We have already seen an overview of the concept of multisensory integration so we shall move on to speak a bit more about the realities of utilizing the concept in clinical practice. Just as a primer, you will not be able to directly view a structure that is covered by your hand and that is totally fine…that is why you will utilize a mix of palpation/haptic feedback and vision. Also, you may be looking at other things in order to make sure you are doing what you think you are doing (aka you are not moving beyond your target).
One of the most basic concepts in any manual therapeutic modality is that one thing stays still and another thing moves in relation to it. What follows will be the first video in a small series about the concept of relational motion which will provide an explanation of the concept as well as a demonstration. Subsequent videos will provide further demonstrations of the concept.
We have already looked at the overarching concepts of assessment so now we will take a look at what we are ACTUALLY testing in Osteopathic Manual Therapy as well as discussing the utilization of broad contact in order to engage multipoint discrimination for better identification of motion dysfunction. Please enjoy the videos below.
Cognitive Biases are an issue. They are an issue that, as individuals, we are poorly equipped to identify in ourselves. They are an issue that, as individuals, we seem to be quite capable of identifying in others. That being said, I may be poorly equipped to identify my own biases while better able to identify them in others, however I strive to identify them in myself (despite the seemingly inherent issues with success in the endeavor). I have taken some time to create an overview of the concept with attention paid to Osteopathic Manual Therapy in the video below…
I will start with the catchphrase: Keep Your Hands and Your Eyes on the prize. As will be described in the video below, it is important to recognize that the combination of senses is highly valuable when performing any form of manual therapeutic assessment or treatment. It is far too easy to be ignorant of mistakes we make by habit and, if using multiple senses in an integrated fashion, we may have a way to avoid those mistakes with greater effectiveness.
Why do I think we teach it poorly? Because we ignore the reality of the patient on the table when doing so. We know that alterations in BMI (regardless of its usefulness as a predictor of health) alters the ability to identify landmarks. We know that utilizing multiple landmarks helps BETTER identify a given structure even though we still don’t do as well as we should. We know these things and continue to teach methods that make it hard to find things while also leaving us minimally accurate…
In light of the above, I have done a few videos with more catch phrases that MIGHT help with palpation.
The general catch phrases that I have chosen to utilize to communicate the consistent concepts of assessment in Osteopathic Manual Therapy are outlined below in fancy video form! Why catch phrases? In order to have relatively straight forward sentences to point to broad concepts as well as many details to be learned over time. At such a point as an individual has a grasp of the individual details the catch phrases take on greater meaning as they point to the details in a simplified way…also, in the developing stages the catch phrases provide the opportunity for coding the details to the simplified catch phrase as they are learned. All that to say – watch the videos for more information!
Following the 4 part patient positioning concepts we take a look at each COMMON patient position taking in to consideration the pros and cons of each GENERALLY. The 4 concepts of patient positioning are also mentioned for reinforcement of the concepts and to point to how they influence each of the patient positions.
That doesn’t make sense! To make obvious what just happened between the title of this article and the first sentence watch this clip from Anchorman (it is crass humor):
There is a phenomenon I am hoping to highlight that connects to the above clip very loosely (due mostly to my personal sense of humor which is not a requirement in order to understand the point here).
What will follow will be 4 videos speaking to the concepts related to patient positioning. Why 4 concepts? Well, as it stands this is the best way I have currently found to describe the overarching themes. I am pretty confident there are many ways to describe these concepts that I have not considered!