The Usefulness of the Armchair Sign for the Diagnosis of Psychosomatic-Prone Myofascial Pain Syndrome in Patients with Incurable Cancer: A Secondary Analysis of a Prospective Multicenter Observational Clinical Study.

Abstract

Background: Because psychosomatic diseases are pathological conditions, it is difficult to identify their degrees. The armchair sign is a test used to assess voluntary muscle relaxation.Objective: We aimed to evaluate the usefulness of the armchair sign for the diagnosis of psychosomatic-prone myofascial pain syndrome (MPS) in patients with incurable cancer.Design: This was a secondary analysis of a prospective multicenter observational clinical study.Setting/Patients: Patients with incurable cancer who were referred to palliative care services at five institutions in Japan between March 2018 and December 2018.Results: A total of 101 patients were enrolled, of whom 44 met MPS diagnostic criteria. Of these, 27 patients (61.3%) had psychosomatic-prone MPS. There was a significant association between the armchair sign and psychosomatic-prone MPS (p = 0.002). Sensitivity and specificity were 40.7% (95% confidence interval [CI]: 18.0–63.4) and 100.0%, respectively. The area under the curve score was 0.704 (95% CI: 0.553–0.855).Conclusions: The armchair sign may be useful as an ancillary test for the diagnosis of psychosomatic-prone MPS in patients with incurable cancer.Trial Registration: UMIN000031338. Registered February 16, 2018.