Palpation of Muscle and Skin. Is this a Reliable and Valid Procedure in Assessment of Patients with Long-lasting Musculoskeletal Pain?

Abstract

The aims of this study were to investigate reliability and aspects of validity of a previously developed method called the Global Physiotherapeutic Muscle Examination (GPM), which comprises items related to palpation of Muscle (18 items) and Skin (12 items). Inter-tester reliability was examined by three physiotherapists examining 19 persons. Construct and discriminative validity was studied by data from 247 patients with long-lasting musculoskeletal pain and 104 healthy subjects. For the patients, concurrent validity was examined by correlating psychological functioning, measured with the revised version of the Minnesota Multiphasic Personality Inventory (MMPI-2), as well as information about pain, with the domains of Muscle and Skin. Reliability was acceptable, with overall intra-class correlation coefficients ranging from 0.54 to 0.84, but with low measurement error. Construct evaluation was done by means of Structural Equation Modeling (SEM), resulting in a modified and improved model with fewer tests: 12 within Muscle and eight within Skin. Composite scores of palpation differed significantly between healthy subjects and patients, and between sub-groups of patients. A relationship was found between Muscle and Skin and psychological characteristics, but differently for females and males. Pain showed a low but significant correlation only to the Muscle domain. The items included in a modified model of palpation can be used in a reliable and valid way when screening patients with long-lasting pain.

• Concurrent Validity
• Construct Validity
• Discriminative Validity
• Gender
• Inter-tester Reliability
• Normative Data
• Mmpi-2
• Sem