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Volume 15, Issue 3, Pages 254-260 (June 2010)


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Standardized simulated palpation training – Development of a Palpation Trainer and assessment of palpatory skills in experienced and inexperienced clinicians

Holsgaard-Larsen AndersabCorresponding Author Informationemail address, Myburgh Corriea, Hartvigsen Janac, Rasmussen Cunoad, Hartvig Mariannea, Marstrand Kristiana, Aagaard Pera

Received 31 August 2009; received in revised form 17 December 2009; accepted 11 January 2010. published online 19 February 2010.

Abstract 

Specific palpation skills are required to identify and treat myofascial pain. The aim of this study was to develop a device that reflects absolute pressure values during simulated palpation, and to test the hypothesis that training through standardized manual palpation results in improved skills for experienced and inexperienced examiners. Experienced (n = 30) and inexperienced (n = 30) examiners were randomly divided into either training or control. A device (Palpation Trainer) was constructed to measure pressure intensity (Ppeak) and rate of pressure development (RPD). Training consisted of 8–10 min standardized simulated palpation, during which examiners followed a standardized pressure–time curve (visualized in real-time on a pc-monitor). Controls received no training. Tests were performed at baseline, immediately post training and again after 48 h and analyzed for Ppeak and RPD. After simulated palpation training, experienced examiners improved palpatory skills related to Ppeak and RPD (i.e. performed closer to predetermined guidelines and with reduced inter-examiner variation), while inexperienced examiners only improved RPD (p < 0.05). Thus, standardized training resulted in acute and temporary (48 h) changes in selected analysis variables during simulated palpation in experienced and to some extent also in inexperienced clinicians. Whether this can be transferred to clinical in vivo setting requires further study.

a Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark

b Institute of Clinical Research, University of Southern Denmark, Denmark

c Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark

d Institute of Sports Science, Århus University, Denmark

Corresponding Author InformationCorresponding author at: Institute of Clinical Research, University of Southern Denmark, Denmark. Tel.: +45 6550 4055.

PII: S1356-689X(10)00004-4

doi:10.1016/j.math.2010.01.003


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