Motyka, T., Yanuck, S.
Expanding the Neurological Examination Using Functional Neurologic Assessment
Part I: Methodological Considerations.
Intern. J. Neuroscience, 1999, Vol. 97, pp. 61 -76
Manual assessment of muscular function, in particular a method known as applied
kinesiology (AK), is a clinical measure of neurologic function. A review of
the literature reveals methodological problems with previous studies of AK
as a form of neurologic assessment. Research designs that do not reflect clinical
practice and principles of AK are common in the literature. Additional study
is warranted to explore the potential of AK manual muscle testing as a diagnostic
tool. We outline principles of AK and recommend that future research reflect
more accurately the clinical practice of functional neurologic assessment and
applied kinesiology.
Schmitt, W. Jr., Yanuck, S.
Expanding the Neurological Examination Using Functional Neurologic Assessment:
Part II Neurologic Basis of Applied Kinesiology.
Intern. J. Neuroscience, 1999, Vol. 97, pp. 77-108 (Click for full article)
Functional Neurologic Assessment and treatment methods common to
the practice of applied kinesiology are presented. These methods
are proposed
to enhance
neurological examination and treatment procedures toward more effective
assessment and care of functional impairment. A neurologic model
for these procedures
is proposed. Manual assessment of muscular function is used to identify
changes associated with facilitation and inhibition, in response
to the introduction
of sensory receptor-based stimuli. Muscle testing responses to sensory
stimulation of known value are compared with usually predictable
patterns based on known
neuroanatomy and neurophysiology, guiding the clinician to an understanding
of the functional status of the patient’s nervous system. These
assessment procedures are used in addition to other standard diagnostic
measures to
augment rather than replace the existing diagnostic armamentarium.
The proper understanding
of the neurophysiologic basis of muscle testing procedures will assist
in the design of further investigations into applied kinesiology.
Accordingly, the
neurophysiologic basis and proposed mechanisms of these methods are
reviewed.
Leisman, G., Shambaugh, P., Ferentz, A.
Somatosensory Evoked Potential Changes During Muscle
Testing.
International Journal of Neuroscience. 1989; 45:143-151.
This study measured the way the central nervous system (brain) is functioning
when muscles test strong versus when they test weak. Clear, consistent and
predictable differences were identified in the brain between weak and strong
muscle test outcomes. This supports the idea that manual muscle testing outcome
changes reflect changes in the central nervous system.
Leisman, G., et al.
Electromyographic Effects of Fatigue and Task Repetition
on the Validity of Estimates of Strong and Weak Muscles in Applied
Kinesiology Muscle Testing Procedures.
Perceptual and Motor Skills. 1995; 80:963-977.
The paper compends six independent studies supporting the following:
Muscles identified as "weak" using applied kinesiology manual muscle testing
methods are in a fundamentally different state than those identified as "strong." Muscles
testing "weak" kinesiologically are fundamentally different than
muscles that are fatigued. The state of "weakness" identified
is not attributable to fatigue. Applied kinesiology muscle testing
procedures can be objectively evaluated via quantifying the neurologic
electrical
characteristics
of muscles. The course and effect of applied kinesiology treatment
can be plotted over time objectively.
Perot, C., Meldener, R., Gouble, F.
Objective Measurement of Proprioceptive Technique Consequences
on Muscular Maximal Voluntary Contraction During Manual Muscle Testing.
Agressologie. 1991; 32,10:471-474.
This French study measured the electrical activity in muscles. It established
that there was a significant difference in electrical activity in the muscle,
which corresponded with the difference of strong versus weak muscle testing
outcomes kinesiologically. It further established that these outcomes were
not attributable to increased or decreased testing force from the doctor during
the tests. In addition, the Perot study showed that manual treatment methods
used by applied kinesiologists to assess the level of tone of spindle cells
in the muscle are in fact capable of creating a reduction in tone of the muscle,
as had been observed clinically. This is a useful tool clinically, so the verification
of its action is useful to doctors in clinical practice.
Esposito, V., Leisman, G.
Neuromuscular Effects of Temporomandibular Joint
Dysfunction.
International Journal of Neuroscience. 1993; 68:3-4.
This study demonstrated that the temporomandibular joint (TMJ) has significant
clinical effects on balance and coordination, and that problems of the TMJ
contribute significantly to loss of neurologic control of mechanical function.
This confirms a significant observation used by applied kinesiologists in assessment
of patient function.
Esposito, V., Leisman, G., Frankenthal, Y.
Non-Force Manual Therapeutic Effects on Disc Herniation.
The Journal of Orthopaedic Medicine. 1997; 19:3,71-77.
This study used "before and after" MRI scans to show that
patients with significant herniated discs in the low back could be
treated successfully
using non-forced cranial adjusting techniques. The outcomes from
this conservative applied kinesiology-based method were better than
other
conservative care methods.
Lawson, A., Calderon, L.
Interexaminer
Agreement for Applied Kinesiology Manual Muscle Testing.
Perceptual and Motor Skills. 1997; 84:539-546.
This study demonstrated significant interexaminer reliability for individual
tests of the pectoralis major and piriformis muscles, but not for the tensor
fascia lata or hamstring, which are essentially tests of groups of muscles
at once. The primary importance of this study is that it demonstrates the reliability
and reproducibility of muscle testing as a clinical tool, while also highlighting
the need for clinicians to be aware of potential inaccuracies involved with
the testing of some muscle groups.
Esposito V et al.
Applied Kinesiology Manual Therapeutic Effects on Disc Herniation
with Real Time Magnetic Resonance Imaging.
The Journal of Manual and Manipulative Therapy. 1998.
Patients were treated using applied kinesiology methods. Pre and Post MRI done
on the same day revealed changes in signal strength of disc material and increased
intervertebral disc spacing, indicating improved status of the disc.
Schmitt WH, Leisman G.
Correlation of applied kinesiology muscle testing
findings with serum immunoglobulin levels for food allergies.
International Journal of Neuroscience. 1998.
This pilot study attempted to determine whether subjective muscle testing employed
by Applied Kinesiology (AK) practitioners, prospectively determines those individuals
with specific hyperallergenic responses. 17 subjects were found positive on
AK muscle testing screening procedures indicating food hypersensitivity (allergy)
reactions. Each subject showed muscle weakening reactions to oral provocative
testing for a total of 21 positive food reactions. Tests for a hypersensitivity
reaction of the serum were performed using both a radio-allergosorbent test
(RAST) and immune complex test for IgE and IgG against all 21 of the foods
that tested positive with AK. These serum tests confirmed 19 of the 21 food
allergies (90.5%) suspected based on AK screening. This study offers a basis
to examine further a means by which to predict the clinical utility of a given
substance for a given patient, based on the patterns of neuromuscular response
elicited from the patient, representing a conceptual expansion of the standard
neurological examination process.
Motyka T, Yanuck S.
Expanding the Neurological Examination Using Functional Neurologic
Assessment Part I: Methodological Considerations.
International Journal of Neuroscience. 1998.
This is a comprehensive review of the existing literature on applied
kinesiology. In addition to the studies described above, early studies
are reviewed. While
some of these early studies provide evidence in support of applied
kinesiology, some failed to corroborate clinical observations common
to applied kinesiology
prctice. Flaws in research methodology inherent in these early studies
are reviewed. Requirements for proper research methodology and for
adequate skill
level of practitioners are reviewed.
Schmitt W, Yanuck S.
Expanding the Neurological Examination Using Functional Neurologic
Assessment Part II: Neurologic Basis of Applied Kinesiology.
International Journal of Neuroscience. 1998. (In press).
This study describes the neurophysiologic mechanisms which form the basis for
the clinical practice of applied kinesiology. A comprehensive neurologic model
is described, providing a conceptual framework for future studies of applied
kinesiology.
Peterson, K.B.
A Preliminary Inquiry into Manual Muscle Testing
Response in Phobic and Control Subjects Exposed to Threatening
Stimuli
J. of Manipulative & Physiological Therapeutics. 19(5):310-6,
1996 Jun.
This study was designed to determine phobic and nonphobic
subject response to a provocative threat stimulus and to
determine variables that confound the
response. The analysis of data demonstrates poor inter- (K = -0.19) and
intraexaminer reliability (K = -0.14(-) +0.29) the test
for independence for valid muscle
testing was strong for both examiners (p = .462, p = 1.00). When confounding
variables were corrected for, the validity of muscle testing increased
to 91%. This preliminary inquiry demonstrates the need
for musculoskeletal, attentional
and presensitized subject variables to be controlled to ascertain if
muscle testing can be reliably used as a tool to identify
emotional arousal.
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