Confiabilidade inter e intraexaminador do diagnóstico de pontos-gatilho miofasciais e limiar de dor à pressão em músculos do ombro

Objectives: To verify the interrater and intrarater reliability of the diagnosis of myofascial trigger points (MTrPs) and pressure pain threshold (PPT) in the shoulder muscles in asymptomatic individuals and individuals with symptoms of unilateral subacromial impingement syndrome (SIS). Methods: Thi...

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Autor principal: Nascimento, José Diego Sales do
Outros Autores: Sousa, Catarina de Oliveira
Formato: Dissertação
Idioma:por
Publicado em: Brasil
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Endereço do item:https://repositorio.ufrn.br/jspui/handle/123456789/22132
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Resumo:Objectives: To verify the interrater and intrarater reliability of the diagnosis of myofascial trigger points (MTrPs) and pressure pain threshold (PPT) in the shoulder muscles in asymptomatic individuals and individuals with symptoms of unilateral subacromial impingement syndrome (SIS). Methods: This is a reliability study, composed to 52 individuals, 26 asymptomatic (12 men and 14 women; 33,8±12,02 years old; 23,99 kg/m2 of BMI) and 26 with symptoms of unilateral SIS (12 men and 14 women; 33,77±11,76 years old; 24,26 kg/m2 of BMI). All of the individuals were evaluated by two novice raters, independent and blinded to clinical condition of the individual. The procedures consisted of evaluation the shoulder muscles for identification and classification of MTrPs in six muscles (upper trapezius, lower trapezius, infraspinatus, supraspinatus, pectoralis minor, and middle deltoid) and PPT in also six muscles (upper trapezius, lower trapezius, infraspinatus, supraspinatus, middle deltoid, and tibialis anterior), evaluated in the same day. Results: The intrarater and interrater reliability of identification of MTrPs was, generally, moderated to almost perfect with percentages of agreements (PA) >70%, in both groups, in exception of three muscles in the intrarater reliability and four muscles in the interrater reliability that presented PA<70% and reliability between slight and fair. In the classification of MTrPs, the reliability of rater 1was slight and fair in four muscles, despite the PA>70% only in two muscles; and the rater 2 obtained PA> 70% in all muscles and reliability between good almost perfect. For the interrater reliability of the classification of MTrPs, this was between slight and moderate, with PA>70% in only one muscle. About the PPT, the intrarater reliability of both raters was good or almost perfect (ICC: 0.73 – 0.96) in asymptomatic and symptomatic individuals, the interrater reliability was almost perfect (ICC: 0.85 – 0.94) in asymptomatic individuals and between good or almost perfect (ICC: 0.77 – 0.91) in symptomatic individuals. Conclusion: This studyshowed acceptable intrarater and interrater reliability for clinical practicing to identification of MTrPs, independent of muscles evaluated, but variable between clinical conditions. About the PPT, the intrarater and interrater reliability presented proper to using in clinical studies and practice, providing reference values for PPT.