{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T22:22:09Z","timestamp":1768083729104,"version":"3.49.0"},"reference-count":21,"publisher":"Walter de Gruyter GmbH","issue":"12","license":[{"start":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T00:00:00Z","timestamp":1752624000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jom-2024-0194_abs_001\">\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Asymmetry of bony landmarks, such as the anterior superior iliac spine (ASIS) or posterior superior iliac spine (PSIS), is often utilized to identify somatic dysfunction in the pelvis. However, establishing good accuracy for these assessments can be challenging, so objective training models have been developed to enhance learning and accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jom-2024-0194_abs_002\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The objective of this study was to determine the effect of training with positional asymmetry models with objective feedback on the improvement and retention of pelvic asymmetry assessment accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jom-2024-0194_abs_003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>First-year osteopathic medical students and undergraduate interns were recruited for model training. After a basic technique demonstration, they completed a 72-question baseline assessment on the ASIS and PSIS models. Subsequent training was conducted for 5\u202fh per week (1\u202fh\/day) for two consecutive weeks. Model accuracy was assessed four times at baseline, midpoint, final, and retention. Assessments were scored as a percent of the correctly identified asymmetries, and change scores were calculated by comparison with the previous assessment score (i.e.,\u00a0baseline to midpoint, midpoint to final, final to retention) and overall (baseline to retention).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jom-2024-0194_abs_004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twelve students (age range, 20.3\u201329.2 years) participated. At baseline, overall scores were 57.6\u202f% for ASIS and 72.9\u202f% for PSIS models. For ASIS models, the change scores improved from baseline to midpoint (+18.9\u202f%, p&lt;0.001) and from midpoint to final (+6.6\u202f%, p=0.01) but decreased from final to retention (\u22127.2\u202f%, p=0.01). The overall retention scores were higher than baseline (+18.3\u202f%, p&lt;0.001). For PSIS models, the change scores improved from baseline to midpoint (+13.0\u202f%, p&lt;0.001), and the overall retention scores were higher than baseline (+15.0\u202f%, p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jom-2024-0194_abs_005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Training with positional asymmetry models with objective feedback resulted in significant sustained improvements in ASIS and PSIS positional asymmetry assessment accuracy. Integration of these models into the standard medical curriculum should be considered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jom-2024-0194","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T10:59:56Z","timestamp":1752577196000},"page":"579-587","source":"Crossref","is-referenced-by-count":1,"title":["Effect of positional asymmetry palpatory models on improvement and retention of accuracy during pelvic asymmetry assessments"],"prefix":"10.1515","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2088-9870","authenticated-orcid":false,"given":"Justin M.","family":"Hajicek","sequence":"first","affiliation":[{"name":"A.T. Still Research Institute and the Kirksville College of Osteopathic Medicine , A.T. Still University , Kirksville , MO , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2220-4423","authenticated-orcid":false,"given":"Madelyn B.","family":"Huhn","sequence":"additional","affiliation":[{"name":"A.T. Still Research Institute and the Kirksville College of Osteopathic Medicine , A.T. Still University , Kirksville , MO , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2285-3544","authenticated-orcid":false,"given":"Ashley","family":"Thurgood","sequence":"additional","affiliation":[{"name":"A.T. Still Research Institute , A.T. Still University , Kirksville , MO , USA"},{"name":"The School of Osteopathic Medicine , A.T. Still University , Mesa , AZ , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3961-8932","authenticated-orcid":false,"given":"Edelheide N.","family":"Isemann","sequence":"additional","affiliation":[{"name":"A.T. Still Research Institute and the Kirksville College of Osteopathic Medicine , A.T. Still University , Kirksville , MO , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0707-9874","authenticated-orcid":false,"given":"Chase B.","family":"Barnwell","sequence":"additional","affiliation":[{"name":"A.T. Still Research Institute and the Kirksville College of Osteopathic Medicine , A.T. Still University , Kirksville , MO , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1993-499X","authenticated-orcid":false,"given":"Zane","family":"Starks","sequence":"additional","affiliation":[{"name":"A.T. Still Research Institute , A.T. Still University , Kirksville , MO , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Ying-Fang Wang","sequence":"additional","affiliation":[{"name":"Department of Research Support , A.T. Still University , Kirksville , MO , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3944-9230","authenticated-orcid":false,"given":"Brian F.","family":"Degenhardt","sequence":"additional","affiliation":[{"name":"A.T. Still Research Institute and the Kirksville College of Osteopathic Medicine Department of Osteopathic Manipulative Medicine , A.T. Still University , Kirksville , MO , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2025,7,16]]},"reference":[{"key":"2025121815515223060_j_jom-2024-0194_ref_001","doi-asserted-by":"crossref","unstructured":"Consorti, G, Basile, F, Pugliese, L, Petracca, M. Interrater reliability of osteopathic sacral palpatory diagnostic tests among osteopathy students. J\u00a0Am Osteopath Assoc 2018;118:637\u201344. https:\/\/doi.org\/10.7556\/jaoa.2018.132.","DOI":"10.7556\/jaoa.2018.132"},{"key":"2025121815515223060_j_jom-2024-0194_ref_002","unstructured":"Cooperstein, R, Hickey, M. The reliability of palpating the posterior superior iliac spine: a systematic review. J\u00a0Can Chiropr Assoc 2016;60:36\u201346."},{"key":"2025121815515223060_j_jom-2024-0194_ref_003","doi-asserted-by":"crossref","unstructured":"Stovall, BA, Kumar, S. Anatomical landmark asymmetry assessment in the lumbar spine and pelvis: a review of reliability. Pharm Manag PM R 2010;2:48\u201356. https:\/\/doi.org\/10.1016\/j.pmrj.2009.11.001.","DOI":"10.1016\/j.pmrj.2009.11.001"},{"key":"2025121815515223060_j_jom-2024-0194_ref_004","doi-asserted-by":"crossref","unstructured":"Mine, K, Ono, K, Tanpo, N. The reliability of palpatory examinations for pelvic landmarks to determine pelvic asymmetry: a systematic review and meta-analysis. Phys Ther Rev 2021;27:181\u201390. https:\/\/doi.org\/10.1080\/10833196.2021.2019368.","DOI":"10.1080\/10833196.2021.2019368"},{"key":"2025121815515223060_j_jom-2024-0194_ref_005","doi-asserted-by":"crossref","unstructured":"Kmita, A, Lucas, NP. Reliability of physical examination to assess asymmetry of anatomical landmarks indicative of pelvic somatic dysfunction in subjects with and without low back pain. Int J Osteopath Med 2008;11:16\u201325. https:\/\/doi.org\/10.1016\/j.ijosm.2008.01.003.","DOI":"10.1016\/j.ijosm.2008.01.003"},{"key":"2025121815515223060_j_jom-2024-0194_ref_006","unstructured":"Degenhardt, BF, Snider, KT, Snider, EJ, Johnson, JC. Interobserver reliability of osteopathic palpatory diagnostic tests of the lumbar spine: improvements from consensus training. J\u00a0Am Osteopath Assoc 2005;105:465\u201373. https:\/\/doi.org\/10.7556\/jaoa.2005.105.10.465."},{"key":"2025121815515223060_j_jom-2024-0194_ref_007","doi-asserted-by":"crossref","unstructured":"Fryer, G, McPherson, HC, O\u2019Keefe, P. The effect of training on the inter-examiner and intra-examiner reliability of the seated flexion test and assessment of pelvic anatomical landmarks with palpation. Int J Osteopath Med 2005;8:131\u20138. https:\/\/doi.org\/10.1016\/j.ijosm.2005.08.004.","DOI":"10.1016\/j.ijosm.2005.08.004"},{"key":"2025121815515223060_j_jom-2024-0194_ref_008","doi-asserted-by":"crossref","unstructured":"O\u2019Haire, C, Gibbons, P. Inter-examiner and intra-examiner agreement for assessing sacroiliac anatomical landmarks using palpation and observation: pilot study. Man Ther 2000;5:13\u201320. https:\/\/doi.org\/10.1054\/math.1999.0203.","DOI":"10.1054\/math.1999.0203"},{"key":"2025121815515223060_j_jom-2024-0194_ref_009","doi-asserted-by":"crossref","unstructured":"Sutton, C, Nono, L, Johnston, RG, Thomson, OP. The effects of experience on the inter-reliability of osteopaths to detect changes in posterior superior iliac spine levels using a hidden heel wedge. J\u00a0Bodyw Mov Ther 2013;17:143\u201350. https:\/\/doi.org\/10.1016\/j.jbmt.2012.07.005.","DOI":"10.1016\/j.jbmt.2012.07.005"},{"key":"2025121815515223060_j_jom-2024-0194_ref_010","doi-asserted-by":"crossref","unstructured":"Potter, NA, Rothstein, JM. Intertester reliability for selected clinical tests of the sacroiliac joint. Phys Ther 1985;65:1671\u20135. https:\/\/doi.org\/10.1093\/ptj\/65.11.1671.","DOI":"10.1093\/ptj\/65.11.1671"},{"key":"2025121815515223060_j_jom-2024-0194_ref_011","unstructured":"Suwanasri, C, Sakullertphasuk, W, Tosiriphattana, M, Sa-ngounsak, T, Ekabutr, W. Inter- and intra-rater reliability of postural assessment for scoliosis. J\u00a0Med Assoc Thai 2014;97:S1\u20135."},{"key":"2025121815515223060_j_jom-2024-0194_ref_012","doi-asserted-by":"crossref","unstructured":"van Kessel-Cobelens, AM, Verhagen, AP, Mens, JM, Snijders, CJ, Koes, BW. Pregnancy-related pelvic girdle pain: intertester reliability of 3 tests to determine asymmetric mobility of the sacroiliac joints. J\u00a0Manip Physiol Ther 2008;31:130\u20136. https:\/\/doi.org\/10.1016\/j.jmpt.2007.12.003.","DOI":"10.1016\/j.jmpt.2007.12.003"},{"key":"2025121815515223060_j_jom-2024-0194_ref_013","unstructured":"Byfield, DC, Mathiasen, J, Sangren, C. The reliability of osseous landmark palpation in the lumbar spine and pelvis. Eur J Chiropr 1992;40:83\u20138."},{"key":"2025121815515223060_j_jom-2024-0194_ref_014","doi-asserted-by":"crossref","unstructured":"Kilby, J, Heneghan, NR, Maybury, M. Manual palpation of lumbo-pelvic landmarks: a validity study. Man Ther 2012;17:259\u201362. https:\/\/doi.org\/10.1016\/j.math.2011.08.008.","DOI":"10.1016\/j.math.2011.08.008"},{"key":"2025121815515223060_j_jom-2024-0194_ref_015","doi-asserted-by":"crossref","unstructured":"Alexander, N, Rastelli, A, Webb, T, Rajendran, D. The validity of lumbo-pelvic landmark palpation by manual practitioners: a systematic review. Int J Osteopath Med 2021;39:10\u201320. https:\/\/doi.org\/10.1016\/j.ijosm.2020.10.008.","DOI":"10.1016\/j.ijosm.2020.10.008"},{"key":"2025121815515223060_j_jom-2024-0194_ref_016","doi-asserted-by":"crossref","unstructured":"Basile, F, Scionti, R, Petracca, M. Diagnostic reliability of osteopathic tests: a systematic review. Int J Osteopath Med 2017;25:21\u20139. https:\/\/doi.org\/10.1016\/j.ijosm.2017.03.004.","DOI":"10.1016\/j.ijosm.2017.03.004"},{"key":"2025121815515223060_j_jom-2024-0194_ref_017","doi-asserted-by":"crossref","unstructured":"Fossum, C, Snider, E, Fryer, G, Gillette, N, Degenhardt, B. The introduction of a novel approach to the teaching and assessment of osteopathic manipulative medicine assessment skills. Int J Osteopath Med 2008;11:165. https:\/\/doi.org\/10.1016\/j.ijosm.2008.08.023.","DOI":"10.1016\/j.ijosm.2008.08.023"},{"key":"2025121815515223060_j_jom-2024-0194_ref_018","doi-asserted-by":"crossref","unstructured":"Stovall, BA, Bae, S, Kumar, S. Anterior superior iliac spine asymmetry assessment on a novel pelvic model: an investigation of accuracy and reliability. J\u00a0Manip Physiol Ther 2010;33:378\u201385. https:\/\/doi.org\/10.1016\/j.jmpt.2010.05.005.","DOI":"10.1016\/j.jmpt.2010.05.005"},{"key":"2025121815515223060_j_jom-2024-0194_ref_019","doi-asserted-by":"crossref","unstructured":"Lee, AS, Pyle, CW, Redding, D. Accuracy of anterior superior iliac spine symmetry assessment by routine structural examination. J\u00a0Am Osteopath Assoc 2015;115:482\u20139. https:\/\/doi.org\/10.7556\/jaoa.2015.102.","DOI":"10.7556\/jaoa.2015.102"},{"key":"2025121815515223060_j_jom-2024-0194_ref_020","doi-asserted-by":"crossref","unstructured":"Colonna, S, Mazzanti, M. Pelvic palpatory tests in manual therapy and osteopathy: a critical review of the literature and suggestions for new research. Cureus 2024;16:e64066. https:\/\/doi.org\/10.7759\/cureus.64066.","DOI":"10.7759\/cureus.64066"},{"key":"2025121815515223060_j_jom-2024-0194_ref_021","doi-asserted-by":"crossref","unstructured":"Lavazza, C, Milano, V, Abenavoli, A, Maggiani, A. How type and number of training sessions influence the reliability of palpation. J\u00a0Bodyw Mov Ther 2018;22:396\u2013401. https:\/\/doi.org\/10.1016\/j.jbmt.2017.07.012.","DOI":"10.1016\/j.jbmt.2017.07.012"}],"container-title":["Journal of Osteopathic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jom-2024-0194\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jom-2024-0194\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T15:52:30Z","timestamp":1766073150000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jom-2024-0194\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,16]]},"references-count":21,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,11,21]]},"published-print":{"date-parts":[[2025,11,21]]}},"alternative-id":["10.1515\/jom-2024-0194"],"URL":"https:\/\/doi.org\/10.1515\/jom-2024-0194","relation":{},"ISSN":["2702-3648"],"issn-type":[{"value":"2702-3648","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,16]]}}}