Document Detail

A systematic, critical review of manual palpation for identifying myofascial trigger points: evidence and clinical significance.
MedLine Citation:
PMID:  18503816     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine the reproducibility of manual palpation in identifying trigger points based on a systematic review of available literature. DATA SOURCES: Medline (1965-2007), CINHAL (1982-2007), ISI Web of Science (1945-2007), and MANTIS (1966-2007) databases and reference lists of articles. STUDY SELECTION: Reproducibility studies relating to identification and diagnosis of trigger points through palpation. Acceptable studies were required to specifically consider either inter- or intrarater reliability of trigger point identification through manual palpation and include kappa statistics as part of their statistical assessment. DATA EXTRACTION: Three independent reviewers considered the studies for inclusion and rated their methodologic quality based on the Standards for Reporting of Diagnostic Accuracy guidelines for the reporting of diagnostic studies. DATA SYNTHESIS: Eleven studies were initially included; however, 5 were subsequently excluded based on the inclusion and exclusion criteria. Only 2 studies were judged to be of high quality, and the level of evidence criteria suggested that, at best, moderate evidence could be found from which to make pronouncements on the literature. Only local tenderness of the trapezius (kappa range, .15-.62) and pain referral of the gluteus medius (kappa range, .298-.487) and quadratus lumborum (kappa range, .36-.501) were found to be reproducible. CONCLUSIONS: The methodologic quality of the majority of studies for the purpose of establishing trigger point reproducibility is generally poor. More high-quality studies are needed to comment on this procedure. Clinicians and scientists are urged to move toward simpler, global assessments of patient status.
Corrie Myburgh; Anders Holsgaard Larsen; Jan Hartvigsen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  89     ISSN:  1532-821X     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-27     Completed Date:  2008-06-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1169-76     Citation Subset:  AIM; IM    
Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark.
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MeSH Terms
Myofascial Pain Syndromes / diagnosis*
Reproducibility of Results
Research Design

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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