Abstract
The aim of this study was to assess the validity and test-retest reliability of Thermovision Technique of Dry Needling (TTDN) for the gluteus minimus muscle. TTDN is a new thermography approach used to support trigger points (TrPs) diagnostic criteria by presence of short-term vasomotor reactions occurring in the area where TrPs refer pain. Method. Thirty chronic sciatica patients (n=15 TrP-positive and n=15 TrPs-negative) and 15 healthy volunteers were evaluated by TTDN three times during two consecutive days based on TrPs of the gluteus minimus muscle confirmed additionally by referred pain presence. TTDN employs average temperature (T avr), maximum temperature (T max), low/high isothermal-area, and autonomic referred pain phenomenon (AURP) that reflects vasodilatation/vasoconstriction. Validity and test-retest reliability were assessed concurrently. Results. Two components of TTDN validity and reliability, T avr and AURP, had almost perfect agreement according to κ (e.g., thigh: 0.880 and 0.938; calf: 0.902 and 0.956, resp.). The sensitivity for T avr, T max, AURP, and high isothermal-area was 100% for everyone, but specificity of 100% was for T avr and AURP only. Conclusion. TTDN is a valid and reliable method for T avr and AURP measurement to support TrPs diagnostic criteria for the gluteus minimus muscle when digitally evoked referred pain pattern is present.
Highlights
The main problem of the pain research filed is the difficulty with an objective quantification of pain
During Thermovision Technique of Dry Needling (TTDN), dry needling related pain sensation consistent with gluteus minimus referred pain was confirmed for TrPspositive exclusively
Among trigger points (TrPs)-positive sciatica subjects, DN related pain sensation on the thigh during TTDN was confirmed for every subject in all three sessions
Summary
The main problem of the pain research filed is the difficulty with an objective quantification of pain. It has been estimated that in around 30% of patients consulting for pain in primary care the coexistence of myofascial pain syndrome (MPS) caused by trigger points (TrPs) was confirmed [2]. This MPS is drug-resistant and very often diagnostically overlooked. Sonoelastography and magnetic resonance elastography, have been recently introduced allowing noninvasive imaging of TrPs [3, 4] Both are not cheap or accessible; TrP confirmation is still based on palpatory diagnostic criteria defined by Travell and Simons [5, 6]
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