Mateusz D. Kobylarz PT, PhD , Juan Antonio Valera-Calero PT, PhD , Sandra Sánchez-Jorge PT, PhD , Jorge Buffet-García PT, PhD , María José Díaz-Arribas PT, PhD , Ricardo Ortega-Santiago PT, PhD , Sebastian Klich PT, PhD
{"title":"用剪切波弹性成像法测量冈下肌潜在触发点及周围区域的僵硬度:检查者内部和检查者之间的可靠性分析。","authors":"Mateusz D. Kobylarz PT, PhD , Juan Antonio Valera-Calero PT, PhD , Sandra Sánchez-Jorge PT, PhD , Jorge Buffet-García PT, PhD , María José Díaz-Arribas PT, PhD , Ricardo Ortega-Santiago PT, PhD , Sebastian Klich PT, PhD","doi":"10.1016/j.apmr.2025.03.036","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>To explore the intra- and interexaminer reliability of shear wave elastograhy (SWE), (an objective alternative to highly subjective procedures with poor inter-rater reliability such as manual palpation) in measuring the stiffness of latent myofascial trigger points (MTrPs) and healthy surrounding areas in the infraspinatus muscle, pressure pain threshold (PPT), interexaminer reliability, and mean differences in SWE and PPTs between MTrPs and control points.</div></div><div><h3>Design</h3><div>Longitudinal observational study: Intra- and interexaminer reliability study.</div></div><div><h3>Setting</h3><div>A university laboratory.</div></div><div><h3>Participants</h3><div>Forty participants (N=40) with latent MTrPs within the infraspinatus muscle.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>One experienced examiner identified and classified latent MTrPs and selected an asymptomatic control point within the infraspinatus muscle. Later, 2 blinded examiners assessed once the PPTs (blinded to the scores) and acquired 2 SWE images of each location. Reliability estimates were calculated for assessing PPT<span> interexaminer reliability and SWE intra- and interexaminer reliability. PPT and SWE scores were compared by location (MTrP and control) and gender (male/female).</span></div></div><div><h3>Results</h3><div>PPTs were significantly lower in MTrPs than control points in males (<em>P=</em>.003) and females (<em>P=</em>.006), and lower in females than males (MTrP <em>P<</em>.001; control point <em>P=</em>.001). Good interexaminer reliability was found for PPTs (intraclass correlation coefficient [ICC]>0.84) and SWE (ICC>0.82). Intraexaminer reliability for SWE was excellent (ICC>0.95) in both the novice and experienced examiners.</div></div><div><h3>Conclusions</h3><div>This study demonstrated excellent SWE intraexaminer reliability (ICCs>0.9) and good interexaminer reliability (ICCs>0.82). Although PPT scores indicated significant differences in hyperirritability between latent MTrPs and control points, SWE measurements revealed no significant differences in muscle stiffness.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 9","pages":"Pages 1384-1391"},"PeriodicalIF":3.7000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Shear Wave Elastography for Measuring the Stiffness of Latent Trigger Points and Surrounding Areas in the Infraspinatus Muscle: Intra- and Interexaminer Reliability Analysis\",\"authors\":\"Mateusz D. Kobylarz PT, PhD , Juan Antonio Valera-Calero PT, PhD , Sandra Sánchez-Jorge PT, PhD , Jorge Buffet-García PT, PhD , María José Díaz-Arribas PT, PhD , Ricardo Ortega-Santiago PT, PhD , Sebastian Klich PT, PhD\",\"doi\":\"10.1016/j.apmr.2025.03.036\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><div>To explore the intra- and interexaminer reliability of shear wave elastograhy (SWE), (an objective alternative to highly subjective procedures with poor inter-rater reliability such as manual palpation) in measuring the stiffness of latent myofascial trigger points (MTrPs) and healthy surrounding areas in the infraspinatus muscle, pressure pain threshold (PPT), interexaminer reliability, and mean differences in SWE and PPTs between MTrPs and control points.</div></div><div><h3>Design</h3><div>Longitudinal observational study: Intra- and interexaminer reliability study.</div></div><div><h3>Setting</h3><div>A university laboratory.</div></div><div><h3>Participants</h3><div>Forty participants (N=40) with latent MTrPs within the infraspinatus muscle.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>One experienced examiner identified and classified latent MTrPs and selected an asymptomatic control point within the infraspinatus muscle. Later, 2 blinded examiners assessed once the PPTs (blinded to the scores) and acquired 2 SWE images of each location. Reliability estimates were calculated for assessing PPT<span> interexaminer reliability and SWE intra- and interexaminer reliability. PPT and SWE scores were compared by location (MTrP and control) and gender (male/female).</span></div></div><div><h3>Results</h3><div>PPTs were significantly lower in MTrPs than control points in males (<em>P=</em>.003) and females (<em>P=</em>.006), and lower in females than males (MTrP <em>P<</em>.001; control point <em>P=</em>.001). Good interexaminer reliability was found for PPTs (intraclass correlation coefficient [ICC]>0.84) and SWE (ICC>0.82). Intraexaminer reliability for SWE was excellent (ICC>0.95) in both the novice and experienced examiners.</div></div><div><h3>Conclusions</h3><div>This study demonstrated excellent SWE intraexaminer reliability (ICCs>0.9) and good interexaminer reliability (ICCs>0.82). Although PPT scores indicated significant differences in hyperirritability between latent MTrPs and control points, SWE measurements revealed no significant differences in muscle stiffness.</div></div>\",\"PeriodicalId\":8313,\"journal\":{\"name\":\"Archives of physical medicine and rehabilitation\",\"volume\":\"106 9\",\"pages\":\"Pages 1384-1391\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of physical medicine and rehabilitation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0003999325006161\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of physical medicine and rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0003999325006161","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
Shear Wave Elastography for Measuring the Stiffness of Latent Trigger Points and Surrounding Areas in the Infraspinatus Muscle: Intra- and Interexaminer Reliability Analysis
Objectives
To explore the intra- and interexaminer reliability of shear wave elastograhy (SWE), (an objective alternative to highly subjective procedures with poor inter-rater reliability such as manual palpation) in measuring the stiffness of latent myofascial trigger points (MTrPs) and healthy surrounding areas in the infraspinatus muscle, pressure pain threshold (PPT), interexaminer reliability, and mean differences in SWE and PPTs between MTrPs and control points.
Design
Longitudinal observational study: Intra- and interexaminer reliability study.
Setting
A university laboratory.
Participants
Forty participants (N=40) with latent MTrPs within the infraspinatus muscle.
Interventions
Not applicable.
Main Outcome Measures
One experienced examiner identified and classified latent MTrPs and selected an asymptomatic control point within the infraspinatus muscle. Later, 2 blinded examiners assessed once the PPTs (blinded to the scores) and acquired 2 SWE images of each location. Reliability estimates were calculated for assessing PPT interexaminer reliability and SWE intra- and interexaminer reliability. PPT and SWE scores were compared by location (MTrP and control) and gender (male/female).
Results
PPTs were significantly lower in MTrPs than control points in males (P=.003) and females (P=.006), and lower in females than males (MTrP P<.001; control point P=.001). Good interexaminer reliability was found for PPTs (intraclass correlation coefficient [ICC]>0.84) and SWE (ICC>0.82). Intraexaminer reliability for SWE was excellent (ICC>0.95) in both the novice and experienced examiners.
Conclusions
This study demonstrated excellent SWE intraexaminer reliability (ICCs>0.9) and good interexaminer reliability (ICCs>0.82). Although PPT scores indicated significant differences in hyperirritability between latent MTrPs and control points, SWE measurements revealed no significant differences in muscle stiffness.
期刊介绍:
The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities.
Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.