Applied kinesiology: Difference between revisions
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'''Applied kinesiology (AK)''' is the study of muscles and the relationship of muscle strength to health. It incorporates a system of manual muscle testing and therapy <ref>{{Cite web|url=http://www.encyclopedia.com/medicine/divisions-diagnostics-and-procedures/medicine/applied-kinesiology|title=Applied kinesiology|last=Gale Encyclopedia of Alternative Medicin|first=3rd ed.|date=COPYRIGHT 2005 The Gale Group, Inc.|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref> and is a method of diagnosis and treatment based on the belief that various muscles are linked to particular organs and glands, and that specific muscle weakness can signal distant internal problems such as nerve damage, reduced blood supply, chemical imbalances or other organ or gland problems. Practitioners contend that by correcting this muscle weakness, you can help heal a problem in the associated internal organ.<ref>{{Cite web|url=https://www.drweil.com/health-wellness/balanced-living/wellness-therapies/applied-kinesiology/|title=Applied Kinesiology|last=Weil, MD|first=Dr. Andrew|date=|website=www.drweil.com|archive-url=https://www.drweil.com/health-wellness/balanced-living/wellness-therapies/applied-kinesiology/|archive-date=|dead-url=|access-date=}}</ref> |
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{{About|a [[chiropractic]] or an [[alternative medicine]] method|the scientific study of human movement|Kinesiology}} |
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{{Infobox alternative intervention |
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| name = Applied kinesiology |
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| image = Muscle Testing.jpg |
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| caption = A person (right) practicing applied kinesiology |
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| MeshID = D018953 |
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{{Alternative medicine sidebar}} |
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'''Applied kinesiology''' ('''AK''') is a technique in [[alternative medicine]] claimed to be able to diagnose illness or choose treatment by testing [[Muscle|muscles]] for strength and weakness.<ref name=pmid11926427>{{cite journal|vauthors=Lüdtke R, Kunz B, Seeber N, Ring J | title=Test-retest-reliability and validity of the Kinesiology muscle test. | journal=Complement Ther Med | year= 2001 | volume= 9 | issue= 3 | pages= 141–5 | pmid=11926427 | doi=10.1054/ctim.2001.0455 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11926427 }}</ref> According to their guidelines on allergy diagnostic testing, the [[American College of Allergy, Asthma and Immunology]] stated there is "no evidence of diagnostic validity" of applied kinesiology.<ref name="pmid18431959">{{cite journal|vauthors=Bernstein IL, Li JT, Bernstein DI, Hamilton R, Spector SL, Tan R | title=Allergy diagnostic testing: an updated practice parameter. | journal=Ann Allergy Asthma Immunol | year= 2008 | volume= 100 | issue= 3 Suppl 3 | pages= S1-148 | pmid=18431959 | doi= 10.1016/S1081-1206(10)60305-5| pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18431959 |display-authors=etal}}</ref> Another study has shown that, as an evaluative method, AK "is no more useful than random guessing",<ref name=kenney>{{cite journal |vauthors=Kenney JJ, Clemens R, Forsythe KD |title=Applied kinesiology unreliable for assessing nutrient status |journal=J Am Diet Assoc |volume=88 |issue=6 |pages=698–704 |date=June 1988 |pmid=3372923 |doi= |url=}}</ref> and the [[American Cancer Society]] has said that "scientific evidence does not support the claim that applied kinesiology can diagnose or treat cancer or other illness".<ref name=ACS2009/> |
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== History |
== History == |
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[[George Goodheart|George J. Goodheart]], a [[Chiropractic|chiropractor]], originated applied kinesiology in 1964<ref name=time>{{cite web|url=http://www.time.com/time/innovators_v2/alt_medicine/profile_goodheart.html |title=Innovators - George Goodheart |publisher=Web.archive.org |date=2011-01-13 |accessdate=2015-12-17 |deadurl=yes |archiveurl=https://web.archive.org/web/20110113204846/http://www.time.com/time/innovators_v2/alt_medicine/profile_goodheart.html |archivedate=January 13, 2011 }}</ref> and began teaching it to other chiropractors.<ref name=ACA_techniques>[http://www.amerchiro.org/pdf/PDR/H-Chiropractic%20Techniques.pdf Chiropractic Techniques.] {{webarchive |url=https://web.archive.org/web/20060728105451/http://www.amerchiro.org/pdf/PDR/H-Chiropractic%20Techniques.pdf |date=July 28, 2006 }} [[American Chiropractic Association]]. </ref> An organization of Goodheart Study Group Leaders began meeting in 1973, selected the name "The International College of Applied Kinesiology" (ICAK) in 1974, adopted bylaws in 1975, elected officers in 1975, and "certified" its charter members (called "diplomates") in 1976.<ref>[http://www.icak.com/index.php?option=com_content&view=article&id=51:john-thie-dc-1973-to-1976&catid=35:history&Itemid=72 John Thie, D.C. – 1973 to 1976] {{webarchive|url=https://web.archive.org/web/20161203235134/http://www.icak.com/index.php?option=com_content&view=article&id=51%3Ajohn-thie-dc-1973-to-1976&catid=35%3Ahistory&Itemid=72 |date=December 3, 2016 }}</ref> ICAK now considers 1976 to be the date it was founded and 1973 to be the date that its first chairman took office.<ref>[http://www.icak.com/index.php?option=com_content&view=article&id=53&Itemid=64 What is the International College of Applied Kinesiology (ICAK)?] {{webarchive |url=https://web.archive.org/web/20161203235128/http://www.icak.com/index.php?option=com_content&view=article&id=53&Itemid=64 |date=December 3, 2016 }}</ref> |
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=== The development of the "AK" technique === |
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While this practice is primarily used by chiropractors, it is now also used by a number of other practitioners.<ref name="Quackwatch-AK">[http://www.quackwatch.org/01QuackeryRelatedTopics/Tests/ak.html Applied Kinesiology: Phony Muscle-Testing for "Allergies" and "Nutrient Deficiencies"] {{webarchive |url=https://web.archive.org/web/20161011024055/http://www.quackwatch.org/01QuackeryRelatedTopics/Tests/ak.html |date=October 11, 2016 }}, by Stephen Barrett, MD</ref> In 2003, it was the 10th most frequently used chiropractic technique in the United States, with 37.6% of chiropractors employing this method and 12.9% of patients being treated with it.<ref name=NBCE_techniques>{{Cite book|title=Job Analysis of Chiropractic |year=2005 |page=135 |place= |publisher=National Board of Chiropractic Examiners |url=http://nbce.org/pdfs/job-analysis/chapter_10.pdf |doi= |id= |isbn=1-884457-05-3 |deadurl=yes |archiveurl=https://web.archive.org/web/20081217004844/http://nbce.org/pdfs/job-analysis/chapter_10.pdf |archivedate=December 17, 2008 }}</ref> Some basic AK based techniques have also been used/misused by [[Dietary supplement|nutritional supplement]] distributors, including [[Multi-level marketing|multilevel distributors]].<ref name="Quackwatch-AK"/><ref name=ACS2009>{{cite book |publisher=[[American Cancer Society]] |title=American Cancer Society Complete Guide to Complementary and Alternative Cancer Therapies |edition=2nd |year=2009 |isbn=9780944235713 |editors=Russell J, Rovere A |pages=160-164 |chapter=Applied Kinesiology}}</ref> |
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Including: who, when, how |
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'''Applied Kinesiology''' (AK) provides an integrated, interdisciplinary approach to health care. [[George Goodheart| George J. Goodheart]], D.C., originated AK in 1964. <ref name="Goodheart1">{{Cite book|title=Applied Kinesiology Manuals|last=Goodheart|first=GJ|date=1964-1998|publisher=Privately published|location=Detroit, MI| }}</ref> <ref name="Green">{{cite journal|last=Green|first=BN|authorlink=|title=George Goodheart, Jr., D.C., and a history of applied kinesiology|journal=J. Manipulative Physiol. Ther.|volume=20|issue=5|pages=331-337|coauthors=Gin, RH}}</ref> Dr. Goodheart found a technique that could immediately make a muscle that tested weak strong. The technique did not correct all muscles that tested weak but from this initial experience, testing muscles in a precise manner became routine in his examination protocol. The investigation of other causes of muscle weakness and their correction developed into what is currently the practice of AK. |
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== Claims== |
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Applied kinesiology is presented as a system that evaluates structural, chemical, and mental aspects of health by using a method referred to as manual muscle testing (MMT) alongside conventional diagnostic methods. The essential premise of applied kinesiology, which is not shared by mainstream medical theory, is that every organ dysfunction is accompanied by a weakness in a specific corresponding muscle in what is termed the "viscerosomatic relationship."<ref name=ACS2009/><ref name='ICAK_status'>{{cite web|url=http://www.icak.com/college/status.shtml |title=Applied Kinesiology Status Statement |accessdate=2008-02-13 |publisher=International College of Applied Kinesiology – USA |archiveurl=https://web.archive.org/web/20080322003013/http://www.icak.com/college/status.shtml |archivedate=2008-03-22 |deadurl=no |df= }}</ref> Treatment modalities relied upon by AK practitioners include joint manipulation and mobilization, myofascial, cranial and [[Meridian (Chinese medicine)|meridian]] therapies, clinical nutrition, and dietary counseling.<ref name="ICAKDEF">{{cite web|title =What is Applied Kinesiology?|publisher=ICAK-USA|url=http://www.icakusa.com/what.php|accessdate=5 December 2007| archiveurl= https://web.archive.org/web/20071130001429/http://www.icakusa.com/what.php| archivedate= 30 November 2007 <!--DASHBot-->| deadurl= no}}</ref> |
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The actual testing of the muscle had been previously and firmly established by [[HO Kendall| Kendall and Kendall]] <ref name="Kendall3">{{cite book|title=Posture and Pain|last=Kendall|first=HO|date=1952|publisher=Williams & Wilkins|location=Baltimore, MD}}</ref> who held that a muscle from a contracted position against increasing applied pressure could either maintain its position (rated as "facilitated" or "strong") or break away and thus be rated as "inhibited" or "weak". The testing of muscle strength itself had been widely practiced in manual medicine for decades by such authorities as Daniels, Worthingham, and the use of the MMT for functional conditions continues today with the work of [[Vladimir Janda|Janda]], [[Leon Chaitow| Chaitow]], Sahrmann, Bergmann, [[Karel Lewit|Lewit]], [[Craig Liebenson| Liebenson]], and [[Warren Hammer|Hammer]]. <ref name="Janda4">{{cite book|title=Muscle Function Testing|last=Janda|first=V|date=1983|publisher=Butterworths|location=London}}</ref> <ref name="Liebenson">{{cite book|title=Rehabilitation of the Spine: A Practitioner's Manual|last=Liebenson|first=C|date=2007|publisher=Lippincott, Williams & Wilkins|edition=2nd|location=Philadelphia}}</ref> <ref name="Lewit">{{cite book|title=Manipulative Therapy in Rehabilitation of the Locomotor System|last=Lewit|first=K|date=1999|publisher=Butterworths|edition=3rd|location=London}}</ref> <ref name="Hammer">{{cite book|title=Functional Soft Tissue Examination and Treatment by Manual Methods|last=Hammer|first=WI|date=1999|publisher=Aspen|edition=3rd|location=Gaithersburg, MD|pages=12,27-33,415-445}}</ref> <ref name="Sahrmann">{{cite book|title=Diagnosis and Treatment of Movement Impairment Syndroms|last=Sahrmann|first=S|date=2001|publisher=Mosby Inc.|location=St. Louis, MO}}</ref> |
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A manual muscle test in AK is conducted by having the patient resist using the target muscle or muscle group while the practitioner applies a force. A smooth response is sometimes referred to as a "strong muscle" and a response that was not appropriate is sometimes called a "weak response". This is not a raw test of strength, but rather a subjective evaluation of tension in the muscle and smoothness of response, taken to be indicative of a difference in spindle cell response during contraction. These differences in muscle response are claimed to be indicative of various stresses and imbalances in the body.<ref name='Sims_Gale'>{{cite journal|title=Applied Kinesiology|journal=Gale Encyclopedia of Alternative Medicine|first=Judith|last=Sims|volume=|issue=|pages=|id= |url=http://findarticles.com/p/articles/mi_g2603/is_0001/ai_2603000168/pg_1|format=|accessdate=2008-02-13 }}</ref> A weak muscle test is equated to dysfunction and chemical or structural imbalance or mental stress, indicative of suboptimal functioning.<ref name='ICAK_history'>{{cite web|url=http://www.icak.com/college/history.shtml |title=Applied Kinesiology: In Retrospect|accessdate=2008-02-13 |publisher=International College of Applied Kinesiology – USA }} {{Dead link|date=October 2010|bot=H3llBot}}</ref> It may be suboptimal functioning of the tested target muscle, or a normally optimally functioning muscle can be used as an indicator muscle for other physiological testing. A commonly known and very basic test is the arm-pull-down test, or "Delta test," where the patient resists as the practitioner exerts a downward force on an [[Extension (kinesiology)|extended]] arm.<ref name="frost">Frost, Robert, ''Applied Kinesiology: A Training Manual and Reference Book of Basic Principles and Practices', p. 4, North Atlantic Books, 2002. [https://books.google.com/books?id=Bl0BQvU6EfQC&printsec=frontcover#PPA3,M1 available online] {{webarchive |url=https://web.archive.org/web/20141214082606/https://books.google.com/books?id=Bl0BQvU6EfQC&printsec=frontcover#PPA3,M1 |date=December 14, 2014 }}</ref> Proper positioning is paramount to ensure that the muscle in question is isolated or positioned as the prime mover, minimizing interference from adjacent muscle groups.<ref name='ICAK_status' /> |
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Each of these researchers uses the MMT to diagnose muscular imbalance. In a sense, the early work of Goodheart and Kendall has influenced generations of practitioners spanning many disciplines and has become consensus methodologies across a broad spectrum of professionals. Even the [[ American Medical Association]] has accepted that the standard method of MMT used in AK is a reliable tool and advocates its use for the evaluation of disability impairments. <ref name="American Medical Association9">{{cite book|title=Guides to the Evaluation of Permanent Impairment|last=American Medical Association|date=2001|edition=5th|location=Chicago, IL|pages=510}}</ref> |
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"Nutrient testing" is used to examine the response of various of a patient's muscles to assorted chemicals. Gustatory and olfactory stimulation are said to alter the outcome of a manual muscle test, with previously weak muscles being strengthened by application of the correct nutritional supplement, and previously strong muscles being weakened by exposure to harmful or imbalancing substances or allergens.<ref name='ICAK_status' /><ref name='Sims_Gale' /><ref name='intelihealth'>{{cite web|url=http://www.intelihealth.com/IH/ihtIH/WSIHW000/8513/34968/358738.html?d=dmtContent |title=Applied Kinesiology |accessdate=2008-02-13 |publisher=InteliHealth |deadurl=yes |archiveurl=https://web.archive.org/web/20071016185021/http://intelihealth.com/IH/ihtIH/WSIHW000/8513/34968/358738.html?d=dmtContent |archivedate=2007-10-16 }}</ref> Though its use is deprecated by the ICAK,<ref name='ICAK_faq'>{{cite web|url=http://www.icak.com/about/icak_faq.shtml |title=International College of Applied Kinesiology – FAQ |accessdate=2008-02-13 |publisher=International College of Applied Kinesiology – USA |archiveurl=https://web.archive.org/web/20070829110654/http://www.icak.com/about/icak_faq.shtml |archivedate=2007-08-29 |deadurl=no |df= }}</ref> stimulation to test muscle response to a certain chemical is also done by contact or proximity (for instance, testing while the patient holds a bottle of pills). |
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[[File:Rosner1.jpg|thumb|191x191px|[http://wikichiro.org/en/images/d/d9/Rosner1.jpg Figure] 1. Hypertonic muscle secondary to inhibited muscle responsive to chiropractic manipulative therapy (AK model)]] |
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[[File:Rosner2.jpg|thumb|187x187px|Fig 2.Inhibited muscle responsive to chiropractic manipulative therapy(AK model)]] |
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Goodheart’s work drew a large following of doctors and recognition. He was the first chiropractor officially appointed to the US Winter Olympic Sports Medicine team. <ref name="Time10">{{cite web|url=http://www.time.com/time/innovators_v2/alt_medicine/profile_goodheart.html|title=Time Magazine Profile}}</ref> |
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In 1976 the International College of Applied Kinesiology was founded to promote the research and teaching of AK. <ref name="ICAK-USA11">{{cite web|url=http://www.icakusa.com/research/|title=AK Research Compendium, Dr. Scott Cuthbert|last=ICAK-USA|accessdate=January 23, 2010}}</ref> <ref name="ICAK-International">{{cite web|url=http://www.icak.com/index.php?option=com_content&view=article&id=68&Itemid=81|title=AK Research Compendium, Dr. Scott Cuthbert|last=ICAK-International|accessdate=January 23, 2010}}</ref> |
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"Therapy localization" is another diagnostic technique using manual muscle testing which is unique to applied kinesiology. The patient places a hand which is not being tested on the skin over an area suspected to be in need of therapeutic attention. This fingertip contact may lead to a change in muscle response from strong to weak or ''vice versa'' when therapeutic intervention is indicated. If the area touched is not associated with a need for such intervention, the muscle response is unaffected.<ref name='ICAK_history' /> |
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The ICAK began in the United States with a majority of chiropractors as members. There are now chapters in Australia, Austria, Benelux, Brazil, Canada, France, Germany, Italy, Korea, Russia, Sweden, Switzerland, United Kingdom, and the USA. The organization is multi-disciplinary; membership includes medical doctors, osteopaths, dentists, psychologists, and other health care providers who are licensed to diagnose patients. Medical practitioners using AK vary by country. There are over 1,000 medical doctors in Germany, for instance, who use AK as part of their diagnostic system. <ref name="International College">{{cite web|url=http://www.icak-d.de/|title=Aktuelle Seminarhinweis|last=International College of Applied Kinesiology Deutschland|accessdate=January 23, 2010}}</ref> |
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Muscle Response Testing (MRT) is claimed to be distinct from Applied Kinesiology in that AK is complementary medicine while MRT only tests one muscle repeatedly as a binary test.{{cn|date=August 2017}} |
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The first book to describe the value of AK to other professions -- "AK and the Stomatognathic System" --was authored by Gelb, a dentist, and Goodheart in 1977. <ref name="Gelb13">{{cite book|title=Clinical Management of Head, Neck and TMJ Pain and Dysfunction|last=Gelb|first=H|date=1977|publisher=W.B. Saunders|location=Philadelphia, PA}}</ref><ref name="Goodheart14">{{cite journal|last=Goodheart|first=GJ Jr.|title=Kinesiology and dentistry|journal=J Amer Soc Psychosomatic Disease|volume=6|pages=16-18}}</ref> |
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== Scientific research == |
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In 2015 the [[Department of Health (Australia)|Australian Government's Department of Health]] published the results of a review of alternative therapies that sought to determine if any were suitable for being covered by [[health insurance]]; applied kinesiology was one of 17 therapies evaluated for which no clear evidence of effectiveness was found.<ref name=aus17>{{cite web |url=http://www.health.gov.au/internet/main/publishing.nsf/content/0E9129B3574FCA53CA257BF0001ACD11/$File/Natural%20Therapies%20Overview%20Report%20Final%20with%20copyright%2011%20March.pdf |publisher=Australian Government – Department of Health |format=PDF |author=Baggoley C |title=Review of the Australian Government Rebate on Natural Therapies for Private Health Insurance |year=2015 |laysummary=https://www.sciencebasedmedicine.org/australian-review-finds-no-benefit-to-17-natural-therapies |lay-source=Gavura, S. Australian review finds no benefit to 17 natural therapies. Science-Based Medicine. |lay-date=19 November 2015}}</ref> According to the [[American Cancer Society]], "available scientific evidence does not support the claim that applied kinesiology can diagnose or treat cancer or other illness".<ref name=ACS2009/> |
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Goodheart set the peer review trend for AK by publishing a discussion of dentistry and AK in 1976. <ref name="Goodheart14">{{cite journal |
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A review of several scientific studies of AK-specific procedures and diagnostic tests concluded that "When AK is disentangled from standard orthopedic muscle testing, the few studies evaluating unique AK procedures either refute or cannot support the validity of AK procedures as diagnostic tests. The evidence to date does not support the use of manual muscle testing for the diagnosis of organic disease or pre/subclinical conditions."<ref name='AK_Haas'>{{cite journal|title=Disentangling manual muscle testing and Applied Kinesiology: critique and reinterpretation of a literature review|journal=Chiropractic & Osteopathy|date=August 2007|first=Mitchell|last=Haas|author2=Robert Cooperstein |author3=David Peterson |volume=15|issue=1|page=11|pmid=17716373 |url=http://www.chiroandosteo.com/content/15/1/11|format=|accessdate=2007-11-30|doi=10.1186/1746-1340-15-11|pmc=2000870| archiveurl= https://web.archive.org/web/20071016095829/http://www.chiroandosteo.com/content/15/1/11| archivedate= 16 October 2007 <!--DASHBot-->| deadurl= no}}</ref> Another concluded that "There is little or no scientific rationale for these methods. Results are not reproducible when subject to rigorous testing and do not correlate with clinical evidence of allergy."<ref name='AK_Wuthrich'>{{cite journal|title=Unproven techniques in allergy diagnosis|journal=Journal of Investigational Allergology and Clinical Immunology|year=2005|first=B.|last=Wurlich|volume=15|issue=2|pages=86–90|pmid=16047707 |url=}}</ref> A double-blind study was conducted by the ALTA Foundation for Sports Medicine Research in Santa Monica, California and published in the June 1988 Journal of the American Dietetic Association. The study used 3 experienced AK practitioners and concluded that, "The results of this study indicated that the use of Applied Kinesiology to evaluate nutrient status is no more useful than random guessing."<ref name=kenney /> |
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| last = Goodheart |
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| first = GJ Jr. |
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| title = Kinesiology and dentistry |
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| journal = J Amer Soc Psychosomatic Disease |
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| volume = 6 |
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| pages = 16-18}}</ref> Scopp published the first research paper discussing the AK approach to a functional organic disorder with allergy testing in 1979.<ref name="Soopp16">{{cite journal|last=Scopp|first=A|title=An experimental evaluation of kinesiology in allergy and deficiency disease diagnosis|journal=J Orthomolecular Psychiatry|volume=7|issue=2|pages=137-138}}</ref> |
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There are now over 100 papers published in peer-reviewed journals on the methods and outcomes of AK. <ref name="ICAK-USA11">{{cite web |
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Despite more than four decades of review, RCT (randomized, controlled trials) and other evaluative methods, even invested researchers delivered the following opinion: |
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| last = ICAK-USA |
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| title = AK Research Compendium, Dr. Scott Cuthbert |
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| url = http://www.icakusa.com/scientificresearch.php}}</ref><ref name="Cuthbert17">{{cite journal|last=Cuthbert|first=SC|date=March 6, 2007|title=On the reliability and validity of manual muscle testing: A literature review|url=http://www.chiroandosteo.com/content/15/1/4|journal=Chiropr Osteo|volume=15|issue=1|pages=4|coauthors=Goodheart GJ Jr}}</ref> Few chiropractic therapeutic methods have been investigated or written about as extensively as AK. There have been 35 separate books published about AK methods since 1964. <ref name="ICAK-USA11">">{{cite web |
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| last = ICAK-USA |
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| title = AK Research Compendium, Dr. Scott Cuthbert |
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| url = http://www.icakusa.com/scientificresearch.php |
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| accessdate = January 23, 2010}}</ref> |
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=== How has the technique changed over the years === |
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<blockquote>One shortcoming is the lack of RCTs to substantiate (or refute) the clinical utility (efficacy, effectiveness) of chiropractic interventions based on MMT findings. Also, because the etiology of a muscle weakness may be multifactorial, any RCT that employs only one mode of therapy to only one area of the body may produce outcomes that are poor due to these limitations.<ref name=cuthbert>{{cite journal|author=Cuthbert, S C|author2=Goodheart, G J|title=On the reliability and validity of manual muscle testing: a literature review |journal=Chiropractic & Osteopathy 2007|volume=15|issue=1|page=4|date=March 2007|doi=10.1186/1746-1340-15-4|pmc=1847521|pmid=17341308}}</ref></blockquote> |
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Since the original discovery, the AK examination system has broadened to include evaluation of the nervous, vascular, and lymphatic systems, nutrition, acupuncture, cerebrospinal fluid function and many other controlling or disturbing factors that influence health and neuromusculoskeletal function. Each of these areas of human function have been shown to effect the muscular system, and AK and allied health systems’ research evidence in this regard is constantly growing. <ref name="ICAK-USA11">{{cite web |
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| last = ICAK-USA |
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| title = AK Research Compendium, Dr. Scott Cuthbert |
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| url = http://www.icakusa.com/scientificresearch.php |
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| accessdate = January 23, 2010}}</ref><ref name="Schmitt18">{{cite journal|last=Schmitt|first=WH|authorlink=|date=2008|title=Common errors and clinical guidelines for manual muscle testing: "The arm test" and other inaccurate procedures|journal=Chiropr & Osteo|volume=16|pages=16|doi=10.1186/1746-1340:16-16|coauthors=Cuthbert SC}}</ref> |
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Three areas that have been shown to effect muscle function are the cranial system, the meridian system, and nutritional imbalances. |
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== Criticism == |
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=== Nutrition and Adverse Chemicals === |
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Nearly all AK tests are subjective, relying solely on practitioner assessment of muscle response. Specifically, some studies have shown test-retest reliability, inter-tester reliability, and accuracy to have no better than chance correlations.<ref name=ACS2009/><ref name=ludtke>{{cite journal|vauthors=Lüdtke R, Kunz B, Seeber N, Ring J|title=Test-retest-reliability and validity of the Kinesiology muscle test|journal=Complement Ther Med|volume=9|issue=3|pages=141–5|date=September 2001 |doi=10.1054/ctim.2001.0455|pmid=11926427}}</ref><ref name='Hyman'>{{cite journal|title=Psychology and 'Alternative Medicine': the mischief-making of ideomotor action|journal=Scientific Review of Alternative Medicine|year=1999|first=Ray|last=Hyman|volume=3|issue=2|pages=|id=|url=http://www.sram.org/0302/ideomotor.html|accessdate=2008-02-25|archiveurl=https://web.archive.org/web/20080210043213/http://www.sram.org/0302/ideomotor.html|archivedate=10 February 2008 <!--DASHBot-->|deadurl=no}}</ref> Some skeptics have argued that there is no scientific understanding of the proposed underlying theory of a viscerosomatic relationship, and the efficacy of the modality is unestablished in some cases and doubtful in others.<ref name=ACS2009/><ref name='intelihealth'/> Skeptics have also dismissed AK as "quackery," "[[magical thinking]]," and a misinterpretation of the [[ideomotor effect]].<ref name="skepdic_ak"/><ref name=skepdic_mag>[http://skepdic.com/magicalthinking.html Magical Thinking.] {{webarchive |url=https://web.archive.org/web/20161121175744/http://skepdic.com/magicalthinking.html |date=November 21, 2016 }} [[Skeptic's Dictionary]]</ref> It has also been criticized on theoretical and [[empirical]] grounds,<ref name="skepdic_ak">{{cite web|url=http://skepdic.com/akinesiology.html|title=Applied Kinesiology|accessdate=2007-07-26|work=The Skeptics Dictionary|author=Carroll, Robert Todd "These are empirical claims and have been tested and shown to be false"|archiveurl=https://web.archive.org/web/20070810143939/http://skepdic.com/akinesiology.html| archivedate=10 August 2007 <!--DASHBot-->|deadurl=no}}</ref> and characterized as [[pseudoscience]].<ref name="atwood">{{cite journal|author=Atwood KC|title=Naturopathy, Pseudoscience, and Medicine: Myths and Fallacies vs Truth |journal=MedGenMed|volume=6|issue=1|page=33|year=2004|url=http://www.medscape.com/viewarticle/471156|doi=|pmc=1140750|pmid=15208545}}</ref> With only [[anecdotal evidence|anecdotal accounts]] claiming to provide positive evidence for the efficacy of the practice, a review of [[peer-review]]ed studies concluded that the "evidence to date does not support the use of [AK] for the diagnosis of organic disease or pre/subclinical conditions."<ref name='AK_Haas'/> |
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The effect of nutrition and chemicals on health and muscle function is evolving. Modern science is constantly discovering new information furthering this knowledge. Nutritional items, when chewed, stimulate the nerve endings in the mouth. This may have an immediate effect on muscle function. For example, if the muscle clinically associated with the stomach is weak and betaine hydrochrloride is indicated for stomach support, tasting this digestive enzyme may cause immediate and dramatic improvement of the muscle’s function, as indicated by the MMT. Conversely, if a toxic chemical is causing a problem in the stomach, a muscle associated with the stomach will test poorly<ref name="Carpenter1">{{cite journal|last=Carpenter|first=SA|date=1977|title=Evaluation of muscle-organ association, Part I|journal=J Clin Chiro|volume=2|issue=6|pages=22-33|coauthors=Hoffman J, Mendel R}}</ref><ref name="Carpenter2">{{cite journal|last=Carpenter|first=SA|date=1977|title=Evaluation of muscle-organ association, Part II|journal=J Clin Chiro|volume=3|issue=1|pages=42-60|coauthors=Hoffman J, Mendel R}}</ref>immediately after the substance is tasted or inhaled. Carpenter showed that this type of muscle-organ relationship existed for other organs as well, including the lungs, stomach, ears and eyes. |
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All aspects of the examination should correlate and lead to the final diagnosis and recommendation for treatment. Applied kinesiology muscle tests for nutrition and chemicals do not take the place of a complete, thorough examination; rather, they augment it by evaluating how the body responds to the substance(s) being tested. This adds a functional evaluation that takes into consideration the biochemical individuality of people. |
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== Position statements == |
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Travell and Simons for instance showed that in the case of myofascial trigger point formation, correction of nutritional “perpetuating factors” can be the most important part of therapy. <ref name="Travell">{{cite book|title=Myofascial Pain and Dysfunction: The Trigger Point Manual|last=Travell|first=JG|date=1983|publisher=Williams & Wilkins|volume=1|location=Baltimore, MD|pages=103-164|coauthors=Simons DG}}</ref> |
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===Allergy diagnosis=== |
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Systemic perpetuating factors for trigger point problems encompass many conditions that compromise muscle energy metabolism. These conditions include anemia, low serum ferritin, inadequate thyroid function, vitamin B1 (the energy vitamin) inadequacy, folic acid, and/or vitamin B12 inadequacy. <ref name="Travell">{{cite book |
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In the US, the [[American Academy of Allergy, Asthma and Immunology]]<ref name="Bernstein08">{{cite journal|last=Bernstein|first=IL|title=Allergy diagnostic testing: an updated practice parameter|journal=Annals of Allergy, Asthma & Immunology|date=March 2008|volume=100|issue=3, Supplement 3|pages=S1-148|pmid=18431959|url=http://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Parameters/allergydiagnostictesting.pdf|doi=10.1016/S1081-1206(10)60305-5|display-authors=etal}}</ref> and the [[National Institute of Allergy and Infectious Diseases]]<ref name=Boyce10>{{cite journal|last=Boyce|first=JA|author2=Assa'ad A |author3=Burks AW |title=Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel.|journal=The Journal of Allergy and Clinical Immunology|date=December 2010|volume=126|issue=6 Suppl.|pages=S1-S58|pmid=21134576|url=http://download.journals.elsevierhealth.com/pdfs/journals/0091-6749/PIIS0091674910015666.pdf|doi=10.1016/j.jaci.2010.10.007|display-authors=etal}}</ref> have both advised that applied kinesiology should not be used in the diagnosis of allergies. The [[European Academy of Allergology and Clinical Immunology]],<ref name=Ortolani99>{{cite journal|last=Ortolani C|author2=Bruijnzeel-Koomen C |author3=Bengtsson U |title=Controversial aspects of adverse reactions to food. European Academy of Allergology and Clinical Immunology (EAACI) Reactions to Food Subcommittee.|journal=Allergy|date=January 1999|volume=54|issue=1|pages=27–45|doi=10.1034/j.1398-9995.1999.00913.x|pmid=10195356|url=http://onlinelibrary.wiley.com/doi/10.1034/j.1398-9995.1999.00913.x/pdf|display-authors=etal}}</ref> the [[National Institute for Clinical Excellence]]<ref name=NICE2011>{{cite journal|last=Centre for Clinical Practice at NICE|title=Food Allergy in Children and Young People: Diagnosis and Assessment of Food Allergy in Children and Young People in Primary Care and Community Settings|journal=NICE Clinical Guidelines|date=February 2011|volume=116|pmid=22259824|url=http://www.ncbi.nlm.nih.gov/books/n/nicecg116/pdf/}}</ref><ref name=NICE>[http://www.nice.org.uk/newsroom/pressreleases/DraftGuidelineOnFoodAllergiesInChildren.jsp NICE consults on draft guideline on food allergies in children] {{webarchive |url=https://web.archive.org/web/20131020220845/http://www.nice.org.uk/newsroom/pressreleases/DraftGuidelineOnFoodAllergiesInChildren.jsp |date=October 20, 2013 }}</ref> of the UK, the [[Australasian Society of Clinical Immunology and Allergy]]<ref name="ASCIA">{{cite web|title=Unorthodox techniques for the diagnosis and treatment of allergy, asthma and immune disorders |date=November 2007 |url=http://www.allergy.org.au/pospapers/unorthodox.htm |publisher=Australasian Society of Clinical Immunology and Allergy |accessdate=7 February 2012 |deadurl=yes |archiveurl=https://web.archive.org/web/20111228204150/http://www.allergy.org.au/pospapers/unorthodox.htm |archivedate=28 December 2011 |df= }}</ref> and the Allergy Society of South Africa<ref name="Motala09">{{cite journal|last=Motala|first=C|author2=Hawarden, D|title=Guideline: Diagnostic testing in allergy|journal=South African Medical Journal|date=July 2009|volume=99|issue=7|pages=531–535|url=http://www.mm3admin.co.za/documents/docmanager/8e7be0a4-2b8d-453f-875e-cd1e5132b829/00015029.pdf}}</ref> has also advised similarly. The [[World Allergy Organization]] does not have a formal position on applied kinesiology, but in educational materials from its ''Global Resources In Allergy'' program it lists applied kinesiology as an unproven test and describes it as useless.<ref name=WAO>{{cite web|title=Global Resources in Allergy (GLORIA) - Module 6: Food Allergy|url=http://www.worldallergy.org/educational_programs/gloria/slides/international/Module6_Food_Allergy.ppt|publisher=World Allergy Organization|accessdate=29 February 2012}}</ref> In 1998, a small pilot study published in the [[International Journal of Neuroscience]] showed a correlation between applied kinesiology muscle testings and serum immunoglobulin levels for food allergies. 19 of 21 (90.5%) suspected food allergies diagnosed by applied kinesiology were confirmed by serum immunoglobulin tests.<ref>{{cite journal | pmid = 10069623 | volume=96 | issue=3-4 | title=Correlation of applied kinesiology muscle testing findings with serum immunoglobulin levels for food allergies | date=December 1998 | pages=237–44 | journal=Int. J. Neurosci. | doi=10.3109/00207459808986471 | last1 = Schmitt | first1 = WH | last2 = Leisman | first2 = G}}</ref> A follow up review published in 2005 in the Current Opinion of Allergy and Clinical Immunology concluded applied kinesiology had no proven basis for diagnosis.<ref name=COACI>{{cite journal|title=Food allergy diagnostics: scientific and unproven procedures |journal=Curr Opin Allergy Clinical Immun |pmid=15864086 | volume=5|date=June 2005|pages=261–6 | last1 = Beyer | first1 = K | last2 = Teuber | first2 = SS | doi=10.1097/01.all.0000168792.27948.f9}}</ref> |
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| last = Travell |
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| first = JG |
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| coauthors = Simons DG |
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| title = Myofascial Pain and Dysfunction: The Trigger Point Manual |
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| publisher = Williams & Wilkins |
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| volume = 1 |
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| date = 1983 |
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| location = Baltimore, MD |
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| pages = 103-164}}</ref> Frequently, several of these are present at once, and the laboratory reports low-normal values. Travell and Simmons are clear in their insistence that nutritional imbalance has to be restored if myofascial pain is to be adequately dealt with: “Nearly half of the patients whom we see with chronic myofascial pain require resolution of vitamin inadequacies for lasting relief.” In their opinion, nutritional factors must be considered in most patients if lasting relief of pain is to be achieved. |
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The neurological, training and positioning requirements indicate that MMT in professional AK is a highly complex and skilled undertaking. Accordingly, the probability of omitting or misinterpreting essential elements of AK from the many derivative procedures which have been cited in the literature is high. The result is that many of the criticisms of MMT in AK may have been directed at versions of AK not performed by individuals specifically trained in professional AK. One simply needs to refer to the very origins of AK in which Goodheart wrote that lingual receptors need to be stimulated in order to obtain reliable nutritional testing. Goodheart's research manuals specifically stated that "holding a glass vial of pills" or "laying pills or substances on the chest" were inappropriate procedures because the responses were neither predictable nor explicable.<ref name="Goodheart">{{cite book|title=Applied Kinesiology Research Manuals|last=Goodheart|first=GJ|date=1964-1998|publisher=Privately published|location=Detroit, MI}}</ref>Taste receptors on the tongue, on the other hand, respond to even miniscule concentrations of substances within a fraction of a second.<ref name="Guyton">{{cite book|title=Textbook of Medical Physiology|last=Guyton|first=AC|date=2005|publisher=W.B. Saunders Company|location=Philadelphia, PA|pages=581-583|coauthors=Hall JE}}</ref> |
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===American Chiropractic Association=== |
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=== Cranial Bone Movement and the MMT === |
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According to the American Chiropractic Association, in 2003 Applied kinesiology was the 10th most frequently used chiropractic technique in the United States, with 37.6% of chiropractors employing this method and 12.9% of patients being treated with it.<ref name=NBCE_techniques/> |
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It was originally thought that the skull was a solid mass primarily protecting the brain. In reality, there is minute predictable movement between the bones that is necessary for normal function of the nerves and spinal fluid. <ref name="Chaitow">{{cite book|title=Cranial Manipulation: Theory and Practice|last=Chaitow|first=L|date=2005|publisher=Elsevier|location=Edinburgh}}</ref> Spinal fluid surrounds the brain and spinal cord, providing nutrition, lubrication, and hormone movement. A bump or other type of strain to the head can jam the skull bones, causing abnormal movement. Improper nerve function may result that can cause problems in remote organs or other body structures. |
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There are several methods for evaluating skull function that have been developed in AK examination. The doctor may test a muscle, apply a challenge to bones of the skull, and then re-test the muscle. The patient may be asked to take a deep breath and hold it, and then a muscle is re-tested to determine any change. The doctor may have the patient touch various areas of their skull while a muscle is tested. Dysfunction of the skull is called a cranial fault. If one is found, a specific gentle pressure, the direction of which is determined by the MMT examination, will be applied to the skull, usually with a specific phase of respiration. If the correction is successful, there will be an immediate improvement of the MMT. Research supporting the functional integration of the neuromuscular system and the craniosacral system has been presented by the ICAK, Walther and Goodheart.<ref name="Goodheart1">{{Cite book |
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{{Quote|This is an approach to chiropractic treatment in which several specific procedures may be combined. Diversified/manipulative adjusting techniques may be used with nutritional interventions, together with light massage of various points referred to as neurolymphatic and neurovascular points. Clinical decision-making is often based on testing and evaluating muscle strength.<ref name=ACA_techniques/>}} |
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| last = Goodheart |
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| first = GJ |
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| title = Applied Kinesiology Manuals |
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| publisher = Privately published |
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| date = 1964-1995 |
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| location = Detroit, MI}}</ref><ref name="ICAK-USA11">{{cite web |
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| last = ICAK-USA |
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| title = AK Research Compendium, Dr. Scott Cuthbert |
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| url = http://www.icakusa.com/scientificresearch.php |
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| accessdate = January 23, 2010}}</ref><ref name="Walther21">{{cite book|title=Applied Kinesiology: Head, Neck, and Jaw Pain and Dysfunction--The Stomatographic System|last=Walther|first=DS|date=1983|publisher=Systems D.C.|volume=II|location=Pueblo, CO}}</ref> |
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=== |
=== Meridian Therapy === |
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The Chinese developed a system of treating disease and maintaining health that balances the energy in the body’s meridians.<ref name="O'Connor">{{cite book|title=Acupuncture: A Comprehensive Text|last=O'Connor|first=J|date=1981|publisher=Eastland Press|location=Seattle, WA|coauthors=Bensky D}}</ref> In modern times, acupuncture – or more accurately “meridian therapy” – has proven a valid method of treatment.<ref name="Kaptchuk">{{cite book|title=The Web Has No Weaver: Understanding Chinese Medicine|last=Kaptchuk|first=T|date=2000|publisher=Contemporary Books|location=Chicago, IL}}</ref> Dr. Goodheart and the ICAK have provided some of the first advancements in this treatment in the Western world.<ref name="Goodheart22">{{cite book|title=Applied Kinesiology Research Manuals|last=Goodheart|first=GJ|date=1972|location=Detroit, MI}}</ref> By using AK techniques, the flow of energy in the meridians can be evaluated and corrected if out of balance. Correction can be made by many methods of stimulation, such as electrical, laser, needles, small tape patches with metal balls, or simply by mechanically stimulating certain spots. There is usually an immediate improvement in muscle function after meridian balancing. A number of recent published reports have demonstrated the effectiveness of the AK system of analysis for acupuncture system dysfunctions.<ref name="Moncayo23">{{cite journal|last=Moncayo|first=R|authorlink=|date=May 29, 2009|title=Evaluation of applied kinesiology meridian techniques by means of surface electromyography (sEMG): Demonstration of the regulatory influence of antique acupuncture points|journal=Chin Med|volume=4|issue=1|pages=9|coauthors=Moncayo H}}</ref><ref name="Costa">{{cite journal|last=Costa|first=LA|date=December 18, 2008|title=The immediate effects of local and adjacent acupuncture on the tibialis anterior muscle: A human study|journal=Chin Med|volume=3|issue=1|pages=17|coauthors=de Araujo JE}}</ref><ref name="Moncayo25">{{cite journal|last=Moncayo|first=R|authorlink=|date=August 2004|title=New diagnostic and therapeutic approach to thyroid-assisted orbitopathy based on applied kinesiology and homeopathic therapy.|journal=J Altern Compl Med|volume=10|issue=4|pages=643-650|coauthors=Moncayo H, Ulmer H, Rainz H}}</ref> |
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[[File:Rosner3.jpg|thumb|160x160px|Fig 3.Abnormal results of the manual muscle test, whether the muscle is weak or hypertonic, may indicate abnormal involvement of any of the factors surrounding it. A change in muscle function when specific stimulation or therapy is applied to one of these elements, also indicates dysfunction of the surrounding factors.]] |
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== Principles & theories == |
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According to a March 26, 1998 letter from the DKF (Dansk Kiropraktor Forening – Danish Chiropractic Association), following public complaints from patients receiving homeopathic care and/or AK instead of standard (DKF defined) chiropractic care, the DKF has determined that applied kinesiology is not a form of chiropractic care and must not be presented to the public as such. AK and homeopathy can continue to be practiced by chiropractors as long as it is noted to be alternative and adjunctive to chiropractic care and is not performed in a chiropractic clinic. Chiropractors may not infer or imply that the Danish chiropractic profession endorses AK to be legitimate or effective, nor may the word/title chiropractic/chiropractor be used or associated with the practice of AK.<ref name=danishchiro>[https://web.archive.org/web/20071016185610/http://chiro.org/chiro-list/newsfile/ak-test.txt Danish Chiropractic Association position]</ref> |
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{{Infobox Alternative Science|topics=|claims=Subjective measurements by those trained in the ideas of applied kinesiology show the positive effects of alternative medicine ideas.|origyear=1964|origprop=[[George Goodheart|George J. Goodheart]]|currentprop=International College of Applied Kinesiology, [[American Chiropractic Association]]}} Q: What are the principles/theories and aim of the technique in terms of both diagnosis (assessment) or treatment (correction)? |
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When muscle dysfunction is found the doctor proceeds with examination to find what therapy restores proper function. Application of the therapy, if successful, immediately returns proper muscle function. Re-examination at a later time determines if the correction is maintained. Thus the system (1) finds disturbance, (2) determines how to fix it, (3) determines if the corrective effort is successful and, most important (4) determines if the correction is stable. If the correction is not stable, further examination is done to find the reason so it can be eliminated. |
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== See also == |
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But what distinguishes AK is its emphasis upon proprioceptive responses of the muscle rather than the strength of the muscle itself. It essentially sees muscle function as a transcript of the central integrative state of the anterior horn motoneurons, summing all excitatory and inhibitory inputs. <ref name="Schmitt26">{{cite journal|last=Schmitt|first=WH Jr.|date=1998|title=Expanding the neurological examination using functional neurological assessment. Part II: Neurological basis of applied kinesiology|journal=Int J Neurosci|volume=97|issue=1-2|pages=77-108|coauthors=Yanuck SF}}</ref> In other words, the locus of dysfunction ultimately rests with the nervous system. A procedure called therapy localization, strictly diagnostic, seeks a change of muscle strength when the patient’s hand is placed over an area of suspected involvement. Challenge defines a mechanism to test the body’s ability to cope with external stimuli, again assessed by muscle testing. |
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* [[Ideomotor effect]] |
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* [[List of ineffective cancer treatments]] |
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* [[List of topics characterized as pseudoscience]] |
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* [[Nambudripad Allergy Elimination Technique]] |
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* [[Observer-expectancy effect]] |
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Challenge is a diagnostic procedure unique to AK that is used to determine the body’s ability to cope with external stimuli, which can be physical, chemical, or mental. Cranial challenge (for instance) has been described in the literature previously. <ref name="Cuthbert27">{{cite journal|last=Cuthbert|first=SC|date=October 2009|title=Developmental delay syndromes: Psychometric testing before and after chiropractic treatment of 157 children|journal=J Manipulative Physiol Ther|volume=32|issue=8|pages=660-669|coauthors=Barras M}}</ref><ref name="Cuthbert28">{{cite journal|last=Cuthbert|first=SC|date=May 2005|title=Symptomatic Arnold-Chiatri malformation and cranial nerve dysfunction: A case study of applied kinesiology cranial evaluation and treatment|journal=J Manipulative Physiol Ther|volume=28|issue=4|pages=e1-6|coauthors=Blum C}}</ref> After an external stimulus is applied, muscle-testing procedures are done to determine a change in the muscle strength as a result of the stimulus. Through this approach, ineffective therapies that produced no improvements in muscle strength are rejected and only those that elicit a positive muscle response are used. This guides the treatment given to a patient. |
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== References == |
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{{Reflist|2}} |
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Therapy localization is a diagnostic procedure unique to AK that consists of placing the patient’s hand over areas of suspected involvement and observing for a change in the MMT. This method is hypothesized to assist the doctor in finding areas that are involved with the muscle dysfunction found on MMT and has been used clinically for over 30 years. <ref name="Goodheart1" /> Pollard et al in a recent literature review presented some of the research about the AK concept of therapy localization. <ref name="Pollard29">{{cite journal|last=Pollard|first=HP|date=2006|title=The ileocecal valve point and muscle testing: A possible mechanism of action.|journal=Chiropr J Aust|volume=36|issue=4|pages=122-126|coauthors=Bablis P, Bonello R}}</ref> Collectively these data suggest that stimulating the skin and the cutaneomotor reflexes can produce changes in muscle function. |
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== External links == |
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=== |
=== Diagnostic considerations === |
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Might include: |
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* [http://www.icak.com/ International College of Applied Kinesiology] |
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# Subluxations or other lesions are demonstrable on x-ray in some specific way or, |
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* [http://www.kinmed.com/ The International Journal of Applied Kinesiology and Kinesiologic Medicine] |
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# Leg length changes or, |
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# Muscle weakness or, |
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# Symptom patterns or, |
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# Or several components together |
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=== What equipment is commonly used if any? === |
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=== Skeptical evaluations === |
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The AK diagnostic philosophy is that if we understand, identify and quantify the abnormal features involved in a patient’s presenting disorders from a broad multi-systems physiological perspective, this will lay the foundation for better differential diagnosis and treatment. It is the AK contention that understanding the underlying processes of human illness and disorders as well as their development over time will direct the development of specific and relevant treatment strategies. In AK, we have developed and tested new treatment strategies for many functional disorders and this process, like all research, is on-going. |
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* [http://www.quackwatch.org/01QuackeryRelatedTopics/Tests/ak.html ''Applied Kinesiology: Muscle-Testing for "Allergies" and "Nutrient Deficiencies"''] by [[Stephen Barrett]], [[Quackwatch]] |
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* [http://www.ncahf.org/articles/a-b/ak.html ''Applied Kinesiology''] by William T. Jarvis, [[The National Council Against Health Fraud]] |
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* [http://www.randi.org/encyclopedia/applied%20kinesiology.html ''Applied kinesiology''] [[James Randi Educational Foundation]], ''[[An Encyclopedia of Claims, Frauds, and Hoaxes of the Occult and Supernatural]]'' |
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* [http://www.sram.org/0302/ideomotor.html ''The Mischief-Making of Ideomotor Action''] by [[Ray Hyman]], ''The Scientific Review of Alternative Medicine'' |
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* [http://www.ntskeptics.org/2003/2003february/february2003.htm#foolishness ''Applied Foolishness''] by John Blanton, The North Texas Skeptics |
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* [https://web.archive.org/web/20071016185021/http://intelihealth.com/IH/ihtIH/WSIHW000/8513/34968/358738.html?d=dmtContent InteliHealth applied kinesiology article material] was reviewed by the Faculty of the [[Harvard Medical School]] with final editing approved by Natural Standard. |
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* [http://www.ankerberg.org/Articles/_PDFArchives/new-age/NA4W0300.pdf ''Muscle Testing''] by John Ankerberg and John Weldon, ''The Encyclopedia of [[New Age]] Beliefs'' |
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* {{citation |url= http://www.watchman.org/na/namedak.htm |title= Testing Muscle Testing: Applied Kinesiology |first= James |last= Walker |work= The Watchman Expositor |volume= 9 |issue= 7 |year= 1992 |publisher= [[Watchman Fellowship|Watchman Fellowship ministry]] }} |
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* [https://web.archive.org/web/20030402064527/http://www.hcrc.org/contrib/lyons/kinesiol.html ''Applied Kinesiology and Nutritional Muscle Response Testing: A Christian Perspective''] by Janice Lyons |
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* [https://web.archive.org/web/20070213081246/http://altmed.creighton.edu/apk/ ''Applied Kinesiology''] By Nicholas Brewer, 2006 |
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* [http://users.adam.com.au/bstett/SkepticsKinesiology68.htm ''Applied Kinesiology''] by Harry Edwards, ''A Skeptic’s Guide to the New Age'' |
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Based on the evidence to date, management of complex motor disturbances, functional illness and illness behaviors, stress-induced diseases, chronic pain disorders and postural instability should address not only impairments but also the source of altered somatosensory input (e.g., impaired muscle function and strength, painful and restricted joints). Thus, AK advocates a multi-model program with treatment inclusive of spinal manipulative therapy (SMT), cranial manipulative therapy, specific muscle testing and correction, biochemical evaluation and treatment, and psychosocial evaluation and treatment in order to improve muscle dysfunction (reflective of neural dysfunction) throughout the body in a holistic way. |
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{{Chiropractic}} |
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{{Pseudoscience}} |
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Since 1964 the AK model has aimed to integrate the physical and psychosocial manifestations of musculoskeletal pain. This integrative model is over-do in the conceptualization and investigation of musculoskeletal pain and the causes of the traditional chiropractic subluxation and will provide a frame work for future investigation of musculoskeletal conditions. This model will also provide an evidence-based basis for the integration and appropriate timing of treatments directed toward both physical (biological) impairments and psychological factors. It is suggested that this integrated approach will be the way forward in the management of musculoskeletal pain rather than the dichotomous separation of physical, biochemical, and psychological factors that so often occurs in research and practice. |
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[[File:Rosner4.png|thumb|160x160px|Fig 4. The "Triad of Health" in AK suggests that structural, biochemical, and psychosocial factors are components in functional disorders that are amenable to chiropractic treatment.]] |
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Such is to propose that the AK technique offers an important diagnostic tool to supplement those already in place. In considering how acupuncturists focus upon meridians, physiotherapists upon rehabilitative exercise, naturopaths upon nutrition, and chiropractors themselves may in some instances devote their attention to the articulations, AK does not overrule the concept of subluxations but rather implies that subluxations may be attributed to areas in addition to the spine. This allows for an integrative model of chiropractic healthcare to be developed: |
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# It frees the profession from having to limit the concept of subluxations strictly to the spine or to joint aberrations. |
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# It helps to overcome popular conceptual limitations of chiropractors as merely practitioners who administer only high-velocity thrusts. |
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# It accommodates the application of physical modalities outside of the spine and, as such, invites closer collaborations of chiropractors with osteopaths, dentists, physiotherapists, massage therapists, physiatrists, and acupuncturists. |
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# By returning the focus to neurological imbalance, it immediately allows such major determinants of health as nutrition and stress to become integrated with chiropractic’s central tenet and message. No longer do nutrition and emotional elements appear as adjunct (and arguably alien) concepts which are difficult to rationalize with the more traditional chiropractic concepts of subluxation. |
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# It recognizes that many sources of irritation lie outside of the spine, such that reflexes often described by chiropractors as "somatovisceral" may in fact be quite the opposite; i.e., a subluxated vertebra could be the result of a visceral disturbance. In this manner, as pointed out by Carpenter, Hoffman and Mendel, the vertebral subluxation could both initiate and reflect neural dysfunction, the latter being the ultimate indicator of compromises to health.<ref name="Carpenter">{{cite journal|last=Carpenter|first=SA|date=2008|title=An investigation into the effect of organ irritation on muscle strength and spinal mobility|journal=J Clin Chiropr|volume=2|issue=6|pages=22-60|coauthors=Hoffman J, Mendel R}}</ref> |
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* Peritonitis, gastric ulcer, and renal calculus usually were found in the muscles overlaying the irritated viscera, first described by James McKenzie in 1909. <ref name="Haldeman">{{cite journal|last=Haldeman|first=S|date=1972|title=Interactions between the somatic and visceral nervous systems|journal=Bulletin of the ECU|volume=21|issue=1}}</ref> |
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* Irritation of the abdominal viscera or stimulation of the visceral nerves elicited skeletal muscle contractions as reported by Miller and Waud in 1925 and Downman and McSwiney in 1946. <ref name="Haldeman" /> |
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These reflexes were ultimately described by Kuntz in 1953 as visceroskeletal or viscerosomatic in nature. It is abundantly clear that further research addressing numerous aspects of AK is clearly warranted. Critics of AK must be mindful that numerous errors in its application and interpretation have hindered its more widespread acceptance. <ref name="Schmitt18">{{cite journal |
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| last = Schmitt |
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| first = WH |
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| coauthors = Cuthbert SC |
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| title = Common errors and clinical guidelines for manual muscle testing: "The arm test" and other inaccurate procedures |
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| journal = Chiropr & Osteop |
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| volume = 16 |
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| pages = 16 |
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| location = |
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| date = 2008 |
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| doi = 10.1186/1746-1340: 16-16}}</ref> <ref name="Hall">{{cite journal|last=Hall|first=S|authorlink=|date=2008|title=A review of the literature in applied and specialised kinesiology|journal=Forsch Komplementaramed|volume=15|pages=40-46|coauthors=Lewith G, Brien S, Little P}}</ref><ref name="Haas33">{{cite journal|last=Haas|first=M|date=August 2007|title=Disentangling manual muscle testing and Applied Kinesiology: Critique and reinterpretation of a literature review|journal=Chirop & Osteo|volume=15|pages=11|coauthors=Cooperstein R, Peterson D}}</ref> |
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== Training levels or certifications == |
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After many years of fielding problems from uneducated people stating they used applied kinesiology, the ICAK trademarked the term Professional Applied Kinesiology. To be considered a Professional Applied Kinesiologist (PAK), a person must be a doctor licensed to diagnose. They must also satisfy ICAK continuing education credit requirements. Most members of the ICAK-USA have taken a basic course that takes over 100 hours of classroom study and practice to complete. A basic proficiency exam in AK must be passed at the conclusion of the course. A minimum of 300 hours of AK instruction, passage of written and practical examinations, and submission of two (2) original research papers are required to become a Diplomate of the International Board of Applied Kinesiology (DIBAK). |
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== Goals == |
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* What are the goals of your technique organization relative to the future? |
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Due to the uniqueness of AK methodologies (its breadth and the number of other health care modalities integrated into its system of diagnosis and treatment) AK will continue to intrigue clinicians who wish to integrate broad methods of examination and treatment into their treatment regimes. There are particular difficulties involved when evaluating patients with chronic pain and stress-induced diseases. Often biomechanical adaptations and compensations have advanced to a stage where biochemical, lymphatic, structural, neural, and psychological interfaces are co-present and abundant. Each of these cofactors affects the choice of protocols and this requires a broad foundation of clinical screening tests. For these reasons it is important to be able to screen for the presence of these factors, and AK provides one means for doing this. |
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== Evidence == |
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A comprehensive review of the evidence supporting AK, as well as an assessment of flaws in several of the criticisms that it has encountered, has recently been published elsewhere.<ref name="Rosner">{{cite journal|last=Rosner|first=AL|date=2012|title=Applied kinesiology: Distinctions in its definition and interpretation|journal=Journal of Bodywork and Movement Therapies|doi=10.1016/j.jbmt.2012.04.004|coauthors=Cuthbert SC}}</ref> |
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Many of the tenets of AK theory pertaining to muscle activity and pain can be recognized in the widely recognized Gate Control Theory of Melczak and Wall, <ref name="Melczak">{{cite journal|last=Melczak|first=R|authorlink=|date=1965|title=Pain mechanisms: A new theory|journal=Science|volume=150|pages=971-979|coauthors=Wall PD}}</ref> the overall concepts having been elegantly presented by Schmitt and Yanuck <ref name="Schmitt18">{{cite journal |
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| last = Schmitt |
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| first = WH Jr |
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| authorlink = |
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| coauthors = Yanuck SF |
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| title = Expanding the neurological examination using functional neurological assessment. Part II: Neurological basis of applied kinesiology |
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| journal = Int J Neurosci |
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| volume = 97 |
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| issue = 1-2 |
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| pages = 77-108}}</ref> Altered patterns of muscle activation with chronic pain have been identified with idiopathic and whiplash-associated neck pain, <ref name="Fallas">{{cite journal|last=Fallas|first=D|date=2004|title=Patients with chronic neck pain demonstrate altered patterns of muscle activation during performance of a functional upper limb task|journal=Spine|volume=29|issue=13|pages=1436-1440|coauthors=Bilenkij G, Jull G}}</ref>, lumbar pain, <ref name="Hodges">{{cite journal|last=Hodges|first=PW|date=1996|title=Inefficient muscular stabilization of the lumbar spine associated with low back pain|journal=Spine|volume=21|pages=2640-2650|coauthors=Richardson CA}}</ref> and inhibition of the quadriceps muscle in patients with knee pain. <ref name="Stokes">{{cite journal|last=Stokes|first=M|date=1984|title=Investigations of quadriceps inhibition: Implications for clinical practice|journal=Physiotherapy|volume=70|pages=425-428|coauthors=Young A}}</ref> At the same time, manipulation of the sacroiliac joint has been shown to reduce the inhibition of knee extensor muscles. <ref name="Suter">{{cite journal|last=Suter|first=E|date=2000|title=Conservative lower back treatment reduces inhibition in knee-extensor muscles: A randomized trial|journal=J Manipulative Physiol Ther|volume=23|issue=2|pages=76-80|coauthors=McMorland G, Herzog W, Bray R}}</ref> |
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Numerous basic research investigations have been able to support the validity and wisdom of manual muscle testing as a diagnostic tool through two approaches: (1) linking it to objective outcome measures, and (2) demonstrating reflex relationships between organ and muscle in the experimental rat. |
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Tying weak and strong muscle testing results by the clinician to objective outcomes, an essential component for establishing their validity, has been strikingly demonstrated by the observations of Leisman and coworkers. Using a force transducer and electronic goniometer, they found patterns of force and displacement corresponding to the testing of strong and weak muscles in healthy subjects, <ref name="Caruso39">{{cite journal|last=Caruso|first=W|date=2001|title=The clinical utility of force/displacement analysis of muscle testing in applied kinesiology|journal=Intern J Neuroscience|volume=106|pages=147-157|coauthors=Leisman G}}</ref><ref name="Caruso40">{{cite journal|last=Caruso|first=W|authorlink=|date=2000|title=A force/displacement analysis of muscle testing|journal=Percep Motor Skills|volume=91|pages=683-692|coauthors=Leisman G}}</ref> the model shown to be accurate 98% of the time in 738 muscle tests compared to judgments of clinicians with more than 5 years of experience. <ref name="Caruso40">">{{cite journal |
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| last = Caruso |
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| first = W |
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| authorlink = |
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| coauthors = Leisman G |
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| title = A force/displacement analysis of muscle testing |
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| journal = Percep Motor Skills |
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| volume = 91 |
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| pages = 683-692 |
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| date = 2000}}</ref> In another group of subjects, distinct patterns in somatosensory evoked potentials (SEP) were identified in the contralateral components to muscles that tested weak, again suggesting a neurologic basis for muscle testing. <ref name="Leisman41">{{cite journal|last=Leisman|first=G|authorlink=|date=1989|title=Somatosensory evoked potential changes during muscle testing|journal=Intern J Neuroscience|volume=45|pages=143-151|coauthors=Shambaugh P, Ferentz AH}}</ref> |
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The other component for establishing validity—interrater reliability—has been supported by numerous observations in a literature review by Cuthbert and Goodheart, <ref name="Cuthbert17">{{cite journal |
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| last = Cuthbert |
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| first = SC |
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| coauthors = Goodheart GJ Jr |
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| title = On the reliability and validity of manual muscle testing: A literature review |
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| journal = Chiropr Osteo |
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| volume = 15 |
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| issue = 1 |
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| pages = 4 |
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| date = March 6, 2007 |
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| url = http://www.chiroandosteo.com/content/15/1/4}}</ref> and in the patient-initiated testing method by Hsieh and Phillips. <ref name="Hsieh">{{cite journal|last=Hsieh|first=C-Y|date=1990|title=Reliability of manual muscle testing with a computerized dynamometer|journal=J Manipulative Physiol Ther|volume=13|issue=2|pages=72-82|coauthors=Phillips RB}}</ref> |
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Organ and muscle relationships could be found in the investigations of Sato, who showed that rising phases of intravesical pressure involving the bladder of the anesthetized rat were accompanied by oscillatory bursts of activity in recordings of EMG activity from the periurethral skeletal muscle. <ref name="Morrison">{{cite journal|last=Morrison|first=JF|date=1995|title=The influence of afferent inputs from skin and viscera on the activity of the bladder and the skeletal muscle surrounding the urethra of the rat|journal=Neuroscience Res|volume=23|issue=2|pages=195-205|coauthors=Sato A, Sato Y, Yamanishi T}}</ref> Elsewhere, the visceromotor response to colorectal distention in the rat was found to be inhibited by simultaneous jejeunal distention, mimicking what is found in therapy localization and offering further clues to the understanding of mechanisms of muscle inhibition that might be found in muscle testing. <ref name="Shafton">{{cite journal|last=Shafton|first=JD|date=2008|title=The viscertomotor responses to colorectal distention and skin pinch are inhibited by simultaneous jejeunal distention|journal=Pain|volume=123|issue=1-2|pages=127-136|coauthors=Shafton AD, Furness JB, Ferens D, Bogeski G, Koh SL, Lean NP, Kitchner PD}}</ref> |
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In broader terms, Applied Kinesiology suggests that subluxations might result from 3 areas of concern, which comprise chemical and mental elements in addition to structural. <ref name="Walther45">{{cite book|title=Applied Kinesiology Synopsis|last=Walther|first=DS|date=2000|publisher=International College of Applied Kinesiology-USA|edition=2nd|location=Shawness Mission, KS|pages=37,71}}</ref> It recognizes how nutritional, <ref name="Schmitt46">{{cite journal|last=Schmitt|first=WH Jr|date=1998|title=Correlation of applied kinesiology muscle testing with serum immunoglobulin levels for food allergies|journal=Intern J Neuroscience|volume=96|issue=3-4|pages=237-244|coauthors=Leisman G}}</ref> hormonal <ref name="Shealy">{{cite journal|last=Shealy|first=CN|date=1984|title=Total life stress and symptomatology|journal=J Holist Med|volume=6|issue=2|pages=109-111}}</ref><ref name="Seyle">{{cite book|title=The Stress of Life|last=Seyle|first=S|date=1956|publisher=McGraw-Hill|location=New York, NY}}</ref>and emotional <ref name="Hechter">{{cite journal|last=Hechter|first=AO|date=1997|title=Relationships of dehydroepiandrosterone and cortisol in disease|journal=Med Hypoth|volume=49|pages=85-91|coauthors=Grossman A, Chatterton RT Jr}}</ref><ref name="Latey">{{cite journal|last=Latey|first=P|date=1996|title=Feelings, muscles and movement|journal=J Bodw Mov Ther|volume=1|issue=1|pages=44-52}}</ref> elements influence neural function as reflected by an established muscle testing protocol <ref name="Kendall3">{{cite book |
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| last = Kendall |
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| first = HO |
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| title = Posture and Pain |
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| publisher = Williams & Wilkins |
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| date = 1952 |
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| location = Baltimore, MD}}</ref><ref name="Janda4">{{cite book |
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| last = Janda |
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| first = V |
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| title = Muscle Function Testing |
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| publisher = Butterworths |
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| date = 1983 |
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| location = London}}</ref>whose reliability and validity have recently been shown. <ref name="Cuthbert17">{{cite journal |
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| last = Cuthbert |
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| first = SC |
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| coauthors = Goodheart GJ Jr |
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| title = On the reliability and validity of manual muscle testing: A literature review |
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| journal = Chiropr Osteo |
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| volume = 15 |
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| issue = 1 |
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| pages = 4 |
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| date = March 6, 2007 |
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| url = http://www.chiroandosteo.com/content/15/1/4}}</ref><ref name="Rosner">{{cite journal |
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| last = Rosner |
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| first = A |
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| coauthors = Cuthbert S |
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| title = Professional Applied Kinesiology: Narrative review and distinctions in the literature |
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| journal = J Bodw Mov Ther |
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| date = 2012 |
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| doi = 10.1016/j.jbmt.2012.04.008}}</ref> |
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The most comprehensive coverage of the research literature substantiating AK methods can be found on numerous websites of the International College of Applied Kinesiology, emphasizing numerous case studies that form the building blocks for future research. <ref name="ICAK-International">{{cite web |
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| last = ICAK-International |
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| title = AK Research Compendium, Dr. Scott Cuthbert |
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| url = http://www.icak.com/college/research/publishedarticles.shtml |
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| accessdate = January 23, 2010}}</ref> Further research and reviews of applied kinesiology are listed at the National Library of Medicine, where AK research has now been given its own MESH heading.<ref name="URL">{{cite web|url=http://www.ncbi.nlm.nih.gov/pubmed/|title=National Library of Medicine}}</ref> An early overview of AK has been provided by Perle <ref name="Perle">{{cite journal|last=Perle|first=SM|date=1995|title=Applied kinesiology (AK)|journal=Chiropr Technique|volume=7|issue=3|pages=103-107}}</ref> |
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What needs to be understood is that several muscle testing protocols which have appeared <ref name="Hall">{{cite journal |
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| last = Hall |
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| first = S |
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| coauthors = Lewith G, Brien S, Little P |
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| title = A review of the literature in applied and specialised kinesiology |
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| journal = Forsch Komplementaramed |
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| volume = 15 |
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| pages = 40-46 |
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| date = 2008}}</ref><ref name="Haas33">{{cite journal |
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| last = Haas |
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| first = M |
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| coauthors = Cooperstein R, Peterson D |
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| title = Disentangling manual muscle testing and Applied Kinesiology: Critique and reinterpretation of a literature review |
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| journal = Chirop & Osteo |
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| volume = 15 |
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| pages = 11 |
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| date = August 2007}}</ref> <ref name="Garrow">{{cite journal|last=Garrow|first=JS|date=1988|title=Kinesiology and food allergy|journal=BMJ (Clinical Research Education)|volume=196|pages=1573-1574}}</ref> <ref name="Kenney">{{cite journal|last=Kenney|first=JJ|date=1988|title=Applied kinesiology unreliable for assessing nutrient status|journal=J Am Diet Assoc|volume=88|pages=698-704|coauthors=Clemens R, Forsyth KD}}</ref> <ref name="Tschernitschek">{{cite journal|last=Tschernitschek|first=H|date=2005|title=Applied kinesiology in medicine and dentistry|journal=Wien Med Wochemsthr|volume=155|pages=59-64|coauthors=Fink M}}</ref> <ref name="Ludke">{{cite journal|last=Ludtke|first=R|date=2001|title=Test-retest reliability and validity of the kinesiology muscle test|journal=Compl Ther Med|volume=9|pages=141-145|coauthors=Kunz B, Seeber N, Ring J}}</ref> <ref name="Pothmann">{{cite journal|last=Pothmann|first=R|date=2001|title=Evaluation of applied kinesiology in nutritional intolerance of childhood|journal=Forsch Komplementarmed Klass Nautrheikld|volume=8|pages=336-344|coauthors=von FS, Hoicke C, Winegarten H, Ludtke R}}</ref> have not adhered to this protocol and as such should never be confused with the methods employed in AK. |
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==References== |
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{{reflist|2}} |
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== External Links == |
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[http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=citmed Additional Information]{{Chiropractic}} |
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{{DEFAULTSORT:Applied Kinesiology}} |
{{DEFAULTSORT:Applied Kinesiology}} |
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[[Category:Alternative medical diagnostic methods]] |
[[Category:Alternative medical diagnostic methods]] |
Revision as of 20:01, 29 August 2017
Applied kinesiology (AK) is the study of muscles and the relationship of muscle strength to health. It incorporates a system of manual muscle testing and therapy [1] and is a method of diagnosis and treatment based on the belief that various muscles are linked to particular organs and glands, and that specific muscle weakness can signal distant internal problems such as nerve damage, reduced blood supply, chemical imbalances or other organ or gland problems. Practitioners contend that by correcting this muscle weakness, you can help heal a problem in the associated internal organ.[2]
History
The development of the "AK" technique
Including: who, when, how
Applied Kinesiology (AK) provides an integrated, interdisciplinary approach to health care. George J. Goodheart, D.C., originated AK in 1964. [3] [4] Dr. Goodheart found a technique that could immediately make a muscle that tested weak strong. The technique did not correct all muscles that tested weak but from this initial experience, testing muscles in a precise manner became routine in his examination protocol. The investigation of other causes of muscle weakness and their correction developed into what is currently the practice of AK.
The actual testing of the muscle had been previously and firmly established by Kendall and Kendall [5] who held that a muscle from a contracted position against increasing applied pressure could either maintain its position (rated as "facilitated" or "strong") or break away and thus be rated as "inhibited" or "weak". The testing of muscle strength itself had been widely practiced in manual medicine for decades by such authorities as Daniels, Worthingham, and the use of the MMT for functional conditions continues today with the work of Janda, Chaitow, Sahrmann, Bergmann, Lewit, Liebenson, and Hammer. [6] [7] [8] [9] [10]
Each of these researchers uses the MMT to diagnose muscular imbalance. In a sense, the early work of Goodheart and Kendall has influenced generations of practitioners spanning many disciplines and has become consensus methodologies across a broad spectrum of professionals. Even the American Medical Association has accepted that the standard method of MMT used in AK is a reliable tool and advocates its use for the evaluation of disability impairments. [11]
Goodheart’s work drew a large following of doctors and recognition. He was the first chiropractor officially appointed to the US Winter Olympic Sports Medicine team. [12]
In 1976 the International College of Applied Kinesiology was founded to promote the research and teaching of AK. [13] [14]
The ICAK began in the United States with a majority of chiropractors as members. There are now chapters in Australia, Austria, Benelux, Brazil, Canada, France, Germany, Italy, Korea, Russia, Sweden, Switzerland, United Kingdom, and the USA. The organization is multi-disciplinary; membership includes medical doctors, osteopaths, dentists, psychologists, and other health care providers who are licensed to diagnose patients. Medical practitioners using AK vary by country. There are over 1,000 medical doctors in Germany, for instance, who use AK as part of their diagnostic system. [15]
The first book to describe the value of AK to other professions -- "AK and the Stomatognathic System" --was authored by Gelb, a dentist, and Goodheart in 1977. [16][17]
Goodheart set the peer review trend for AK by publishing a discussion of dentistry and AK in 1976. [17] Scopp published the first research paper discussing the AK approach to a functional organic disorder with allergy testing in 1979.[18]
There are now over 100 papers published in peer-reviewed journals on the methods and outcomes of AK. [13][19] Few chiropractic therapeutic methods have been investigated or written about as extensively as AK. There have been 35 separate books published about AK methods since 1964. [13]
How has the technique changed over the years
Since the original discovery, the AK examination system has broadened to include evaluation of the nervous, vascular, and lymphatic systems, nutrition, acupuncture, cerebrospinal fluid function and many other controlling or disturbing factors that influence health and neuromusculoskeletal function. Each of these areas of human function have been shown to effect the muscular system, and AK and allied health systems’ research evidence in this regard is constantly growing. [13][20]
Three areas that have been shown to effect muscle function are the cranial system, the meridian system, and nutritional imbalances.
Nutrition and Adverse Chemicals
The effect of nutrition and chemicals on health and muscle function is evolving. Modern science is constantly discovering new information furthering this knowledge. Nutritional items, when chewed, stimulate the nerve endings in the mouth. This may have an immediate effect on muscle function. For example, if the muscle clinically associated with the stomach is weak and betaine hydrochrloride is indicated for stomach support, tasting this digestive enzyme may cause immediate and dramatic improvement of the muscle’s function, as indicated by the MMT. Conversely, if a toxic chemical is causing a problem in the stomach, a muscle associated with the stomach will test poorly[21][22]immediately after the substance is tasted or inhaled. Carpenter showed that this type of muscle-organ relationship existed for other organs as well, including the lungs, stomach, ears and eyes.
All aspects of the examination should correlate and lead to the final diagnosis and recommendation for treatment. Applied kinesiology muscle tests for nutrition and chemicals do not take the place of a complete, thorough examination; rather, they augment it by evaluating how the body responds to the substance(s) being tested. This adds a functional evaluation that takes into consideration the biochemical individuality of people.
Travell and Simons for instance showed that in the case of myofascial trigger point formation, correction of nutritional “perpetuating factors” can be the most important part of therapy. [23]
Systemic perpetuating factors for trigger point problems encompass many conditions that compromise muscle energy metabolism. These conditions include anemia, low serum ferritin, inadequate thyroid function, vitamin B1 (the energy vitamin) inadequacy, folic acid, and/or vitamin B12 inadequacy. [23] Frequently, several of these are present at once, and the laboratory reports low-normal values. Travell and Simmons are clear in their insistence that nutritional imbalance has to be restored if myofascial pain is to be adequately dealt with: “Nearly half of the patients whom we see with chronic myofascial pain require resolution of vitamin inadequacies for lasting relief.” In their opinion, nutritional factors must be considered in most patients if lasting relief of pain is to be achieved.
The neurological, training and positioning requirements indicate that MMT in professional AK is a highly complex and skilled undertaking. Accordingly, the probability of omitting or misinterpreting essential elements of AK from the many derivative procedures which have been cited in the literature is high. The result is that many of the criticisms of MMT in AK may have been directed at versions of AK not performed by individuals specifically trained in professional AK. One simply needs to refer to the very origins of AK in which Goodheart wrote that lingual receptors need to be stimulated in order to obtain reliable nutritional testing. Goodheart's research manuals specifically stated that "holding a glass vial of pills" or "laying pills or substances on the chest" were inappropriate procedures because the responses were neither predictable nor explicable.[24]Taste receptors on the tongue, on the other hand, respond to even miniscule concentrations of substances within a fraction of a second.[25]
Cranial Bone Movement and the MMT
It was originally thought that the skull was a solid mass primarily protecting the brain. In reality, there is minute predictable movement between the bones that is necessary for normal function of the nerves and spinal fluid. [26] Spinal fluid surrounds the brain and spinal cord, providing nutrition, lubrication, and hormone movement. A bump or other type of strain to the head can jam the skull bones, causing abnormal movement. Improper nerve function may result that can cause problems in remote organs or other body structures.
There are several methods for evaluating skull function that have been developed in AK examination. The doctor may test a muscle, apply a challenge to bones of the skull, and then re-test the muscle. The patient may be asked to take a deep breath and hold it, and then a muscle is re-tested to determine any change. The doctor may have the patient touch various areas of their skull while a muscle is tested. Dysfunction of the skull is called a cranial fault. If one is found, a specific gentle pressure, the direction of which is determined by the MMT examination, will be applied to the skull, usually with a specific phase of respiration. If the correction is successful, there will be an immediate improvement of the MMT. Research supporting the functional integration of the neuromuscular system and the craniosacral system has been presented by the ICAK, Walther and Goodheart.[3][13][27]
Meridian Therapy
The Chinese developed a system of treating disease and maintaining health that balances the energy in the body’s meridians.[28] In modern times, acupuncture – or more accurately “meridian therapy” – has proven a valid method of treatment.[29] Dr. Goodheart and the ICAK have provided some of the first advancements in this treatment in the Western world.[30] By using AK techniques, the flow of energy in the meridians can be evaluated and corrected if out of balance. Correction can be made by many methods of stimulation, such as electrical, laser, needles, small tape patches with metal balls, or simply by mechanically stimulating certain spots. There is usually an immediate improvement in muscle function after meridian balancing. A number of recent published reports have demonstrated the effectiveness of the AK system of analysis for acupuncture system dysfunctions.[31][32][33]
Principles & theories
Template:Infobox Alternative Science Q: What are the principles/theories and aim of the technique in terms of both diagnosis (assessment) or treatment (correction)?
When muscle dysfunction is found the doctor proceeds with examination to find what therapy restores proper function. Application of the therapy, if successful, immediately returns proper muscle function. Re-examination at a later time determines if the correction is maintained. Thus the system (1) finds disturbance, (2) determines how to fix it, (3) determines if the corrective effort is successful and, most important (4) determines if the correction is stable. If the correction is not stable, further examination is done to find the reason so it can be eliminated.
But what distinguishes AK is its emphasis upon proprioceptive responses of the muscle rather than the strength of the muscle itself. It essentially sees muscle function as a transcript of the central integrative state of the anterior horn motoneurons, summing all excitatory and inhibitory inputs. [34] In other words, the locus of dysfunction ultimately rests with the nervous system. A procedure called therapy localization, strictly diagnostic, seeks a change of muscle strength when the patient’s hand is placed over an area of suspected involvement. Challenge defines a mechanism to test the body’s ability to cope with external stimuli, again assessed by muscle testing.
Challenge is a diagnostic procedure unique to AK that is used to determine the body’s ability to cope with external stimuli, which can be physical, chemical, or mental. Cranial challenge (for instance) has been described in the literature previously. [35][36] After an external stimulus is applied, muscle-testing procedures are done to determine a change in the muscle strength as a result of the stimulus. Through this approach, ineffective therapies that produced no improvements in muscle strength are rejected and only those that elicit a positive muscle response are used. This guides the treatment given to a patient.
Therapy localization is a diagnostic procedure unique to AK that consists of placing the patient’s hand over areas of suspected involvement and observing for a change in the MMT. This method is hypothesized to assist the doctor in finding areas that are involved with the muscle dysfunction found on MMT and has been used clinically for over 30 years. [3] Pollard et al in a recent literature review presented some of the research about the AK concept of therapy localization. [37] Collectively these data suggest that stimulating the skin and the cutaneomotor reflexes can produce changes in muscle function.
Diagnostic considerations
Might include:
- Subluxations or other lesions are demonstrable on x-ray in some specific way or,
- Leg length changes or,
- Muscle weakness or,
- Symptom patterns or,
- Or several components together
What equipment is commonly used if any?
The AK diagnostic philosophy is that if we understand, identify and quantify the abnormal features involved in a patient’s presenting disorders from a broad multi-systems physiological perspective, this will lay the foundation for better differential diagnosis and treatment. It is the AK contention that understanding the underlying processes of human illness and disorders as well as their development over time will direct the development of specific and relevant treatment strategies. In AK, we have developed and tested new treatment strategies for many functional disorders and this process, like all research, is on-going.
Based on the evidence to date, management of complex motor disturbances, functional illness and illness behaviors, stress-induced diseases, chronic pain disorders and postural instability should address not only impairments but also the source of altered somatosensory input (e.g., impaired muscle function and strength, painful and restricted joints). Thus, AK advocates a multi-model program with treatment inclusive of spinal manipulative therapy (SMT), cranial manipulative therapy, specific muscle testing and correction, biochemical evaluation and treatment, and psychosocial evaluation and treatment in order to improve muscle dysfunction (reflective of neural dysfunction) throughout the body in a holistic way.
Since 1964 the AK model has aimed to integrate the physical and psychosocial manifestations of musculoskeletal pain. This integrative model is over-do in the conceptualization and investigation of musculoskeletal pain and the causes of the traditional chiropractic subluxation and will provide a frame work for future investigation of musculoskeletal conditions. This model will also provide an evidence-based basis for the integration and appropriate timing of treatments directed toward both physical (biological) impairments and psychological factors. It is suggested that this integrated approach will be the way forward in the management of musculoskeletal pain rather than the dichotomous separation of physical, biochemical, and psychological factors that so often occurs in research and practice.
Such is to propose that the AK technique offers an important diagnostic tool to supplement those already in place. In considering how acupuncturists focus upon meridians, physiotherapists upon rehabilitative exercise, naturopaths upon nutrition, and chiropractors themselves may in some instances devote their attention to the articulations, AK does not overrule the concept of subluxations but rather implies that subluxations may be attributed to areas in addition to the spine. This allows for an integrative model of chiropractic healthcare to be developed:
- It frees the profession from having to limit the concept of subluxations strictly to the spine or to joint aberrations.
- It helps to overcome popular conceptual limitations of chiropractors as merely practitioners who administer only high-velocity thrusts.
- It accommodates the application of physical modalities outside of the spine and, as such, invites closer collaborations of chiropractors with osteopaths, dentists, physiotherapists, massage therapists, physiatrists, and acupuncturists.
- By returning the focus to neurological imbalance, it immediately allows such major determinants of health as nutrition and stress to become integrated with chiropractic’s central tenet and message. No longer do nutrition and emotional elements appear as adjunct (and arguably alien) concepts which are difficult to rationalize with the more traditional chiropractic concepts of subluxation.
- It recognizes that many sources of irritation lie outside of the spine, such that reflexes often described by chiropractors as "somatovisceral" may in fact be quite the opposite; i.e., a subluxated vertebra could be the result of a visceral disturbance. In this manner, as pointed out by Carpenter, Hoffman and Mendel, the vertebral subluxation could both initiate and reflect neural dysfunction, the latter being the ultimate indicator of compromises to health.[38]
- Peritonitis, gastric ulcer, and renal calculus usually were found in the muscles overlaying the irritated viscera, first described by James McKenzie in 1909. [39]
- Irritation of the abdominal viscera or stimulation of the visceral nerves elicited skeletal muscle contractions as reported by Miller and Waud in 1925 and Downman and McSwiney in 1946. [39]
These reflexes were ultimately described by Kuntz in 1953 as visceroskeletal or viscerosomatic in nature. It is abundantly clear that further research addressing numerous aspects of AK is clearly warranted. Critics of AK must be mindful that numerous errors in its application and interpretation have hindered its more widespread acceptance. [20] [40][41]
Training levels or certifications
After many years of fielding problems from uneducated people stating they used applied kinesiology, the ICAK trademarked the term Professional Applied Kinesiology. To be considered a Professional Applied Kinesiologist (PAK), a person must be a doctor licensed to diagnose. They must also satisfy ICAK continuing education credit requirements. Most members of the ICAK-USA have taken a basic course that takes over 100 hours of classroom study and practice to complete. A basic proficiency exam in AK must be passed at the conclusion of the course. A minimum of 300 hours of AK instruction, passage of written and practical examinations, and submission of two (2) original research papers are required to become a Diplomate of the International Board of Applied Kinesiology (DIBAK).
Goals
- What are the goals of your technique organization relative to the future?
Due to the uniqueness of AK methodologies (its breadth and the number of other health care modalities integrated into its system of diagnosis and treatment) AK will continue to intrigue clinicians who wish to integrate broad methods of examination and treatment into their treatment regimes. There are particular difficulties involved when evaluating patients with chronic pain and stress-induced diseases. Often biomechanical adaptations and compensations have advanced to a stage where biochemical, lymphatic, structural, neural, and psychological interfaces are co-present and abundant. Each of these cofactors affects the choice of protocols and this requires a broad foundation of clinical screening tests. For these reasons it is important to be able to screen for the presence of these factors, and AK provides one means for doing this.
Evidence
A comprehensive review of the evidence supporting AK, as well as an assessment of flaws in several of the criticisms that it has encountered, has recently been published elsewhere.[42]
Many of the tenets of AK theory pertaining to muscle activity and pain can be recognized in the widely recognized Gate Control Theory of Melczak and Wall, [43] the overall concepts having been elegantly presented by Schmitt and Yanuck [20] Altered patterns of muscle activation with chronic pain have been identified with idiopathic and whiplash-associated neck pain, [44], lumbar pain, [45] and inhibition of the quadriceps muscle in patients with knee pain. [46] At the same time, manipulation of the sacroiliac joint has been shown to reduce the inhibition of knee extensor muscles. [47]
Numerous basic research investigations have been able to support the validity and wisdom of manual muscle testing as a diagnostic tool through two approaches: (1) linking it to objective outcome measures, and (2) demonstrating reflex relationships between organ and muscle in the experimental rat.
Tying weak and strong muscle testing results by the clinician to objective outcomes, an essential component for establishing their validity, has been strikingly demonstrated by the observations of Leisman and coworkers. Using a force transducer and electronic goniometer, they found patterns of force and displacement corresponding to the testing of strong and weak muscles in healthy subjects, [48][49] the model shown to be accurate 98% of the time in 738 muscle tests compared to judgments of clinicians with more than 5 years of experience. [49] In another group of subjects, distinct patterns in somatosensory evoked potentials (SEP) were identified in the contralateral components to muscles that tested weak, again suggesting a neurologic basis for muscle testing. [50]
The other component for establishing validity—interrater reliability—has been supported by numerous observations in a literature review by Cuthbert and Goodheart, [19] and in the patient-initiated testing method by Hsieh and Phillips. [51]
Organ and muscle relationships could be found in the investigations of Sato, who showed that rising phases of intravesical pressure involving the bladder of the anesthetized rat were accompanied by oscillatory bursts of activity in recordings of EMG activity from the periurethral skeletal muscle. [52] Elsewhere, the visceromotor response to colorectal distention in the rat was found to be inhibited by simultaneous jejeunal distention, mimicking what is found in therapy localization and offering further clues to the understanding of mechanisms of muscle inhibition that might be found in muscle testing. [53]
In broader terms, Applied Kinesiology suggests that subluxations might result from 3 areas of concern, which comprise chemical and mental elements in addition to structural. [54] It recognizes how nutritional, [55] hormonal [56][57]and emotional [58][59] elements influence neural function as reflected by an established muscle testing protocol [5][6]whose reliability and validity have recently been shown. [19][42]
The most comprehensive coverage of the research literature substantiating AK methods can be found on numerous websites of the International College of Applied Kinesiology, emphasizing numerous case studies that form the building blocks for future research. [14] Further research and reviews of applied kinesiology are listed at the National Library of Medicine, where AK research has now been given its own MESH heading.[60] An early overview of AK has been provided by Perle [61]
What needs to be understood is that several muscle testing protocols which have appeared [40][41] [62] [63] [64] [65] [66] have not adhered to this protocol and as such should never be confused with the methods employed in AK.
References
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