Jacobs J W, Geenen R, van der Heide A, Rasker J J, Bijlsma J W
Department of Rheumatology, University Hospital Utrecht, The Netherlands.
Scand J Rheumatol. 1995;24(4):243-7. doi: 10.3109/03009749509100882.
To determine the reliability of tender point assessment by manual palpation in patients with fibromyalgia, and to investigate the sources of variance, tender point scores by manual palpation were obtained in 30 fibromyalgia patients by 2 investigators; the assessments were repeated after 1 week. Test-retest stability and inter-observer agreement of tender point scores was moderate to high. The most important sources of variance were inter-individual patient differences in (1) mean tenderness (pain thresholds) and (2) tender point profiles (consistent intra-individual differences between the 14 tender point scores), and (3) residual variance, not attributable to any systematic effect (error). It is concluded that the reliability of tender point assessment by manual palpation is acceptable. It seems to be not less than reliability of assessment by pressure algometer. Tender point scores in fibromyalgia reflect individual differences in mean pain thresholds as well as individual tender point profiles.
为确定纤维肌痛患者通过手动触诊进行压痛点评估的可靠性，并探究变异来源，两名研究者对30例纤维肌痛患者进行手动触诊以获取压痛点评分；1周后重复评估。压痛点评分的重测稳定性和观察者间一致性为中度到高度。最重要的变异来源为个体患者在以下方面的差异：（1）平均压痛（疼痛阈值）；（2）压痛点分布（14个压痛点评分之间个体内一致的差异）；以及（3）残余变异，不归因于任何系统效应（误差）。得出结论，通过手动触诊进行压痛点评估的可靠性是可接受的。其可靠性似乎不低于压力痛觉计评估的可靠性。纤维肌痛中的压痛点评分反映了平均疼痛阈值的个体差异以及个体压痛点分布。
