Trigger Points of Supraspinatus Muscle: Osteopaths' Palpation Reproductibility and Ultrasound Translation

Study Overview
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Brief Summary
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Trigger points (TP) are described as hard, palpable nodules located within the taut bands of skeletal muscle (Bardoni, 2022). The aim of this study is to evaluate the reproductibility of palpation of TP between osteopaths and to compare this perception to ultrasound measures of echogenicity. Method: A sample of 61 patients will be included in the study. An osteopath will determine the eligibility of the study. The supraclavicular area will be mark every 2 cm to establish a grid for all evaluations. First an osteopath will evaluate with palpation the presence of TP at every box of the grid. A second osteopath will evaluate the same boxes and will be blinded to the result of the first osteopath. At each step of palpation, a pain assessment will be carried out at each box. Then, the ultrasound technician will evaluate the echogeneicity of every box and will be blinded to the prior results. The protocol will be approve by a french ethic committee.

Detailed Description
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sensitivity and specificity of osteopathic tests will be conducted in comparaison to echograph results (a binary outcomes assessing the presence of an hypoechogenicity). The reproductibility of osteopaths' tests will be be calculated using Cohen's kappa weighted by the distance between the TPs found. Finally, the pain reported by patients on areas with a TP defined by the osteopath, and the pain reported by patients on areas without a TP defined by the osteopath will be compared using a student test.

Official Title
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Trigger Points of Supraspinatus Muscle: Osteopaths' Palpation Reproductibility and Ultrasound Translation

Conditions
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Shoulder Pain

Intervention / Treatment
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* Diagnostic Test: osteopathic palpation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults (18 to 50 years old), affiliation to a social security scheme or beneficiary of such a scheme Exclusion Criteria: pregnant and breastfeeding women, adults under guardianship and protected patients. History of integumentary or muscular involvement in the area of interest Allergic reaction wish to stop the study

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: osteopathic palpation|comparaison of ultrasound caracteristics of areas with ad without TP|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| sensitivity and specificity of osteopathic tests | to compare osteopath TP detection to ultrasound echogenicity | at day 1 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Inter examiner reproductibility of TP detection | using Cohen's kappa weighted by the distance between the TPs found. Quadratic weighting will be used. | at day 1 | 
| camparison of pain reported by patient with TP detection by osteopath | using a student test between pain means in areas with and without TP | at day 1 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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trigger point, osteopathic palpation, ultrasound