Applied kinesiology

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This article is about a chiropractic or an alternative medicine method. For other uses, see Kinesiology (disambiguation).
Applied kinesiologist (right) practicing

Applied Kinesiology (AK) is a chiropractic diagnostic method[1] using manual muscle-strength testing for medical diagnosis and a subsequent determination of prescribed therapy. According to followers of the theory, it gives feedback on the functional status of the body. AK draws together many similar therapies. It attempts an integrated, interdisciplinary approach to health care. George J. Goodheart, a chiropractor, originated AK in 1964[2] and began teaching it to other chiropractors.[3] The International College of Applied Kinesiology was founded in 1976[4] (or 1973.[5][6])

AK is a practice within the realm of alternative medicine and is different from "kinesiology," which is the scientific study of human movement. AK has been criticized on theoretical and empirical grounds,[7] and characterized as pseudoscience.[8] With only anecdotal accounts providing positive evidence for the efficacy of the practice, a review of peer-reviewed studies concluded that the "evidence to date does not support the use of [AK] for the diagnosis of organic disease or pre/subclinical conditions."[9]

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.[10] Although the prevalence of use among non-chiropractors is unknown, it is also used by naturopaths, medical doctors, dentists, nutritionists, physical therapists, massage therapists, nurse practitioners and multilevel distributors.[11]

Contents

[edit] History

In 1964, George J. Goodheart invented Applied Kinesiology through his unique interpretation and application of Muscles: Testing and Function written by two physical therapists Kendall and Kendall.[12] While it is primarily used by chiropractors, it is now also used by a number of other practitioners.[11] Applied kinesiology has been documented to be used by chiropractors, naturopaths, physicians, dentists, nutritionists, physical therapists, massage therapists, and nurses of various stripes.[13] Goodheart died March 5, 2008 at the age of 89.[14]

[edit] Basics

Applied kinesiology is a system that evaluates structural, chemical, and mental aspects of health using manual muscle testing alongside conventional diagnostic methods. The essential premise of applied kinesiology that is not shared by mainstream medical theory is that every organ dysfunction is accompanied by a weakness in a specific corresponding muscle, the viscerosomatic relationship.[13][15] Treatment modalities relied upon by practitioners include joint manipulation and mobilization, myofascial, cranial and meridian therapies, clinical nutrition, and dietary counseling.[16]

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 stresses and imbalances in the body.[17] A weak muscle test is equated to dysfunction and chemical or structural imbalance or mental stress, indicative of a body dissatisfied with suboptimal functioning.[18] The most common test is the arm-pull-down test, or "Delta test," where the patient resists as the practitioner exerts a downward force on an extended arm.[12] Proper positioning is paramount to ensure that the muscle in question is the prime mover, minimizing interference from adjacent muscle groups.[15]

"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.[15][17][19] Though its use is deprecated by the ICAK,[20] 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).

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."[21]

"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 is hypothesized to focus the mind on the relevant area, leading 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.[18]

Another commonly used technique in AK is to have the subject wear colored glasses (blue, green, red, etc.) and perform the muscle monitoring while wearing each color of glasses. The color that causes the greatest perceived smoothness of reaction gains might be a color that is in some way beneficial to the client. There are many tests believed to reveal information about the subject's condition.[citation needed]

[edit] Scientific research

Pseudoscientific concepts
Claims
Subjective measurements by those trained in the ideas of applied kinesiology show the positive effects of alternative medicine ideas.
Related scientific disciplines
Physics, Biology, Psychology
Year proposed
1964
Original proponents
George J. Goodheart
Subsequent proponents
International College of Applied Kinesiology, American Chiropractic Association

Proponents of AK cite evidence about the methods, clinical efficacy, and neurologic rationales of applied kinesiology examination and treatment.[22][23][24][25]. However, many studies of Applied Kinesiology have failed to show clinical efficacy. For example, muscle testing has not been shown to distinguish a test substance from a placebo under double-blind conditions, and the use of applied kinesiology to evaluate nutrient status has not been shown to be more effective than random guessing. Some scientific studies have shown that applied kinesiology tests are not reproducible.[26][27][28][29][30] A review of several scientific studies have shown that 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."[9] 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."[31]

A review of the literature revealed methodological problems with previous AK studies[23] and some studies show clinical efficacy. For example one study showed a high degree of correlation between AK muscle testing for food allergies and antibodies for those foods. The AK procedure in this study involved stimulation of taste receptors followed by muscle testing for change in strength.[24] The patient was suspected of being allergic to foods that disrupted muscle function. Blood drawn subsequently showed the presence of antibodies to the foods which were found to be allergenic through AK assessment. In another blinded study, the response of a calf muscle, to an inhibitory reflex technique used in AK was studied using graphical recordings of electromyography and mechanical parameters. The study found that with good coordination between the examiner and subject, muscle inhibition was easily recorded.[25]

Some of the studies, research and reviews of applied kinesiology mentioned above are listed at the National Library of Medicine and National Institutes of Health.[21] [29] [28] [32] [33] [34] [35]

[edit] Criticism

Nearly all AK tests are subjective, relying solely on practitioner assessment of muscle response. Specificity, test-retest reliability, inter-tester reliability, and accuracy have been shown to have no better than chance correlations.[13][29][36] 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.[13][19] Skeptics have called AK "quackery," "magical thinking," and a misinterpretation of the ideomotor effect.[7][37]

[edit] Position statements

[edit] American Chiropractic Association

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.[10]

"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."[3]

[edit] Danish Chiropractic Association

According to a March 26, 1998 letter from the DKF (Dansk Kiropractor-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.[38]

[edit] See also

[edit] References

  1. ^ Citations supporting considering it a chiropractic technique:
  2. ^ Profile of Goodheart
  3. ^ a b Chiropractic Techniques. American Chiropractic Association.
  4. ^ International College of Applied Kinesiology founded in 1976
  5. ^ Or was the International College of Applied Kinesiology founded in 1973?
  6. ^ International College of Applied Kinesiology first President from 1973-1976.
  7. ^ a b Carroll, Robert Todd "These are empirical claims and have been tested and shown to be false". "Applied Kinesiology". The Skeptics Dictionary. http://skepdic.com/akinesiology.html. Retrieved on 2007-07-26. 
  8. ^ Atwood KC (2004). "Naturopathy, pseudoscience, and medicine: myths and fallacies vs truth". MedGenMed 6 (1): 33. PMID 15208545. PMC: 1140750. http://www.medscape.com/viewarticle/471156. 
  9. ^ a b Haas, Mitchell; Robert Cooperstein, and David Peterson (2007-08). "Disentangling manual muscle testing and Applied Kinesiology: critique and reinterpretation of a literature review". Chiropractic & Osteopathy 15. doi:10.1186/1746-1340-15-11. PMID 17716373 doi:10.1186/1746-1340-15-11. http://www.chiroandosteo.com/content/15/1/11. Retrieved on 2007-11-30. |url=http://www.chiroandosteo.com/content/15/1/11|format=|accessdate=2007-11-30|doi_brokendate=2008-09-10 }}
  10. ^ a b Job Analysis of Chiropractic, National Board of Chiropractic Examiners, 2005, pp. 135, http://nbce.org/pdfs/job-analysis/chapter_10.pdf 
  11. ^ a b Applied Kinesiology: Phony Muscle-Testing for "Allergies" and "Nutrient Deficiencies", by Stephen Barrett, MD
  12. ^ a b Frost, Robert, Applied Kinesiology: A Training Manual and Reference Book of Basic Priciples and Practices', p. 4, North Atlantic Books, 2002. available online
  13. ^ a b c d Applied Kinesiology, American Cancer Society, May 23, 2007. available online
  14. ^ George Goodheart: A medical innovator
  15. ^ a b c "Applied Kinesiology Status Statement". International College of Applied Kinesiology - USA. http://www.icak.com/college/status.shtml. Retrieved on 2008-02-13. 
  16. ^ "What is Applied Kinesiology?". ICAK-USA. http://www.icakusa.com/what.php. Retrieved on 12/05/07. 
  17. ^ a b Sims, Judith. "Applied Kinesiology". Gale Enyclopedia of Alternative Medicine. http://findarticles.com/p/articles/mi_g2603/is_0001/ai_2603000168/pg_1. Retrieved on 2008-02-13. 
  18. ^ a b "Applied Kinesiology: In Retrospect". International College of Applied Kinesiology - USA. http://www.icak.com/college/history.shtml. Retrieved on 2008-02-13. 
  19. ^ a b "Applied Kinesiology". InteliHealth. http://www.intelihealth.com/IH/ihtIH/WSIHW000/8513/34968/358738.html?d=dmtContent. Retrieved on 2008-02-13. 
  20. ^ "International College of Applied Kinesiology - FAQ". International College of Applied Kinesiology - USA. http://www.icak.com/about/icak_faq.shtml. Retrieved on 2008-02-13. 
  21. ^ a b Kenney JJ, Clemens R, Forsythe KD (June 1988). "Applied kinesiology unreliable for assessing nutrient status". J Am Diet Assoc 88 (6): 698–704. PMID 3372923. 
  22. ^ Literature
  23. ^ a b Motyka TM, Yanuck SF (March 1999). "Expanding the neurological examination using functional neurologic assessment part I: methodological considerations". Int. J. Neurosci. 97 (1-2): 61–76. PMID 10681118. 
  24. ^ a b Schmitt WH, Leisman G (December 1998). "Correlation of applied kinesiology muscle testing findings with serum immunoglobulin levels for food allergies". Int. J. Neurosci. 96 (3-4): 237–44. PMID 10069623. 
  25. ^ a b Perot C, Meldener R, Goubel F (1991). "Objective measurement of proprioceptive technique consequences on muscular maximal voluntary contraction during manual muscle testing". Agressologie 32 (10 Spec No): 471–4. PMID 1844106. 
  26. ^ Friedman MH, Weisberg J (March 1981). "Applied kinesiology--double-blind pilot study". J Prosthet Dent 45 (3): 321–3. PMID 6938675. 
  27. ^ Garrow JS (June 1988). "Kinesiology and food allergy". Br Med J (Clin Res Ed) 296 (6636): 1573–4. PMID 3135014. 
  28. ^ a b Haas M, Peterson D, Hoyer D, Ross G (1994). "Muscle testing response to provocative vertebral challenge and spinal manipulation: a randomized controlled trial of construct validity". J Manipulative Physiol Ther 17 (3): 141–8. PMID 8006528. 
  29. ^ a b c Lüdtke R, Kunz B, Seeber N, Ring J (September 2001). "Test-retest-reliability and validity of the Kinesiology muscle test". Complement Ther Med 9 (3): 141–5. doi:10.1054/ctim.2001.0455. PMID 11926427. 
  30. ^ Pothmann R,Evaluation of applied kinesiology in nutritional intolerance of childhood,Forsch komplementärmed klass Naturheilkunde,2001,9:115
  31. ^ Wurlich, B. (2005). "Unproven techniques in allergy diagnosis". Journal of investigational allergology and clinical immunology 15: 86–90. PMID 16047707. 
  32. ^ Staehle HJ, Koch MJ, Pioch T (November 2005). "Double-blind study on materials testing with applied kinesiology". J. Dent. Res. 84 (11): 1066–9. PMID 16246943. http://jdr.iadrjournals.org/cgi/pmidlookup?view=long&pmid=16246943. 
  33. ^ Wüthrich B (2005). "Unproven techniques in allergy diagnosis". J Investig Allergol Clin Immunol 15 (2): 86–90. PMID 16047707. 
  34. ^ Tschernitschek H, Fink M (February 2005). "["Applied kinesiology" in medicine and dentistry--a critical review]" (in German). Wien Med Wochenschr 155 (3-4): 59–64. PMID 15791778. 
  35. ^ Teuber SS, Porch-Curren C (June 2003). "Unproved diagnostic and therapeutic approaches to food allergy and intolerance". Curr Opin Allergy Clin Immunol 3 (3): 217–21. doi:10.1097/00130832-200306000-00011. PMID 12840706. 
  36. ^ Hyman, Ray (1999). "Psychology and 'Alternative Medicine': the mischief-making of ideomotor action". The Scientific review of Alternative Medicine 3 (2). http://www.sram.org/0302/ideomotor.html. Retrieved on 2008-02-25. 
  37. ^ Magical Thinking. Skeptic's Dictionary
  38. ^ Danish Chiropractic Association position

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