Center for Health Research and Movement Science, University of Santo Tomas, Philippines; College of Rehabilitation Sciences, University of Santo Tomas, Philippines.
Center for Health Research and Movement Science, University of Santo Tomas, Philippines; College of Rehabilitation Sciences, University of Santo Tomas, Philippines.
J Bodyw Mov Ther. 2023 Jul;35:238-243. doi: 10.1016/j.jbmt.2023.04.013. Epub 2023 Apr 14.
Palpation evaluates the fascia, a three-dimensional web of connective tissues. We propose altered fascia system displacement in patients with myofascial pain syndrome. This study determined the concurrent validity of palpation and musculoskeletal ultrasound (MSUS) videos played on Windows Media Player 10 (WMP) when evaluating the direction of the fascia system's displacement at the end of the cervical active range of motion (AROM).
This cross-sectional study used palpation as index test and MSUS videos on WMP as reference test. First, three physical therapists palpated right and left shoulders for each cervical AROM. Second, during cervical AROM, PT-Sonographer recorded the fascia system displacement. Third, using the WMP, the physical therapists evaluated the direction of skin, superficial and deep fascia displacements at the end of cervical AROM. MedCalc Version 19.5.3 determined the "exact" Clopper-Pearson Interval (CPI).
We found strong accuracy between palpation and MSUS videos on WMP when determining the direction of skin displacement during cervical flexion and extension (CPI= 78.56 to 96.89). There was moderate agreement between palpation and MSUS videos on WMP when determining the direction of the skin, superficial fascia, and deep fascia displacements during cervical lateral flexion and rotation (CPI= 42.25 to 64.13).
Skin palpation during cervical flexion and extension may be useful in evaluating patients with myofascial pain syndrome (MPS). It is unclear what fascia system was evaluated when shoulders were palpated at the end of cervical lateral flexion and rotation. Palpation as diagnostic tool for MPS was not investigated.
触诊评估筋膜，即三维结缔组织网。我们提出在肌筋膜疼痛综合征患者中，筋膜系统的移位发生改变。本研究旨在确定触诊与 Windows Media Player 10（WMP）上播放的肌肉骨骼超声（MSUS）视频在评估颈椎主动活动范围（AROM）末端筋膜系统移位方向时的同时效度。
这是一项横断面研究，使用触诊作为指标试验，WMP 上的 MSUS 视频作为参考试验。首先，三位物理治疗师对每个颈椎 AROM 的右侧和左侧肩部进行触诊。其次，在颈椎 AROM 过程中，PT 超声医师记录筋膜系统的移位。然后，物理治疗师使用 WMP 评估颈椎 AROM 末端皮肤、浅筋膜和深筋膜的移位方向。MedCalc Version 19.5.3 确定“精确”Clopper-Pearson 区间（CPI）。
我们发现，在确定颈椎屈伸过程中皮肤移位方向时，触诊与 WMP 上的 MSUS 视频具有很强的准确性（CPI=78.56 至 96.89）。在确定颈椎侧屈和旋转过程中皮肤、浅筋膜和深筋膜的移位方向时，触诊与 WMP 上的 MSUS 视频具有中等程度的一致性（CPI=42.25 至 64.13）。
颈椎屈伸过程中的皮肤触诊可能有助于评估肌筋膜疼痛综合征（MPS）患者。当触诊颈椎侧屈和旋转末端的肩部时，不清楚评估的是哪个筋膜系统。触诊作为 MPS 的诊断工具尚未得到研究。
