A comparative investigation of palpation sensitivity amongst qualified osteopaths with five years or more experience, final year osteopathic students and persons with no prior manual therapy training

Paola Ash                                                                 Supervisor: Nico Tanguy

ABSTRACT

Objective

Palpation is a fundamental osteopathic skill that forms part of the patient treatment and management plan.  It provides important information about the quality of neuromusculoskeletal tissues including tissue temperature, texture, resistance and joint motion.  Based on the above it was the author’s intent to explore the relationship of palpation sensitivity related to experience and to examine whether an ideal palpatory pressure exists when palpating anatomical landmarks on a human body. 

Design

A mixed group design was employed in order to compare any possible palpatory sensitivity difference and to identify any possible correlation of ideal pressure(s) applied whilst palpating 3 landmarks.  The volunteer’s landmarks were covered by 10 sheets of cotton with ready made detachable Velcro cut-outs in order to ensure the surrounding other neuromusculoskeletal areas were covered.  Times taken to palpate each anatomical landmark were recorded.  A record was also made of the number of sheets that were requested to be removed in order to palpate each landmark. 

The 3 groups have been divided into:

·               Group A - Persons with no prior manual therapy training (n=15).

·               Group B - 15 Final Year osteopathic Students (n=15)  

·               Group C - Qualified osteopaths with over five years experience (n=15)

All Subjects were required to blindfold themselves whilst undertaking the experiment. 

Results

A statistical significance was demonstrated by qualified osteopaths and final year students increased ability to palpate the patella and clavicle landmark within shorter time scales and over more sheets comparatively to those in the non experienced group (p<0.05).  A non-significant statistical significance was found when qualified osteopaths and final year students were compared to the non experienced group in anterior superior iliac spine landmark identification.

Conclusion

For the clavicle and patella landmark identification this study demonstrates that palpatory skill is enhanced in qualified osteopaths and those in their final year of an osteopathic degree course comparatively to those with no prior manual therapy training.

For anterior superior iliac spine landmark identification this study demonstrates that neither final year students nor qualified osteopaths have enhanced palpatory skill comparative to those with no experience.

Key Words

Algometer, chiropractic, dysfunction, manual therapy, neuromusculoskeletal, osteopathy, palpatory awareness, palpation, palpometer, physiotherapy, pressure threshold, proprioception, somatic dysfunction, sensibility, sensitivity, START, student(s), temperature, texture, tissue, tone, touch.