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Center for Advancement of Osteopathic Research Methodologies

Developing Valid Models for Assessing Clinicians’ Ability to Identify Positional Asymmetry of Bony Landmarks. 

SRI Scientists

  • Brian Degenhardt, DO
  • Eric Snider, DO
  • Ken Pamperin, MS

Purpose and Aims

The objective of this line of research is to develop and pilot instruments that can be used to objectify, standardize and assess the accuracy, reliability and validity of commonly used osteopathic palpatory tests assessing positional asymmetry, tests that are part of national educational standards in OMM. Because of the difficulties in objectifying position of skeletal landmarks on humans, models have been developed, calibrated and used to provide direct feedback to examiners regarding the accuracy and sensitivity of their palpatory skills.   We have developed various types of models that assess examiners’ skills in determining asymmetry of bony landmarks within the coronal and horizontal plane.  The following is a breakdown of the different type of palpatory models being used in research and educational activities.  These models are designed to test the skills

  • Type 1: Laminated static coronal plane (paper) models assess visual and palpatory skills (maximizing visual and minimizing peripheral sensory input) necessary for palpating the Anterior Superior Iliac Spine (ASIS), Posterior Superior Iliac Spine (PSIS) Ischial Tuberosities (IT) and Pubic Tubercles (PT);
  • Type 2: Static wooden models assess examiners’ ability to differentiate levels of coronal plane asymmetry requiring examiners to use more palpatory than visual input. These skills are used for palpation of the ASIS, PSIS, IT and PT landmarks;
  • Type 3: Simulated lumbar wooden models are static models that assess recognition of positional asymmetry in the horizontal plane.  These models have been manufactured and calibrated so that the structures being palpated are positioned geometrically consistent with the landmarks in humans to reinforce to the examiners the positional interrelationships of these landmarks.
  • Type 4: Anatomical lumbar spine models are static models that utilize bronze casted lumbar vertebrae to assess positional asymmetry of the transverse processes in the horizontal plane;
  • Type 5: Anatomical pelvic models are dynamic models preset to specific asymmetries, allowing for the assessment of the iliac crest (IC), ASIS and PTs.  Dynamic posterior pelvic models allow for the assessment of the IC, PSIS and IT