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Center for Advancement of Osteopathic Research Methodologies

Advancing the Clinical Identification and Quantification of Musculoskeletal Pain.       

SRI Scientists

  • Brian Degenhardt, DO
  • Jane Johnson, MA
  • Eric Snider, DO
  • Karen Snider, DO
  • Ken Pamperin, MS
  • Steve Webb, BA, BS

Other Investigators

  • Thomas Graven-Nielsen, PhD, DMSc
  • Todd Hammond, PhD

Purpose and Aims

Despite much research in the area of tender and trigger points, there continues to be poor consistency between pressure algometry and manual palpation.  The goal of this collaboration with Thomas Graven-Nielsen, PhD, DMSc, Aalborg University-Center for Sensory-Motor Interaction.and Todd Hammond, PhD of the Mathematics Department at Truman State University is to improve the co-identification of tender and trigger points between palpation and pressure algometryTo achieve this goal, the collaboration will determine the effect of applying varying increment rates of pressure in palpation and pressure algometry, determine the effect of direction of pressure when localizing tender and trigger points with a pressure algometer, objectify characteristics of palpation so that pressure pain thresholds and tissue deformation can be quantified, improve localization and description of the structures being influenced by forces generated by palpation and algometry, evaluate the sensory characteristics reported by subjects during palpation and pressure algometry, evaluate the sensory characteristics reported by the palpating examiners in relation to force displacement curves, and to translate study outcomes into training programs.



  1. Degenhardt BF, Johnson JC, Snider KT, Snider EJ. Maintenance and improvement of interobserver reliability of osteopathic palpatory tests over a 4-month period. J Am Osteopath Assoc. 2010;110(10):579-586.
Presentations and Abstracts
  1. Degenhardt BF, Johnson JC, Hammond T, Snider KT, Snider EJ, Pamperin K, Webb S, Graven-Nielsen T. Pressure pain thresholds are altered as a result of variations in technique when examining tender points. J Am Osteopath Assoc. 2014;114(8):e89.
  2. Degenhardt BF, Snider EJ, Snider KT, Pamperin K, Yang Q, Johnson JC, Graven-Nielsen T. Comparing Pressure Pain Thresholds Determined by Algometry and Manual Palpation, Poster presented at: 14th World Congress on Pain; August 27-31, 2012; Milan, Italy; and at the 4th Annual Interdisciplinary Biomedical Research Conference; Kirksville, MO; September 29, 2012.
  3. Degenhardt BF, Snider KT, Johnson JC, Snider EJ, Pamperin K, Yang Q, Graven-Nielsen T. Reliability of Pressure Pain Thresholds in the Supraspinatous Muscle—Palpation and Algometry. JAOA 2012 112(8) 546-547 (Abstract)
  4. Degenhardt BF, Johnson JC, Snider KT, Snider EJ, Pamperin K, Yang Q, Graven-Nielsen T. Pain Pressure Thresholds of Predicted Tender Points by Algometry and Palpation. JAOA 2012 112(8) 546-547 (Abstract)