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Soft Robotics Apr 2022Medical palpation is a diagnostic technique in which physicians use the sense of touch to manipulate the soft human tissue. This can be done to enable the diagnosis of...
Medical palpation is a diagnostic technique in which physicians use the sense of touch to manipulate the soft human tissue. This can be done to enable the diagnosis of possibly life-threatening conditions, such as cancer. Palpation is still poorly understood because of the complex interaction dynamics between the practitioners' hands and the soft human body. To understand this complex of soft body interactions, we explore robotic palpation for the purpose of diagnosing the presence of abnormal inclusions, or tumors. Using a Bayesian framework for training and classification, we show that the exploration of soft bodies requires complex, multi-axis, palpation trajectories. We also find that this probabilistic approach is capable of rapidly searching the large action space of the robot. This work progresses "robotic" palpation, and it provides frameworks for understanding and exploiting soft body interactions.
Topics: Bayes Theorem; Humans; Palpation; Robotics; Touch; Touch Perception
PubMed: 34432994
DOI: 10.1089/soro.2020.0129 -
The Journal of the American Osteopathic... Oct 2015The palpation of motions is at the heart of the practice of foreign-trained osteopaths. When practicing osteopathic manual therapy (care provided by foreign-trained...
CONTEXT
The palpation of motions is at the heart of the practice of foreign-trained osteopaths. When practicing osteopathic manual therapy (care provided by foreign-trained osteopaths) in the cranial field or osteopathic cranial manipulative medicine, the palpation of small motions (several tens of micrometers) is a key process. However, to the authors' knowledge, the smallest detectable motion has not been identified.
OBJECTIVE
To quantify motion detection capacity by passive palpation.
METHODS
Participants were instructed to hold a mechanical device containing a micrometric actuator between their hands and report when they felt motion while 6 series of 27 random motions were generated by the actuator. After each series, if a participant succeeded or failed to detect motion with a confidence level of greater than 98%, the motions in the next series were set to a smaller or larger magnitude, respectively. After 6 series, the individual motion detection capacity was recorded. Statistical significance was set at P=.02.
RESULTS
A total of 21 participants were selected, comprising 14 osteopaths and 7 nonosteopaths. The average performance of the sample was 148 μm. Thirteen participants (62%) perceived motions of 200 μm or less, and 7 participants (33%) detected motions of 50 μm or less with bare hands. Osteopathic training did not notably affect the performance. Osteopaths were twice as likely to claim detection of nonexisting motions than to miss existing ones, whereas nonosteopaths were equally subject to both types of errors.
CONCLUSION
The data show human passive palpatory sensitivity to be in the range of several tens of micrometers. This range is comparable to that reported for calvarial motion (10-50 μm).
Topics: Adult; Female; Humans; Male; Musculoskeletal Manipulations; Osteopathic Medicine; Palpation; United States; Young Adult
PubMed: 26414713
DOI: 10.7556/jaoa.2015.121 -
Journal of Bodywork and Movement... Jul 2023Palpation evaluates the fascia, a three-dimensional web of connective tissues. We propose altered fascia system displacement in patients with myofascial pain syndrome....
BACKGROUND AND PURPOSE
Palpation evaluates the fascia, a three-dimensional web of connective tissues. We propose altered fascia system displacement in patients with myofascial pain syndrome. This study determined the concurrent validity of palpation and musculoskeletal ultrasound (MSUS) videos played on Windows Media Player 10 (WMP) when evaluating the direction of the fascia system's displacement at the end of the cervical active range of motion (AROM).
METHODS
This cross-sectional study used palpation as index test and MSUS videos on WMP as reference test. First, three physical therapists palpated right and left shoulders for each cervical AROM. Second, during cervical AROM, PT-Sonographer recorded the fascia system displacement. Third, using the WMP, the physical therapists evaluated the direction of skin, superficial and deep fascia displacements at the end of cervical AROM. MedCalc Version 19.5.3 determined the "exact" Clopper-Pearson Interval (CPI).
RESULTS
We found strong accuracy between palpation and MSUS videos on WMP when determining the direction of skin displacement during cervical flexion and extension (CPI= 78.56 to 96.89). There was moderate agreement between palpation and MSUS videos on WMP when determining the direction of the skin, superficial fascia, and deep fascia displacements during cervical lateral flexion and rotation (CPI= 42.25 to 64.13).
CONCLUSION
Skin palpation during cervical flexion and extension may be useful in evaluating patients with myofascial pain syndrome (MPS). It is unclear what fascia system was evaluated when shoulders were palpated at the end of cervical lateral flexion and rotation. Palpation as diagnostic tool for MPS was not investigated.
Topics: Humans; Cross-Sectional Studies; Myofascial Pain Syndromes; Fibromyalgia; Fascia; Palpation; Range of Motion, Articular
PubMed: 37330776
DOI: 10.1016/j.jbmt.2023.04.013 -
Journal of ISAKOS : Joint Disorders &... Jun 2024The purpose of this study was to evaluate the validity and reliability of two techniques, palpation and fluoroscopy, for assessing medial patellofemoral ligament (MPFL)...
OBJECTIVES
The purpose of this study was to evaluate the validity and reliability of two techniques, palpation and fluoroscopy, for assessing medial patellofemoral ligament (MPFL) reconstruction femoral tunnel position accuracy.
METHODS
Twenty-one fresh frozen cadaveric knees had an MPFL femoral tunnel drilled and filled with a metal screw. Tunnels were created in a nonstandard fashion to ensure the sample included a range of tunnel positions from poor to ideal. Six experienced sport medicine and arthroscopy surgeons evaluated the placement of the femoral tunnel by palpating the screw in relation to anatomic landmarks and by fluoroscopy related to Schöttle's Point. They evaluated 1) the accuracy of femoral tunnel placement, 2) the direction of tunnel error, and 3) the clinical acceptability of the tunnel position. Validity measures included sensitivity, specificity, and correlation to clinical acceptability, which were calculated for the palpation and fluoroscopic assessments. Reliability measures included interrater reliability (ICC 2,k) for femoral tunnel accuracy and percent agreement of the raters' tunnel direction assessment.
RESULTS
The palpation method demonstrated a sensitivity of 0.79 and specificity of 0.84 for assessing the accuracy of femoral tunnel placement, while the fluoroscopic method showed a sensitivity of 0.83 and specificity of 0.92. Pearson correlation coefficients for clinical acceptability of tunnel position were high, with both techniques ranging from .589 to .854. Interrater reliability for the palpation and fluoroscopic techniques for assessment of tunnel accuracy were 0.31 and 0.55 (ICC 2,k), respectively. Assessment of the direction of tunnel error was good with the fluoroscopic technique slightly more accurate than palpation.
CONCLUSION
This study demonstrated that both palpation and fluoroscopy are valid techniques for assessing femoral tunnel position after MPFL reconstruction. Despite demonstrating good validity, the accuracy of assessing tunnel position was unreliable in a group of six experienced knee surgeons. Further research into MPFL reconstruction femoral tunnel assessment techniques, including patient-specific reference standards, is warranted.
LEVEL OF EVIDENCE
Level 2.
Topics: Humans; Fluoroscopy; Palpation; Reproducibility of Results; Femur; Patellofemoral Joint; Cadaver; Male; Female; Plastic Surgery Procedures; Middle Aged; Sensitivity and Specificity; Aged; Bone Screws
PubMed: 38492848
DOI: 10.1016/j.jisako.2024.03.005 -
Journal of Manipulative and... Jun 2022The purpose of this study was to examine the accuracy of palpation methods for locating the transverse processes of the first cervical vertebra and masseter muscle using...
OBJECTIVE
The purpose of this study was to examine the accuracy of palpation methods for locating the transverse processes of the first cervical vertebra and masseter muscle using radiographic images as the gold-standard method and the association between personal characteristics with the observed accuracy.
METHODS
This was a single-blinded, diagnostic accuracy study. Ninety-five participants (49 women, 58 ± 16 years of age) were enrolled in this study. A single examiner palpated the neck and face region of all participants to identify the transverse processes of the first cervical vertebra and masseter muscles bilaterally. In sequence, participants underwent a multislice computed tomography scan for assessment of the superimposed inner body structure. Two radiologists assessed the computed tomography images using the same criteria and were blinded regarding each other's assessment and the anatomic landmarks under investigation. The palpation accuracy was calculated as the proportion of the correctly identified landmarks in the studied sample. The correlation of the palpation outcome (correct = 1; incorrect = 0) with age, sex (male = 1; female = 0), and body mass index was investigated using the point-biserial correlation coefficient.
RESULTS
The right and left transverse processes were correctly located in 76 (80%) and 81 (85%) participants, respectively, and bilaterally in 157 events (83%), as evaluated by the consensus of the 2 radiologists. The masseter muscles were correctly localized bilaterally in 95 of 95 (100%) participants. Body mass showed statistical evidence of a weak, positive correlation with the correct location of the transverse processes of the first cervical vertebra at the right body side (r = .219; 95% confidence interval, 0.018-0.403; P = .033).
CONCLUSION
Palpation methods used in this study accurately identified the location of the first cervical vertebra spinous processes and the masseter muscles.
Topics: Humans; Male; Female; Masseter Muscle; Palpation; Neck; Tomography, X-Ray Computed; Body Mass Index
PubMed: 36175313
DOI: 10.1016/j.jmpt.2022.07.005 -
Annals of the Royal College of Surgeons... May 1992
Topics: Arterial Occlusive Diseases; Humans; Leg; Palpation; Pulse
PubMed: 1616254
DOI: No ID Found -
Journal of Feline Medicine and Surgery Jun 2009
Topics: Animals; Cat Diseases; Cats; Female; Hyperthyroidism; Male; Organ Size; Palpation; Physical Examination; Predictive Value of Tests; Thyroid Gland; Thyroxine; Ultrasonography
PubMed: 19465328
DOI: 10.1016/j.jfms.2009.02.002 -
The Clinical Journal of Pain Feb 2014To compare test-retest variability of palpation between a new palpometer and manual palpation using (1) right or left hand, (2) index or middle finger, (3) randomized or...
OBJECTIVES
To compare test-retest variability of palpation between a new palpometer and manual palpation using (1) right or left hand, (2) index or middle finger, (3) randomized or fixed sequence of force levels, (4) palpation on soft or hard surface, and (5) palpation for 2 or 10 seconds.
METHODS
Twelve clinicians were instructed to target 0.5, 1.0, and 2.0 kg on a force meter using a palpometer (adjustable spring-coil with a small pin touching the examiner's hand when the correct pressure is achieved) and manual palpation with right or left hand, index or middle finger, randomized or fixed sequence of force levels, on hard or soft surface, and for 2 or 10 seconds. During all experiments, 10 force measures were taken and variability was determined as coefficient of variation (CV) and compared with analyses of variance.
RESULTS
In all experiments, the palpometer had lower variability compared with manual palpation (P<0.001). There were no differences between the CVs of right and left hand (P=0.122), index and middle finger (P=0.240), and soft and hard surface (P=0.240). Random sequence of force levels had higher CVs than fixed sequence with manual palpation (P=0.004), but not with palpometer (P=0.856). CVs for 2 seconds palpation were higher than 10 seconds (P=0.002).
CONCLUSIONS
The palpometer had low test-retest variability and provided a more accurate and reproducible pressure stimulus than manual palpation. The findings of this study may help to standardize palpation of human muscles required for accurate and reliable diagnosis of musculoskeletal pain conditions.
Topics: Adult; Female; Fingers; Hand; Humans; Male; Middle Aged; Musculoskeletal Pain; Pain Measurement; Pain Threshold; Palpation; Physical Examination; Pressure; Reference Standards; Reproducibility of Results
PubMed: 24398392
DOI: 10.1097/AJP.0b013e31828c893d -
Avian Pathology : Journal of the W.V.P.A Feb 2023The aim of this study was to estimate the sensitivity and specificity of palpation relative to necropsy for detection of keel bone fractures (KBF) in broiler breeders....
The aim of this study was to estimate the sensitivity and specificity of palpation relative to necropsy for detection of keel bone fractures (KBF) in broiler breeders. In addition, the study investigated observer reliability of palpation. Four commercial breeder flocks (Ross 308 = 2, Ranger Gold = 1, Hubbard JA 757, = 1) were included in the study. A total of 400 hens and 60 roosters were examined after culling or slaughter, at end of lay (63 weeks). Keel bones were first palpated independently by two raters with a varying degree of experience in palpation of keel bones in laying hens. After palpation, a necropsy with investigation of the keel bone was conducted. The prevalence of KBF at end of lay for hens, as diagnosed by necropsy, varied from 14-58%, while only one in 60 assessed roosters had KBF. Palpation had poor sensitivity, with differences between raters ranging from 56% to 36% when hybrid is not considered. The specificity of palpation for all hybrids together was 85% and 88%, for the two raters, respectively. The two raters had moderate agreement, Gwet's agreement coefficient (95% confidence interval): 0.60 (0.52-0.69). In conclusion, palpation has poor diagnostic accuracy for detection of KBF in broiler breeders, and other methods, like necropsy, must be applied for reliable assessments. KBF appears to be a prevalent condition in different hybrids of broiler breeder hens, but not in roosters. This is the first study to investigate palpation as a diagnostic method for detection of KBF in broiler breeders.Palpation has poor diagnostic accuracy for detection of KBF in broiler breeder hens with differences between raters.KBF can be a prevalent problem in broiler breeder hens of several hybrids, but not in roosters.
Topics: Animals; Female; Male; Chickens; Reproducibility of Results; Fractures, Bone; Palpation; Sternum
PubMed: 36415970
DOI: 10.1080/03079457.2022.2147416 -
Lymphatic Research and Biology Aug 2022We aimed to clarify whether pathological changes in skin and subcutaneous tissue with lymphedema affected the skin hardness sensed by palpation. In 50 patients with...
We aimed to clarify whether pathological changes in skin and subcutaneous tissue with lymphedema affected the skin hardness sensed by palpation. In 50 patients with unilateral legs with lymphedema (LE), the skin hardness of the lower inner thigh and lower inner calf was determined using a scale ranging from 1 (softest) to 7 (hardest) based on palpation. Then, the skin hardness was correlated with the measurements of skin/subcutaneous tissue ultrasonography images obtained from the palpated parts. Multivariate logistic regression analysis demonstrated that dermal thickness was a significant factor that affected the difference in skin hardness between the LE and the contralateral asymptomatic leg for both thigh ( < 0.05) and calf ( < 0.01). When the thigh and calf in the LE were individually studied, subcutaneous echogenicity ( < 0.05), indicating subcutaneous inflammation/fibrosis, and subcutaneous thickness ( < 0.01) also seemed to affect skin hardness, respectively. The skin hardness sensed in the LE seemed to be affected predominantly by dermal thickening. In addition, the pathological changes in the subcutaneous tissue caused by LE seemed to have an impact on skin hardness. Clinical Trial Registration number 2020-150.
Topics: Hardness; Humans; Leg; Lymphedema; Palpation; Skin
PubMed: 34788154
DOI: 10.1089/lrb.2020.0133