内相关系数（ICC）、测量标准误差（SEM）和MDC进行测量。
对于灰度，观察者内一致性几乎完美（κ = 1.00），观察者间一致性较高（κ = 0.75）。除TrP面积外，大多数参数的观察者内和观察者间可靠性都非常好（观察者内：ICC = 0.71，较高；观察者间：ICC = 0.52，较高）。观察者内可靠性的MDC在0.04至0.05之间（SEM%在2.4%至38.87%之间），观察者间可靠性的MDC在0.05至0.07之间（SEM%在3.18%至55.10%之间），面积的MDC值更高。
通过超声获得的UT肌肉灰度、静息肌肉厚度和肌肉收缩等参数，显示出良好的观察者内和观察者间可靠性，SEM%较低。TrP面积的观察者内和观察者间可靠性在使用时需谨慎。
