title: Interexaminer reliability of the palpation of trigger points in the trunk and lower limb muscles.
abstract: OBJECTIVE
  To determine the interexaminer reliability of palpation of three characteristics of trigger points (taut band, local twitch response, and referred pain) in patients with subacute low back pain, to determine whether training in palpation would improve reliability, and whether there was a difference between the physiatric and chiropractic physicians.
  
  
  METHODS
  Reliability study.
  
  
  METHODS
  Whittier Health Campus, Los Angeles College of Chiropractic.
  
  
  METHODS
  Twenty-six nonsymptomatic individuals and 26 individuals with subacute low back pain.
  
  
  METHODS
  Twenty muscles per individual were first palpated by an expert and then randomly by four physician examiners.
  
  
  METHODS
  Palpation findings.
  
  
  RESULTS
  Kappa scores for palpation of taut bands, local twitch responses, and referred pain were .215, .123, and .342, respectively, between the expert and the trained examiners, and .050, .118, and .326, respectively, between the expert and the untrained examiners. Kappa scores for agreement for palpation of taut bands, twitch responses, and referred pain were .108, -.001, and .435, respectively, among the nonexpert, trained examiners, and -.019, .022, and .320, respectively, among the nonexpert, untrained examiners.
  
  
  CONCLUSIONS
  Among nonexpert physicians, physiatric or chiropractic, trigger point palpation is not reliable for detecting taut band and local twitch response, and only marginally reliable for referred pain after training.
authors.affiliation: Center for Research and Spine Care, Research Division, Los Angeles College of Chiropractic, CA, USA.
authors.forename: C Y
authors.initials: CY
authors.lastname: Hsieh
authors.forename: C Z
authors.initials: CZ
authors.lastname: Hong
authors.forename: A H
authors.initials: AH
authors.lastname: Adams
authors.forename: K J
authors.initials: KJ
authors.lastname: Platt
authors.forename: C D
authors.initials: CD
authors.lastname: Danielson
authors.forename: F K
authors.initials: FK
authors.lastname: Hoehler
authors.forename: J S
authors.initials: JS
authors.lastname: Tobis
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology*; D009209:Myofascial Pain Syndromes / Q000175:diagnosis*; D010173:Palpation; D015203:Reproducibility of Results