Ability to categorize end-feel joint movement according to years of clinical experience: an experiment with an end-feel simulator.
Hiroyuki Kawamura, Shimon Tasaka, Atsutoshi Ikeda and 3 others
PMID 32273654WHAT IT FOUND
Therapists with clinical experience identified simulated joint end-feel more accurately than students, particularly when always conscious of end-feel.
Muscular and tissue approximation were often confused, so end-feel alone may not pinpoint the cause of limited motion.
Key findings
01Therapists identified simulated end-feel types more accurately than students, especially when distinguishing bone-to-bone from muscle or tissue approximation.
02Therapists with 6 to 9 years of experience had the highest accuracy for most end-feel types, but experience did not significantly improve discrimination of muscular or tissue approximation alone.
03Therapists who were always conscious of end-feel scored higher than those who were highly conscious.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The test used a simulator, not real patients, so it does not show how accurately therapists diagnose end-feel at the bedside. End-feel remains a subjective judgment, and the study did not compare it with an independent standard such as imaging or ultrasound. The sample was mostly physical therapists, with only 2 occupational therapists, so the findings should not be generalised broadly to occupational therapy. There were far fewer therapists with 15 or more years of experience than therapists with less experience, which makes the cutoff values unstable. The students and experienced therapists had different educational backgrounds, and the study could not control for that. The study excluded muscle spasm, empty feel, and capsular feel, so it did not test the full set of end-feel types used clinically.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not conclude that end-feel alone can identify the cause of limited range of motion. This study tested a simulator, not patients, and muscular and tissue approximation were often confused.