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This mixed-method blinded research study used high-frequency diagnostic medical sonography (DMS) to document myofascial trigger points (MTrPs) associated with ankle/foot pain. A total of 17 symptomatic and 8 asymptomatic participants provided 500 MTrP areas for palpation. Forty-nine of these MTrP areas (including 16 tender points, 15 palpable MTrPs...
Context in source publication
... participants were first asked to complete a question- naire consisting of four written sections. The first section consisted of the widely used SF-12 Health Survey (modi- fied) to access their overall health, both mentally and physically. 12 The second section was the Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A), which is a valid and reliable tool for measur- ing Achilles tendinopathy. The scores are summated for a total of 100, where a score of 100 equates to an asymp- tomatic person. While the VISA-A is an index of severity of Achilles tendinopathy, other conditions that influence the lower limb function, such as an ankle sprain, will reduce a person's VISA-A score. 13 The third section included a visual analog scale (VAS) for participants to rate their ankle/foot pain for each limb on a scale of 0 to 10 (Figure 1). 14 The fourth section included demographic questions, along with occupation and sports activity inquiries. In addition to the written data collected, another researcher not blinded to the participant's symptomology obtained a thorough history about the person's ankle/foot pain, inclusive of current and past ...
... W badaniach ultrasonograficznych (ang. ultrasound, US) w okolicach stawu skokowego i grzbietowej części stopy rozmiar TR wynosił między 0,05 do 0,21 cm 2 . S. Skidar zauważył, że TR w okolicach mięśnia czworobocznego grzbietu występują jako dyskretne, ogniskowe, hipoechogeniczne obszary o eliptycznym kształcie i powierzchni ok. ...
Introduction and Objective. The myofascial pain syndrome (MPS) is an important clinical problem which, despite numerous scientific reports, remains not fully understood. This refers in particular to unclearly stated pathomechanism and undefined diagnostic and therapeutic standards. In daily clinical practice, palpation is the most commonly applied method of myofascial pain syndrome diagnostics. However, this may be associated with inaccurate diagnosis. Therefore, the diagnosis of myofascial pain syndrome requires reliable, repeatable measurements which should be characterized by high sensitivity in order to detect clinically important changes. The aim of this study is to review the objective diagnostic methods essential for the correct diagnosis of myofascial pain syndrome. Brief description of the state of knowledge. The progress of clinical medicine depends on the ability to accurately diagnose the disease and objectively assess the effects of the treatment. Therefore, it seems crucial to develop effective, objective methods for diagnosing myofascial pain syndrome. Currently, there is no consensus among clinicians regarding the myofascial pain syndrome diagnostic procedure. Conclusion. Manual palpation performed by an experienced physiotherapist seems to be the most reliable examination, followed by establishing the Simons’ diagnostic criteria on its basis, together with supporting the diagnosis using one of the objective tools assessing changes in muscle tissue suggesting the presence of trigger points.
... For the evaluation of pain severity, medical experts used a Visual Analogue Scale (VAS; Aitken, 1969) with a range of scores from 1 to 10. The version used, an Spanish adaptation of the proposal by Zale et al. (2015), included, in addition to numbers, a range of colors (green -yellow -red) and a series of words (none, annoying, uncomfortable, dreadful, horrible, agonizing), both markers ordered according to severity. ...
The SIMS is used in the medico-legal context to assess people who have suffered a traffic accident without proven scientific evidence to support this procedure. The objective of this research is to evaluate the SIMS' ability to discriminate instructed malingerers, general population, patients who have suffered a traffic accident, and overreporting patients. A simulation design was used to evaluate a total of 650 subjects divided into the four mentioned groups. Our results indicate that the cutoff scores proposed by the authors of the English and Spanish versions (14 and 16) produce moderate sensitivity and specificity values. With a cutoff score of 10, specificity decreases, but sensitivity significantly increases. These results suggest that the SIMS needs to be adapted to the context's particularities, either by using the proposed cutoff score and other instruments that compensate for the low specificity or by designing new subscales that include symptoms that are typical for the usual conditions in the context.
This study systematically reviewed the published literature on the objective characterization of myofascial pain syndrome and myofascial trigger points using imaging methods. PubMed, Embase, Ovid and the Cochrane Library databases were utilized, while citation searching was conducted in Scopus. Citations were restricted to those published in English and in peer-reviewed journals between 2000-2021. Out of 1,762 abstracts screened, 69 articles underwent full-text review and 33 were included. Imaging data assessing myofascial trigger points (MTrPs) or myofascial pain syndrome (MPS) were extracted and important qualitative and quantitative information on general study methodologies, study populations, sample sizes, and MTrP/MPS evaluation were tabulated. Methodological quality of eligible studies was assessed based on the QUADAS (Quality Assessment of Diagnostic Accuracy Studies) criteria. Biomechanical properties and blood flow of active and latent MTrPs assessed via imaging were found to be quantifiably distinct from those of healthy tissue. While these studies show promise, more studies are needed. Future studies should focus on assessing diagnostic test accuracy and testing the reproducibility of results to establish the best performing methods. Increasing methodological consistency would further motivate implementing imaging methods in larger clinical studies. Considering the evidence on efficacy, cost, ease of use and time constraints, US-based methods are currently the imaging modalities of choice for MPS/MTrP assessment.
Ultrasound-guided injections in pain medicine are a common intervention. They have been used to manage myofascial trigger points (MTrPs) in different muscles of the body. The main objectives of this article were to review ultrasound-guided injection techniques used for treating MTrPs. We also summarize the anatomy and sonoanatomy of MTrPs using the upper trapezius muscle as an example.
Objective: To achieve a statistical estimate of the agreement of manual palpation for identification of myofascial trigger points (MTrPs) and secondarily to investigate potential factors impacting the agreement of this technique. Methods: We searched MEDLINE(R) and Embase for studies examining the reproducibility of manual palpation for the identification of MTrPs from the year 2007 to present. In addition, we utilized studies identified by 2 comprehensive systematic reviews that covered the period before 2007. The included studies were original peer-reviewed research articles and included Cohen κ measures or data with which to calculate Cohen κ. Studies were excluded if they lacked a measure of variability or information required to calculate variability. Studies that examined palpation through body cavities were also excluded. Of the 18 potentially relevant articles only 6 met inclusion criteria including 363 patients. Modified QUADAS tool was used to assess study validity. Subgroup comparisons were made utilizing Q and Z tests. Results: An estimate of κ=0.452 (95% confidence interval, 0.364-0.540) was obtained for interrater agreement of manual palpation of MTrPs. Localized tenderness (κ=0.676) and pain recognition (κ=0.575) were the most reliable criteria. Only 1 study met inclusion criteria for intrarater agreement and therefore no meta-analysis was performed. Discussion: Use of manual palpation for identification of MTrPs is unreliable, and future investigation should focus on integration with more reliable techniques.
The objective of this study was to determine if a relationship exists between sonographic pathological findings of the ankle/foot and self-reported ankle/foot pain. Symptomatic and asymptomatic participants were recruited and evaluated using sonographic imaging of the ankle and foot bilaterally. Participants also completed the Short Form<@150>12 (SF-12, a national physical and mental health scoring system), a visual analog scale (VAS) for pain, and the Victorian Institute of Sports Assessment–Achilles (VISA-A, a scoring system for Achilles tendon abnormalities), as well as provided a health history and demographic information. Twenty-five participants were evaluated. Symptomatic participants had below average physical SF-12 scores (mean [SD], 48.3 [7.3]), while asymptomatic patients had above-average physical SF-12 scores (54.9 [4.0]). Painful right ankle and/or foot were significantly associated with SF-12 physical health (R2 = 0.2, P < .03) and VISA-A (R2 = 0.6, P < .001) scores. Painful left ankle/foot was associated with only VISA-A (R2 = 0.5, P < .003). The modified D’Agostino scores for positive sonographic evidence of pathology were statistically linked to painful right (P < .02) and left ankle/foot (P < .04). The combination of SF-12 physical health score, palpable myofascial trigger points (MTrPs), and MTrPs sonographically visualized were statistically associated with the VAS for pain (P < .02). In conclusion, sonography of the foot/ankle combined with self-reported data could aid in the holistic evaluation of ankle/foot pain.