On the basis of the limited number of studies available , and significant problems with their design , reporting , statistical integrity , and clinical applicability , physical examination can not currently be recommended as a reliable test for the diagnosis of trigger points .
BACKGROUND Trigger points are promoted as an important cause of musculoskeletal pain .
There is no accepted reference st and ard for the diagnosis of trigger points , and data on the reliability of physical examination for trigger points are conflicting .
OBJECTIVES To systematic ally review the literature on the reliability of physical examination for the diagnosis of trigger points .
Test-retest reliability of myofascial trigger point detection in patients with rotator cuff tendonitis
Objectives : To investigate the test-retest reliability of the following clinical diagnostic characteristics of myofascial trigger points : taut b and , spot tenderness , jump sign , pain recognition , referred pain and local twitch responses ( LTRs ) . Design : Test-retest reliability study . Setting : This study was undertaken in an outpatient physiotherapy department . Subjects : Fifty-eight patients ( 31 males and 27 females ) with rotator cuff tendonitis were recruited into this study . Intervention : Rotator cuff muscles were assessed by an expert for the presence or absence of the main clinical diagnostic characteristics of trigger point assessment . The process was then repeated three days later by the same expert . Main measures : Outcomes included the presence or absence of : a taut b and , spot tenderness , jump sign , pain recognition , referred pain and LTRs . Results : Kappa values between testing situations for the taut b and , spot tenderness , jump sign and pain recognition were 1 . Kappa scores for referred pain ranged between 0.79 and 0.88 and for the local twitch response between 0.75 and 1 depending on the muscles under investigation . Conclusions : The presence or absence of the taut b and , spot tenderness , jump sign and pain recognition was highly reliable between sessions . Referred pain and local twitch response reliability varied depending on the muscle being studied
On the basis of the limited number of studies available , and significant problems with their design , reporting , statistical integrity , and clinical applicability , physical examination can not currently be recommended as a reliable test for the diagnosis of trigger points .
BACKGROUND Trigger points are promoted as an important cause of musculoskeletal pain .
There is no accepted reference st and ard for the diagnosis of trigger points , and data on the reliability of physical examination for trigger points are conflicting .
OBJECTIVES To systematic ally review the literature on the reliability of physical examination for the diagnosis of trigger points .