VCOM Research Day Program Book 2023

Medical Resident Research Cl inical

05 Quantifying Osteopathic Palpatory Motion

Kristopher Schock, DO; Christopher Ciccone, OMS IV; Michael Mitkos, OMS III; David T. Redden, PhD; Hollis H. King, DO, PhD, FAAO, FCA; Albert Kozar, DO, FAOASM, R-MSK Corresponding

Edward Via College of Osteopathic Medicine-Virginia Campus; VCOM Sports and Osteopathic Medicine

6 series of 27 randomized events. The events entailed either a single expansion, contraction, or no motion and each series was within defined range of motion change (50-149, 150-249, 250-349, 350-449, 450 549, 550-649, 650-749, 750-849, 850-949, and 950-1050 micrometers). The randomization of the 27 events is via RAND function in excel of the order of motions or non-motions, with 25% being contractions, 25% expansions, and 50% being non-motions. The subject states a response of motion or no-motion, and if motion, states the motion direction if able (as in or out). The participant starts with the 450-549 micrometer range, and if they correctly determined ≥70% of the 27 events, the subject’s next series was moved down to the next smaller motion range. If <70% are correct, then the participant is given the next larger motion range. This study’s results have been added to the 2018 and 2020 accumulation of the same study information, with the new goal of being able to differentiate between non-trained, students, residents, and experienced practicing physicians. Results: New data is pending but will be complete and analyzed fully for VCOM-VA research day. Our

earlier pilot study noted human motion detection capacity can be in the tens of micrometers but for most people they’re palpatory sensitivity is limited to ~400µm. In the pilot, Osteopathic physicians and students tended to be better at palpating smaller movements than untrained individuals, though this was not statistically significant. 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 the number of years in training. Limitations to the study were previously sample size, and participant hobbies that could be affecting their maximal palpatory threshold.

Introduction/Background: Palpation is an integral and intuitive examination procedure of physicians and particularly osteopathic physicians in which the kinesthetic and tactile perceptual sensations are utilized. In the fields of manual medicine, the ability to feel small finite motions is necessary to both diagnose and treat somatic dysfunctions (SD). Few studies have evaluated the sensitivity threshold of human palpation for small dimensions of motion, despite the daily utilization of these skills by thousands of manual medicine providers worldwide. Objective/Hypothesis: To determine each subject’s smallest palpable motion threshold (SBMT) to the tens of micrometers, thereby defining the typical human threshold of detectable palpable motion change. We hypothesize that training would decrease an individual subject’s SBMT, thereby improving their palpation sensitivity to even smaller motions. Methods: We conducted a prospective, randomized controlled trial in which the subjects, blinded to visual and auditory stimuli, palpated a device containing a movement actuator that produced


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