Ist die manuelle Untersuchung von aktiven myofaszialen Triggerpunkten bei Patienten mit Spannungskopfschmerzen zuverlässig?

Zusammenfassung

Die manuelle Untersuchung stellt die einfachste Methode dar, um myofasziale Triggerpunkte (mTrP) zu diagnostizieren. Dabei wird der betroffene Muskel anhand klinischer (maximale Druckempfindlichkeit innerhalb eines Hartspannstrangs, Reproduktion bekannter Symptome durch mechanische Stimulation) und zusätzlicher Diagnosekriterien (ausstrahlende Schmerzen) untersucht. Die Zuverlässigkeit der manuellen Untersuchung von mTrP wird aktuell jedoch kontrovers diskutiert.

Die vorliegende Studie bestimmte die Interrater-Reliabilität der palpatorischen Untersuchung klinischer und zusätzlicher Diagnosekriterien sowie der Gesamtbeurteilung und Lokalisation von aktiven mTrP im M. sternocleidomastoideus bei Patienten mit Spannungskopfschmerzen.

Die Diagnosekriterien Hartspannstrang, maximale Druckempfindlichkeit, Symptomreproduktion und ausstrahlende Schmerzen erzielten eine ausreichende bis moderate Interrater-Reliabilität, während die Kriterien Hartspannstrang und maximale Druckempfindlichkeit sowie die Gesamtbeurteilung der aktiven mTrP keine bis geringe Übereinstimmungen aufwiesen.

Abstract

Manual examination is the easiest method of diagnosing myofascial trigger points. The affected muscle is examined by using clinical (spot tenderness within a taut band, pain recognition through mechanical stimulation) and additional diagnostic criteria (referred pain). However, currently the reliability of the manual examination of mTrP has been discussed controversially.

This study determined the interrater reliability of palpatory examination of the clinical and additional diagnostic criteria as well as the overall assessment and localisation of active mTrP in the sternocleidomastoid muscle in patients with tension-type headache.

The diagnostic criteria taut band, local tenderness, symptom reproduction and referred pain shows an adequate to moderate interrater reliability. The criteria taut band and spot tenderness as well as the overall assessment of active mTrP show no to poor compliance.

Schlüsselwörter

myofasziale Triggerpunkte - Interrater-Reliabilität - manuelle Untersuchung - Spannungskopfschmerzen

Keywords

myofacial trigger points - interrater reliability - manual examination - tension-type headache

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