Reliability and Usefulness of the Pressure Pain Threshold Measurement in Patients with Myofascial Pain

OBJECTIVE: To assess the usefulness of a pressure algometer to measure pressure pain threshold (PPT) for diagnosis of myofascial pain syndrome (MPS) in the upper extremity and trunk muscles. METHOD: A group of 221 desk workers complaining of upper body pain participated in this study. Five physiatrists made the diagnosis of MPS using physical examination and PPT measurements. PPT measurements were determined for several muscles in the back and upper extremities. Mean PPT data for gender, side, and dominant hand groups were analyzed. Sensitivity and specificity of Fischer's standard method were evaluated. PPT cut-off values for each muscle group were determined using an ROC curve. RESULTS: Cronbach's alpha for each muscle was very high. The PPT in men was higher than in females, and the PPT in the left side was higher than in the right side for all muscles tested (p<0.05). There was no significant difference in PPT for all muscles between dominant and non-dominant hand groups. Diagnosis of MPS based on Fischer's standard showed relatively high specificity and poor sensitivity. CONCLUSION: The digital pressure algometer showed high reliability. PPT might be a useful parameter for assessing a treatment's effect, but not for use in diagnosis or even as a screening method.

Reliability and Validity of Korean Version of Falls Efficacy Scale-International (KFES-I)

OBJECTIVE: To develop and validate the Korea version of falls efficacy scale-international (KFES-I) in Korean elderly which was developed to assess fear of falling in older people and have been already validated in some European countries. METHOD: Surveys of 385 older persons from the public health center in Korea based on KFES-I and fall questionnaire such as presence, frequency of fracture within last 6 months, and combined medical illness were taken. KFES-I was composed with 16 items of activities of daily living including social activities and graded from 1 to 4 in each item. Two-week KFES-I re-test data were collected. Reliability and validity estimates were computed as well as KFES-I sum scores according to age, sex, and falls history. RESULTS: Cronbach's alpha was 0.971 and mean inter-item correlation was 0.665. Test-retest Pearson correlation coefficient was 0.960 (p<0.01). As expected, KFES-I scores were associated with age, sex, and falls history (p<0.05). In addition, the KFES-I discriminated between sub-groups somewhat better than the original ten-item KFES scale. CONCLUSION: KFES-I appears to be a reliable and valid method for measuring fear of falling in older adults. This study provides the preliminary evidence that KFES-I is a useful tool in evaluating Korean elderly who fear falling.