Health care ergonomics Part 1: The fundamental skill of palpation - A review and critique

Palpation of tissues, organs and body parts at rest or in physiological motion are fundamental skills utilised by clinicians in the clinic and the research laboratory. The accuracu of clinical assessments, task analysis and the fidelity of sophisticated motion analysis systems, are dependent on the accuracy of palpation. This accuracy is usually accepted unchallenged. However, a review of the literature on palpation provides little support for this position. Both within- and between-rater tests of palpation are generally unreliable. Several recommendations are made: (1) standardization of test protocol and training; (2) systematic investigation of factors that affect palpation accuracy; (3) the establishment of test-retest reliability prior to studies using palpation; and (4) determination of the measurement error of key landmarks used in clinical practice.