Within just one session of using the Virtual Haptic Back, first-year medical student Aaron Miller could tell a difference in his palpatory skills. Since then, Miller believes that training on the computer program should be a requirement for all students at OU-COM.

“The Virtual Haptic Back is one of the most interesting and intelligently designed machines I have ever come across,” Miller says. “It was fascinating to use. Anyone truly interested in osteopathic manipulative medicine (OMM) should try it. It allows one to better understand what they should be feeling for.” 

Funding for the Virtual Haptic Back came from Ohio University and the Osteopathic Heritage Foundation (OHF), which has committed $1.16 million to the project. “The OHF grant provides the funds to buy equipment, including haptic devices, computers, cameras, supplies, and to pay salaries,” says John Howell, Ph.D., professor of physiology. “The project would not have been possible without that support.”

Howell says the development of the software for the haptic back began in 2001. The programming was done by Robert Conatser, lab research associate, Interdisciplinary Institute for Neuromusculoskeletal Research, in collaboration with biomedical sciences and family medicine and the Department of Mechanical Engineering.

The Virtual Haptic Back Laboratory houses the computer equipment which simulates patients’ problems for students to practice upon, says Howell. The haptic back is capable of simulating a range of dysfunctions from disks being out of alignment to strained muscles.

So how does it work?

First, one places his or her fingertips inside two robotic arms to begin the simulation. You then are in a virtual space in which as you manipulate your fingertips and hands, the haptic back simulates the tactile sensations of tissue and muscles that one would experience during a patient examination. These virtual muscles are likewise examined to pinpoint the pain producing problems. A computer screen provides a visual interface for the user. The computer can simulate the feel of strained or tight muscles, which students must find by palpation.
“We have data that shows students get better after repeated use of the haptic back,” Howell says. During the lab sessions, students perform a pretest and then complete eight sessions of 15 minute each on the haptic back.

Students then complete a posttest, which showed they had improved their ability to find muscles in stress. Howell says the testing helped students hone their manipulation skills, while gaining confidence in palpitating.

Tony Le, a first-year medical student, saw his skills enhanced by using the computer simulation.

“After approximately six months experience in the OMM lab, I initially used the haptic back to try and enhance my sensitivity in diagnosing a disorder,” he says. “As the practice sessions went on, I started to imitate the actual procedure that we use in the OMM lab. I believe that the haptic back has enhanced my capability to detect more sensitive areas. But without continued practice, I could eventually lose that ability.”

Like his fellow classmate Miller, Le says he would like to see training on haptic back integrated into OU-COM’s curriculum. After further research, Howell says the university would like to see the software used nationwide, helping other students better their skills. Le believed all students — with and without clinical experience — can benefit from haptic back training.

“For the ones that have never performed OMM, this can help sharpen the receptors on the fingers that will be used,” Le says. “It can help initiate one so one understands and actually feels what is explained in lectures and labs. For students learning OMM, like me, it helps enhance palpatory sensitivity. Because of this training, I can focus on and have a much better sense of how to interpret a wide range of feelings and sensations.”