Development of the Palpation Domain for Muscle and Skin in the Global Body Examination

Abstract

Objectives: To develop new scales within palpation of muscle and skin domains based on 16 items from the Global Physiotherapy Examination and 46 items from the Comprehensive Body Examination [CBE], and to investigate how well these new scales would discriminate between healthy individuals and different groups of patients, when compared with the original methods. Methods: Two physiotherapists independently examined 132 persons [34 healthy, 32 with localized pain, 32 with widespread pain, and 34 with psychoses]. Muscle and skin domains were studied separately. The numbers of items were reduced by omitting items with too high a correlation and by exploratory factor analysis [EFA]. Internal consistency was examined with Cronbach’s α. Discriminative validity was examined using the Mann–Whitney U-test and the area under the curve. Results: Only items from the left body half was included in the EFA, as very high correlation [mean r = 0.90] was found in the 23 bilateral palpation pairs in CBE. The initial 62 items were reduced to 11 for palpation of muscle and 5 for palpation of skin. Cronbach’s α was 0.88 for the subscales for Muscle and Skin. The new Palpation domain in the Global Body Examination showed excellent discriminative ability between healthy persons and the different patient groups [P < 0.001; area under the curve 0.81–0.94]. Patients with localized pain had significantly less muscular and skin aberration than patients with widespread pain. Conclusions: A new Global Body Examination Palpation domain with acceptable psychometric properties was developed. It had fewer items than the Global Physiotherapy Examination and CBE, but with almost the same discriminating ability.