Reliability of Dynamic Soft Tissue Pain Assessment Using Novel Methodology and Technology

Abstract

Soft tissue manipulation (STM) is a form of manual therapy used to treat chronic conditions such as myofascial pain. There is a need to address how myofascial tissues contribute to chronic pain, which is critical for future biomarker development. An important step is the creation of Quantifiable Soft Tissue Manipulation (QSTM®). The purpose of this study is to determine the reliability of Quantifiable Soft Tissue Manipulation (QSTM®) devices on dynamic pain threshold assessment, and to determine effects of soft tissue assessment on secondary clinical outcomes in different body regions. In this observational study, 4 trained clinicians (2 novice, 2 experienced) treated patients with the QSTM® system Q1 and Q2 devices. The clinicians tested a total of 44 subjects (21 male and 23 female). Subjects were excluded if BMI was <19 or >30 kg/m2. All subjects were placed into age groups: young adults (18-30) and older adults (50-75). Secondary clinical outcomes were also measured. For average peak and maximum peak 3-dimensional resultant force, the interclass correlation coefficient (ICC) demonstrated good inter-rater (0.65-0.73), and intra-rater (ICC 0.62-0.91) reliability for all subjects, however the inter-rater reliability was less for older adults (0.53 - 0.72). For the rate and angle, the intra-rater (ICC 0.15-0.94) was less than fair to excellent depending on the examiner, but greater than the inter-rater (ICC 0.18-0.34) reliability. The inter-rater reliability was less for older adults (ICC 0.00-0.19). Dynamic pain threshold assessment can be reliably assessed but the methodology needs to further be standardized, i.e., performed at a standardized rate and angle of force application, to improve reliability of this testing method.