Reliability of Clinical Assessment Measures for the Classification of Myofascial Pain Syndrome

SUMMARY

Purposes: There is still controversy regarding the clinical relevance of myofascial pain syndromes [MPS] because the current approaches to diagnosis lack defined reliability and validity. The express purpose of the proposed study will be to establish reliable classification criteria for MPS in the upper torso [versus healthy normal controls, HNC] which can then be applied [for research and clinical purposes] with a high degree of sensitivity and specificity.

Methods: By the consensus of recognized authorities, the design of a multicenter [N = 20 centers], controlled trial of classification [diagnostic] criteria was developed immediately following MYOPAIN '98. At each study center, twenty study subjects in each of two groups [MPS, HNC] will be identified [Delphi method] and examined [un-blinded] for the record by the center's principal investigator. Inclusion criteria will limit MPS to involvement of 10 specific muscles in the neck/shoulder [upper torso] area. Fifteen questions or maneuvers will be applied on a standardized basis to each of the 10 muscles. A second examiner [blinded to the diagnosis group] at each center will conduct the same standardized examination on all study subjects and propose a diagnosis. Data analysis will determine the combination of questions and maneuvers which best distinguish MPS in the upper torso from HNC. The reliability of the resultant composite criteria will be determined for each examined muscle and for all 10 muscles.

Conclusions: It is hoped that this approach will provide accurate data for examination of MPS in the upper torso and will establish a model for developing classification [diagnostic] criteria for MPS at all other potentially affected body sites.

KEYWORDS:

• Regional pain
• trigger point
• diagnosis
• diagnostic criteria
• clinical study