title: Pressure-controlled palpation: a new technique which increases the reliability of manual palpation.
abstract: The objective of the present study was to investigate whether the reliability of tenderness evaluation can be increased by using a new technique called "pressure-controlled palpation" (pcp). The technique has been made possible by a newly invented piece of equipment called a palpometer, with which a pressure-sensitive plastic film attached to the index finger records the pressure exerted. In 15 patients with chronic tension-type headache and in 15 healthy volunteers, 2 investigators studied myofascial tenderness using conventional palpation and pressure-controlled palpation. Tenderness was scored on a 4-point scale in each of the examined pericranial regions. The sum of tenderness scores recorded by two observers using conventional palpation differed significantly (p = 0.0003), while results did not differ between observers using pressure-controlled palpation (p = 0.89). During palpation with seven different pressure intensities a positive and linear relation between pressure and pain intensity was found (p = 0.00006). Pain intensity reported by the subjects correlated highly with tenderness scored by the observer (rs = 0.95, p < 0.0001). These results demonstrate for the first time that tenderness scores can be compared between observers if palpation pressure is controlled. Pressure-controlled palpation represents a major improvement on current palpation techniques and should be standard in future research on myofascial pain disorders.
authors.affiliation: Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark.
authors.forename: L
authors.initials: L
authors.lastname: Bendtsen
authors.forename: R
authors.initials: R
authors.lastname: Jensen
authors.forename: N K
authors.initials: NK
authors.lastname: Jensen
authors.forename: J
authors.initials: J
authors.lastname: Olesen
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009209:Myofascial Pain Syndromes / Q000175:diagnosis*; D010147:Pain Measurement; D010173:Palpation / Q000379:methods*; D011312:Pressure; D015203:Reproducibility of Results