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Journal of Bodywork and Movement... Apr 2012
Topics: Humans; Musculoskeletal Diseases; Osteopathic Medicine; Pain; Palpation; Range of Motion, Articular
PubMed: 22464110
DOI: 10.1016/j.jbmt.2012.01.018 -
Journal of Manipulative and... 1993Palpation is one of the main tools in manipulative therapy as well as diagnosis. Analysis of palpation shows that it combines two types of sensation: that of touch and...
Palpation is one of the main tools in manipulative therapy as well as diagnosis. Analysis of palpation shows that it combines two types of sensation: that of touch and of motion, i.e., proprioception. In addition, it causes interaction with the patient resulting in a feedback-situation, which further complicates reproduction, e.g., objectification and measurement. The objection to palpation being "subjective" is further enhanced by the discovery of palpatory illusion. Thus, there is an urgent need for research in palpation, which could provide basic scientific credibility to manipulative techniques.
Topics: Chiropractic; Humans; Palpation
PubMed: 8133193
DOI: No ID Found -
Journal of Osteopathic Medicine Oct 2023Medical students with no previous experience may find it difficult to identify and palpate bony landmarks while learning physical examination skills. In a study of 168...
CONTEXT
Medical students with no previous experience may find it difficult to identify and palpate bony landmarks while learning physical examination skills. In a study of 168 medical schools, 72.6 % have indicated that they are utilizing ultrasound in their curriculum. Although the integration of ultrasound curriculum has become more widespread, the depth of instruction is inconsistent. Ultrasound is not commonly taught in conjunction with palpation of bony landmarks in osteopathic structural examination.
OBJECTIVES
The objective of this analysis was to identify whether utilizing ultrasound assistance in teaching palpation of specific thoracic vertebral bony landmarks would improve palpation accuracy in first-year medical students with no previous palpatory experience.
METHODS
First-year medical students were given video instructions to palpate and identify a thoracic vertebral transverse process and to mark it with invisible ink. The participants were then taught and instructed to utilize ultrasound to identify the same landmark and mark it with a different color. The accuracy of palpation was measured with digital calipers.
RESULTS
A test of the overall hypothesis that participants will show improved accuracy utilizing ultrasound compared with hand palpation was not significant (F=0.76, p>0.05). When separating students into groups according to patient body mass index (BMI), however, there was a trend toward significance (F=2.90, p=0.071) for an interaction effect between patient BMI and the repeated measures variable of palpation/ultrasound. When looking specifically at only those participants working with a normal BMI patient, there was a significant improvement in their accuracy with the use of ultrasound (F=7.92, p=0.017).
CONCLUSIONS
The analysis found increased accuracy in bony landmark identification in untrained palpators utilizing ultrasound vs. palpation alone in a normal BMI model, but not in obese or overweight BMI models. This study shows promise to the value that ultrasound may have in medical education, especially with respect to early palpation training and landmark identification.
Topics: Humans; Palpation; Ultrasonography; Physical Examination; Curriculum; Students, Medical
PubMed: 37498573
DOI: 10.1515/jom-2023-2002 -
The Clinical Journal of Pain Aug 2017To achieve a statistical estimate of the agreement of manual palpation for identification of myofascial trigger points (MTrPs) and secondarily to investigate potential... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To achieve a statistical estimate of the agreement of manual palpation for identification of myofascial trigger points (MTrPs) and secondarily to investigate potential factors impacting the agreement of this technique.
METHODS
We searched MEDLINE(R) and Embase for studies examining the reproducibility of manual palpation for the identification of MTrPs from the year 2007 to present. In addition, we utilized studies identified by 2 comprehensive systematic reviews that covered the period before 2007. The included studies were original peer-reviewed research articles and included Cohen κ measures or data with which to calculate Cohen κ. Studies were excluded if they lacked a measure of variability or information required to calculate variability. Studies that examined palpation through body cavities were also excluded. Of the 18 potentially relevant articles only 6 met inclusion criteria including 363 patients. Modified QUADAS tool was used to assess study validity. Subgroup comparisons were made utilizing Q and Z tests.
RESULTS
An estimate of κ=0.452 (95% confidence interval, 0.364-0.540) was obtained for interrater agreement of manual palpation of MTrPs. Localized tenderness (κ=0.676) and pain recognition (κ=0.575) were the most reliable criteria. Only 1 study met inclusion criteria for intrarater agreement and therefore no meta-analysis was performed.
DISCUSSION
Use of manual palpation for identification of MTrPs is unreliable, and future investigation should focus on integration with more reliable techniques.
Topics: Humans; Myofascial Pain Syndromes; Observer Variation; Palpation; Trigger Points
PubMed: 28098584
DOI: 10.1097/AJP.0000000000000459 -
Surgical Endoscopy Apr 2019The loss of tactile feedback in minimally invasive robotic surgery remains a major challenge to the expanding field. With visual cue compensation alone, tissue...
BACKGROUND
The loss of tactile feedback in minimally invasive robotic surgery remains a major challenge to the expanding field. With visual cue compensation alone, tissue characterization via palpation proves to be immensely difficult. This work evaluates a bimodal vibrotactile system as a means of conveying applied forces to simulate haptic feedback in two sets of studies simulating an artificial palpation task using the da Vinci surgical robot.
METHODS
Subjects in the first study were tasked with localizing an embedded vessel in a soft tissue phantom using a single-sensor unit. In the second study, subjects localized tumor-like structures using a three-sensor array. In both sets of studies, subjects completed the task under three trial conditions: no feedback, normal force tactile feedback, and hybrid vibrotactile feedback. Recordings of correct localization, incorrect localization, and time-to-completion were used to evaluate performance outcomes.
RESULTS
With the addition of vibrotactile and pneumatic feedback, significant improvements in the percentage of correct localization attempts were detected (p = 0.0001 and p = 0.0459, respectively) during the first experiment with phantom vessels. Similarly, significant improvements in correct localization were found with the addition of vibrotactile (p = 2.57E-5) and pneumatic significance (p = 8.54E-5) were observed in the second experiment involving tumor phantoms.
CONCLUSIONS
This work demonstrates not only the superior benefits of a multi-modal feedback over traditional single-modality feedback, but also the effectiveness of vibration in providing haptic feedback to artificial palpation systems.
Topics: Blood Vessels; Equipment Design; Feedback, Sensory; Humans; Minimally Invasive Surgical Procedures; Models, Anatomic; Neoplasms; Palpation; Robotic Surgical Procedures; Touch; Vibration
PubMed: 30187198
DOI: 10.1007/s00464-018-6405-8 -
British Journal of Nursing (Mark Allen...Physical assessment is a new responsibility for many nurses in the UK who are expanding their parameters of advanced clinical practice. A physical assessment framework... (Review)
Review
Physical assessment is a new responsibility for many nurses in the UK who are expanding their parameters of advanced clinical practice. A physical assessment framework can be used by both community and acute care nurses as a guide to the process of conducting a physical assessment. The framework presented here consists of the following sequence of steps: identifying the purpose of the assessment; taking a health history; choosing a comprehensive or focused approach; and examining the patient using the sequence of inspection, palpation, percussion and auscultation. The next step, interpretation of the clinical findings, which results in either the recognition of abnormality or identification of a differential diagnosis, then becomes the basis for clinical decision making. This paper describes a comprehensive, head-to-toe assessment as one example of the application of this physical assessment framework in clinical practice.
Topics: Auscultation; Heart Sounds; Humans; Medical History Taking; Models, Nursing; Nurse's Role; Nursing Assessment; Nursing Process; Palpation; Percussion; Physical Examination; Professional Autonomy; Respiratory Sounds; United Kingdom
PubMed: 16926720
DOI: 10.12968/bjon.2006.15.13.21482 -
The Journal of the American Osteopathic... Oct 1989
Review
Topics: Humans; Musculoskeletal Physiological Phenomena; Osteopathic Medicine; Palpation; Perception; Physical Examination
PubMed: 2681094
DOI: No ID Found -
Cephalalgia : An International Journal... Apr 1996
Topics: Equipment Design; Headache; Humans; Pain Measurement; Palpation; Transducers, Pressure
PubMed: 8665580
DOI: 10.1046/j.1468-2982.1996.1602127.x -
Clinical Oral Investigations Feb 2022This study aimed to determine if standardized palpations of the temporalis muscle evoke referred pain and/or sensations in individuals without TMD. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
This study aimed to determine if standardized palpations of the temporalis muscle evoke referred pain and/or sensations in individuals without TMD.
MATERIALS AND METHODS
This was a randomized, single-blinded study. The mechanical sensitivity of the right temporalis muscle was assessed in 32 participants without TMD with nine different stimulations to 15 test sites using palpometers (different stimulus intensities (0.5, 1.0, and 2.0 kg) and durations (2, 5, and 10 s). After each stimulus, participants were asked to score perceived pain intensity and intensity of unpleasantness on a 0-100 numeric rating scale as an indicator of mechanical sensitivity in the temporalis muscle and to indicate any areas of referred pain/sensations on a body chart.
RESULTS
Pain intensity significantly differed between palpation durations, intensities, and test sites (P < 0.001). In contrast, unpleasantness significantly differed between palparation duration and intensities (P < 0.001), but not test sites. Participants more frequently reported referred pain/sensations evoked by the 10-s (34.4%) as opposed to the 2-s (6.3%) and 5-s (15.6%) palpation duration at the 2.0-kg stimulus intensity (P < 0.05).
CONCLUSIONS
Our present results indicate that referred pain/sensations in the orofacial region can be evoked by standardized palpation of the temporalis muscle and influenced by the palpation duration in individuals without TMD.
CLINICAL RELEVANCE
Referred pain/sensations from the temporalis muscle were duration- and intensity-dependent processes originating from local stimuli.
Topics: Humans; Pain Measurement; Pain, Referred; Palpation; Sensation; Temporal Muscle
PubMed: 34342760
DOI: 10.1007/s00784-021-04096-z -
Journal of the Royal Society of Medicine Dec 2006
Topics: Humans; Palpation; Skin Diseases; Telemedicine
PubMed: 17139058
DOI: 10.1177/014107680609901203