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Quantifying Osteopathic Palpatory Motion

Journal: The AAO Journal Date: 2023/06, 33(2):Pages: 18. doi: Subito , type of study: randomized controlled trial

Full text    (https://meridian.allenpress.com/aaoj/article/33/2/10/493538/LBORC-NUFA-Poster-Abstracts-2023-Residents)

Keywords:

palpation [170]
randomized controlled trial [710]

Abstract:

Introduction/Background: Palpation is an examination procedure in which kinesthetic and tactile perceptual sensations are utilized to feel small finite motions, which is fundamental to manual medicine diagnosis and treatment. Few studies have evaluated human’s smallest palpable motion threshold (SBMT). Objective/Hypothesis: To determine the SBMT to the tens of micrometers in trained and un-trained subjects. We hypothesize that osteopathic medical training will improve SBMT. Methods: A prospective, randomized controlled trial of 50 non-trained individuals was compared to 100 trained individuals (students, residents, and experienced practicing physicians), blinded to visual and auditory stimuli, palpated a device containing a movement actuator that produced 6 series of 27 randomly ordered motions or non-motions events: 25% contractions, 25% expansions, and 50% non-motions. Each series was within a defined motion range in sets of 100 micrometers from 50-1050. Participants start with 450-549 micrometer range and move up or down based on <70% correct profile. 2022-2023 results have been added to 2018-2020 data. Groups compared with paired t-tests with significance set at P=.05. Results: To date, Osteopathic physicians (n=10) on average were able to palpate down to ~356μm (SD 212μm) with 2 being able to palpate <100μm (20%). Non-osteopaths (n=20) averaged their smallest palpatory increment at ~418μm (SD 324μm). Student (n=24) and Resident (n=12) averages were similar to physicians but more variable. Complete data and full statistical analysis will be presented. Discussion/Conclusion: We have defined the SBMT in groups of non-trained individuals and trained Osteopaths. Subject’s SBMT trends toward being inversely proportional to number of years in training. Future study includes IRB/AAO approval for evaluation of more practicing osteopaths at 2023 convocation. Limitations to the study were sample size, and single sided actuator.


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