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Journal of the Korean Academy of Rehabilitation Medicine 1999;23(3):595-600.
Importance of Local Twitch Response Induced by Needling in Myofascial Pain Syndrome.
Han, Tai Ryoon , Kim, Jin Ho , Paik, Nam Jong , Lim, Suk Jin
Department of Rehabilitation Medicine, Seoul National University College of Medicine.
근막통 증후군의 진단에 있어 침 삽입에 의한 국소연축반응의 중요성
한태륜, 김진호, 백남종, 임석진
서울대학교 의과대학 재활의학교실
Abstract

Objective
The diagnosis of myofascial pain syndrome (MPS) is commonly made by Simons' clinical diagnostic criteria which is mainly based on patients' complaints, so it is difficult to distinguish from malingering. The purpose of this study is to evaluate local twitch response by needling (LTR) as an objective diagnostic criterion of MPS.


Method
Forty four industrial designers complaining of regional pain in neck, shoulder, or upper arm were examined by a physiatrist. If trigger point was detected, local twitch response by needling was confirmed and than severity was measured by 4 grades. Sensitivity, specificity, and positive predictive value of local twitch response was calculated with diagnosis made by Simons' clinical diagnostic criteria. Correlation between grade of local twitch response and sum of clinical features in Simons' criteria was also evaluated.


Results
Local twitch response by needling was corresponding with the diagnosis of MPS by Simons' criteria (sensitivity 100%, specificity 96.7%, positive predictive value 93.3%), and the severity of local twitch response was significantly associated with sum of clinical features in Simons' criteria (Spearman correlation 0.950; p=0.048)


Conclusion
Local twitch response by needling is an important and objective diagnostic criterion of MPS.

Key Words: Local twitch response, Trigger point, Myofascial pain syndrome


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