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applied kinesiology

What is Applied Kinesiology

Applied kinesiology is a diagnostic technique in alternative medicine that is supposedly able to diagnose illnesses and select treatments by testing muscle strength and weakness 1. Applied kinesiology also called specialized kinesiology should be distinguished from kinesiology (biomechanics), which is the “scientific study of movement”. According to the International College of Applied Kinesiology 2, applied kinesiology is a “system that evaluates structural, chemical and mental aspects of health using manual muscle testing combined with other standard methods of diagnosis”. Applied kinesiology is a non-invasive system of evaluating body function. The combined terms “applied” and “kinesiology” describe the basis of this system, which is the use of manual muscle testing (MMT) to evaluate body function through the dynamics of the musculoskeletal system 2. Applied kinesiology basic notion is that every organ dysfunction is accompanied by a specific muscle weakness, which enables diseases to be diagnosed through muscle-testing procedures. The principle belief behind applied kinesiology is that doctors can tell what is wrong with a patient by seeing the way his/her muscles respond when they are pushed on. Applied kinesiology technique uses manual muscle testing (MMT) not just to evaluate the functional integrity of muscle and nerve supply, but also as a means to “diagnose structural [and functional], chemical, and mental dysfunctions” 3. Some of applied kinesiology distinguishing diagnostic procedures include the use of provocative tests (i.e., applied kinesiology challenge and therapy localization) in conjunction with manual muscle testing (MMT) to identify the need for treatment of neuromusculoskeletal, organic, and metabolic conditions 4. Muscle weakness is also considered diagnostic of preclinical or subclinical organic, non-neuromusculoskeletal disease. Applied kinesiology claims to identify specific allergies through measuring the patient’s muscle strength by manual muscle testing in the presence of a putative allergen 5.

A Michigan chiropractor George J. Goodheart came up with the concept of applied kinesiology in 1964 6. Goodheart claimed to have corrected a patient’s chronic winged scapula by pressing on nodules found near the origin and insertion of the involved serratus anterior muscle 6. This finding led to the origin and insertion treatment, the first method developed in applied kinesiology. Goodheart began practicing and teaching applied kinesiology to other chiropractors. He even started an organization called the Goodheart Study Group Leaders that now goes by the name of “The International College of Applied Kinesiology” 2. This is mostly used by chiropractors, but it has started to gain popularity with other practitioners. In recent years, applied kinesiology became the 10th most used chiropractic technique in the United States 7.

Applied kinesiology proponents claim that nutritional deficiencies, allergies, and other adverse reactions to foods or nutrients can be detected by having the patient chew or suck on these items or by placing them on the tongue so that the patient salivates. Some practitioners advise that the test material merely be held in the patient’s hand or placed on another part of the body. Many muscle-testing proponents assert that nutrients tested in these various ways will have an immediate effect: “good” substances will make specific muscles stronger, whereas “bad” substances will cause weaknesses that “indicate trouble with the organ or other tissue on the same nerve, vascular, nutrition, etc., grouping.” A leading applied kinesiology text 8, for example, states: “If a patient is diagnosed as having a liver disturbance and the associated pectoralis major [chest muscle] tests weak, have the patient chew a substance that may help the liver, such as vitamin A. If . . . the vitamin A is appropriate treatment, the muscle will test strong”. Treatments may involve specific joint manipulation or mobilization, various myofascial therapies, cranial techniques, meridian and acupuncture skills, clinical nutrition, dietary management, counseling skills, evaluating environmental irritants and various reflex procedures 2.

Applied kinesiology muscle testing

Manual muscle testing is a standard component of the neuromusculoskeletal physical examination 9. Manual muscle testing is useful in the assessment of weakness of muscles directly involved with pain, injury, and neuromusculoskeletal disorders. Manual muscle test was established by Kendall and Kendall 10, who held that when pressure is increasingly applied to a contracted muscle, the muscle either maintains its position (rated as “facilitated” or “strong”) or breaks away (rated as “inhibited” or “weak”). According to this rating system, a grade 5 manual muscle test is normal muscle strength, demonstrating complete (100%) range of movement against gravity, with firm resistance offered by the practitioner. Grade 4 is 75-percent efficiency in achieving range of motion against gravity with slight resistance, with decreasing increments of 25-percent efficiency with each lower grade to 0. A muscle graded 4 or less is considered inhibited, warranting interventions as described in the report 10.

Applied kinesiology manual muscle tests evaluate the ability of the nervous system to adapt the muscle to meet the changing pressure of the examiners test 3. This requires that the examiner be trained in the anatomy, physiology, and neurology of muscle function. The action of the muscle being tested, as well as the role of synergistic muscles, must be understood. Manual muscle testing is both a science and an art. To achieve accurate results, muscle tests must be performed according to a precise testing protocol. The following factors must be carefully considered when testing muscles in clinical and research settings 3.

  • Proper positioning so the test muscle is the prime mover
  • Adequate stabilization of regional anatomy
  • Observation of the manner in which the patient or subject assumes and maintains the test position
  • Observation of the manner in which the patient or subject performs the test
  • Consistent timing, pressure, and position
  • Avoidance of preconceived impressions regarding the test outcome by the tester
  • Utilizing non-painful contact ensuring a nonpainful execution of the test
  • Contraindications due to age, debilitative disease, acute pain and local pathology or inflammation

Does applied kinesiology work?

Applied kinesiology is a way of evaluating structural, chemical, and mental areas of health by using manual muscle testing (MMT) along with conventional methods. The idea behind applied kinesiology is that every organ dysfunction is associated with weakness in a corresponding muscle. This is called the “viscerosomatic relationship”. Applied kinesiology is just one of the many different types of alternative medicine with lacking studies to prove its effectiveness. The evidence for applied kinesiology is based mostly on anecdotal evidence from practitioners’ assessments of muscle response making it not very reliable. It is also argued that there is no scientific understanding of the viscerosomatic relationship. Only the anecdotal reviews have shown positive support for applied kinesiology. Every peer-reviewed study has concluded that there is no evidence that applied kinesiology is able to diagnose organic diseases or conditions. In the US, the American Academy of Allergy, Asthma and Immunology 11, the National Institute of Allergy and Infectious Diseases 12 and the American Cancer Society 13 have all released position statements saying that applied kinesiology should not be used in the diagnosis of allergies, cancer, etc. In 2015 the 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 14. There are also many other organizations just like these from other parts of the world that have a similar stance on this form of alternative medicine.

A double-blind, randomized study to assess the validity of applied kinesiology as a diagnostic tool concluded that “Applied kinesiology has not demonstrated that it is a useful or reliable diagnostic tool upon which health decisions can be based” 1. A review of the literature in applied kinesiology and specialized kinesiology 15 found there is insufficient evidence for diagnostic accuracy within kinesiology, the validity of muscle response and the effectiveness of kinesiology for any condition. Few studies evaluating specific applied kinesiology procedures either refute or cannot support the validity of applied kinesiology procedures as diagnostic tests 16. In particular, the use of manual muscle testing for the diagnosis of organic disease or putative pre/subclinical conditions is insupportable. A review of applied kinesiology literature showed the studies to be unreliable 17. Teuber and Porch-Curren 18 note that several studies refute applied kinesiology in diagnosis of food allergies and they concluded: “The weight of the evidence to date suggests that this diagnostic modality is not validated when subjected to scrutiny”. The Committee on Food Allergies 19 recommends that physicians use evidence-based, standardized procedures as the basis for food allergy diagnosis and avoid nonstandardized and unproven procedures such as applied kinesiology, immunoglobulin G panels or electrodermal testing. When food allergy is suspected, a patient should be evaluated by a physician who has the training and experience to select and interpret appropriate diagnostic tests.

Tschernitschek and Fink 20 reviewed applied kinesiology procedures including those used in dentistry. They concluded that there is a lack of evidence for applied kinesiology effectiveness, reliability, and validity 20. Haas 21 found that manual muscle testing reliability could not be substantiated before 1991 because of methodological and statistical limitations of published studies. Klinkoski and LeBoeuf 22 reviewed scientific papers published by the International College of Applied Kinesiology between 1981 and 1987. The authors 22 concluded that no conclusions could be drawn because of inadequate methodological quality based on clear identification of sample size, inclusion criteria, blind and naive subjects, reliable test methods, blind assessors, and statistical analysis. Motyka and Yanuck 23 found that the body of applied kinesiology research is equivocal, sometimes confirmatory of reliability and validity, other times not confirmatory, and often simply irrelevant due to various design flaws.

Researchers have subjected the manual muscle testing procedures to several well-designed controlled tests and some have found no difference in muscle response from one substance to another, while others have found no difference between the results with test substances and with placebos.

  • Three practitioners testing eleven subjects made significantly different assessments; their diagnoses of nutritional deficiencies did not correspond to the nutrient levels obtain by blood serum analysis; and that the responses to nutrient substances did not significantly differ from responses to placebos 24.
  • Another study found no effect from administering the nutrients “expected” to strengthen a muscle diagnosed as “weak” by applied kinesiology practitioners” 25.
  • Researchers who conducted an elaborate double-blind trial concluded that “muscle response appeared to be a random phenomenon” 26.
  • Another study showed that suggestion can influence the outcome of muscle-testing 27. During part of this experiment, college students were told that chewing M&M candies would give them instant energy that would probably make them test stronger. Five out of nine did so 27.
  • Four applied kinesiology practitioners tested seven patients who were extremely sensitive to wasp venom 28. Altogether, 140 muscle tests were done to see how the patients responded to preparations of venom or salt water in a bottle. If the test were valid, the venom bottles should result in “strong” reactions and the salt-water bottles should produce “weak” test reactions. However, the practitioners were unable to identify which bottles contained which 28. The results suggest that the use of Health Kinesiology as a diagnostic tool is not more useful than random guessing. This should at least be true in patients with insect venom allergy that are tested by examiners with average skills 28.
  • Several chiropractors were tested at a medical office while under unblinded and blinded conditions 29. During the volunteers could resist downward pressure when a drop of glucose was placed on their tongue but could resist when fructose was administered. The arm tests were repeated using substances in coded test tubes so that the volunteer, the chiropractors, and the onlookers could not tell which solution being applied to the volunteer’s tongue. When the code was revealed, there was no connection between ability to resist and whether the volunteer was given the “good” or the “bad” sugar 29.
References
  1. Stephan A. Schwartz, Jessica Utts, S. James P. Spottiswoode, Christopher W. Shade, Lisa Tully, William F. Morris, Ginette Nachman. A Double-Blind, Randomized Study to Assess the Validity of Applied Kinesiology (AK) as a Diagnostic Tool and as a Nonlocal Proximity Effect. EXPLORE, Volume 10, Issue 2, 2014, Pages 99-108, ISSN 1550-8307. https://doi.org/10.1016/j.explore.2013.12.002
  2. International College of Applied Kinesiology. https://www.icakusa.com
  3. Cuthbert, S. C., & Goodheart, G. J., Jr (2007). On the reliability and validity of manual muscle testing: a literature review. Chiropractic & osteopathy, 15, 4. https://doi.org/10.1186/1746-1340-15-4
  4. Frost R: Applied Kinesiology: a training manual and reference book of basic principles and practices. 2002, Berkeley, CA, North Atlantic Books
  5. Leonard Bielory, Abba I. Terr. 101 – Unconventional Theories and Unproven Methods in Allergy. Middleton’s Allergy (Eighth Edition), W.B. Saunders, 2014, Pages 1616-1635, ISBN 9780323085939. https://doi.org/10.1016/B978-0-323-08593-9.00102-9
  6. Gin RH, Green BN. George Goodheart, Jr., D.C., and a history of applied kinesiology. J Manipulative Physiol Ther. 1997 Jun;20(5):331-7.
  7. Christensen MG, Kerkhoff D, Kollasch MW, Cohn L: Job analysis of chiropractic, 2000: a project report, survey analysis and summary of the practice of chiropractic within the United States. 2000, Greeley, CO, National Board of Chiropractic Examiners
  8. Applied kinesiology nutritional testing. In Walther DS. Applied Kinesiology: Synopsis. Pueblo, Colorado: Systems DC, 1988, p 135.
  9. Magee DJ: Orthopedic physical assessment. 1987, Philadelphia, W.B. Saunders
  10. Kendall H.O., Kendall F.P., Boynton D.A. Williams & Wilkins Company; Baltimore: 1952. Posture and pain.
  11. Bernstein IL, Li JT, Bernstein DI, Hamilton R, Spector SL, Tan R, Sicherer S, Golden DB, Khan DA, Nicklas RA, Portnoy JM, Blessing-Moore J, Cox L, Lang DM, Oppenheimer J, Randolph CC, Schuller DE, Tilles SA, Wallace DV, Levetin E, Weber R; American Academy of Allergy, Asthma and Immunology; American College of Allergy, Asthma and Immunology. Allergy diagnostic testing: an updated practice parameter. Ann Allergy Asthma Immunol. 2008 Mar;100(3 Suppl 3):S1-148. doi: 10.1016/s1081-1206(10)60305-5
  12. NIAID-Sponsored Expert Panel, Boyce JA, Assa’ad A, Burks AW, Jones SM, Sampson HA, Wood RA, Plaut M, Cooper SF, Fenton MJ, Arshad SH, Bahna SL, Beck LA, Byrd-Bredbenner C, Camargo CA Jr, Eichenfield L, Furuta GT, Hanifin JM, Jones C, Kraft M, Levy BD, Lieberman P, Luccioli S, McCall KM, Schneider LC, Simon RA, Simons FE, Teach SJ, Yawn BP, Schwaninger JM. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010 Dec;126(6 Suppl):S1-58. doi: 10.1016/j.jaci.2010.10.007
  13. American Cancer Society Complete Guide to Complementary and Alternative Cancer Therapies (2nd ed.). American Cancer Society. pp. 160–164. ISBN 9780944235713
  14. https://web.archive.org.au/awa/20191108002458mp_/https://www1.health.gov.au/internet/main/publishing.nsf/Content/4899F1657E19A6F4CA2583A50020140D/$File/Natural%20Therapies%20Overview%20Report%20Final%20with%20copyright%2011%20March.pdf
  15. Hall S, Lewith G, Brien S, Little P. A review of the literature in applied and specialised kinesiology. Forsch Komplementmed. 2008 Feb;15(1):40-6. https://doi.org/10.1159/000112820
  16. Haas, M., Cooperstein, R. & Peterson, D. Disentangling manual muscle testing and Applied Kinesiology: critique and reinterpretation of a literature review . Chiropr Man Therap 15, 11 (2007). https://doi.org/10.1186/1746-1340-15-11
  17. Wendy Hodsdon, ND. 14 – Food Hypersensitivities. Textbook of Natural Medicine (Fifth Edition), Churchill Livingstone, 2020, Pages 134-139.e2, ISBN 9780323523424. https://doi.org/10.1016/B978-0-323-43044-9.00014-5
  18. Teuber SS, Porch-Curren C. Unproved diagnostic and therapeutic approaches to food allergy and intolerance. Curr Opin Allergy Clin Immunol. 2003 Jun;3(3):217-21. doi: 10.1097/00130832-200306000-00011
  19. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Food and Nutrition Board; Committee on Food Allergies: Global Burden, Causes, Treatment, Prevention, and Public Policy; Oria MP, Stallings VA, editors. Finding a Path to Safety in Food Allergy: Assessment of the Global Burden, Causes, Prevention, Management, and Public Policy. Washington (DC): National Academies Press (US); 2016 Nov 30. 4, Assessments, Diagnostic Testing, Disease Monitoring, and Prognosis. Available from: https://www.ncbi.nlm.nih.gov/books/NBK435944
  20. Tschernitschek H, Fink M. “Angewandte Kinesiologie” in Medizin und Zahnmedizin–eine kritische Ubersicht [“Applied kinesiology” in medicine and dentistry–a critical review]. Wien Med Wochenschr. 2005 Feb;155(3-4):59-64. German. doi: 10.1007/s10354-004-0113-9
  21. Haas M. The reliability of reliability. J Manipulative Physiol Ther. 1991 Mar-Apr;14(3):199-208.
  22. Klinkoski B, Leboeuf C. A review of the research papers published by the international College of Applied Kinesiology from 1981 to 1987. J Manipulative Physiol Ther. 1990 May;13(4):190-4.
  23. Motyka TM, Yanuck SF. Expanding the neurological examination using functional neurologic assessment part I: methodological considerations. Int J Neurosci. 1999 Mar;97(1-2):61-76. doi: 10.3109/00207459908994303
  24. Kenny JJ, Clemens R, Forsythe KD. Applied kinesiology unreliable for assessing nutrient status. Journal of the American Dietetic Association 88:698-704, 1988.
  25. Triano JJ. Muscle strength testing as a diagnostic screen for supplemental nutrition therapy: a blind study. Journal of Manipulative and Physiological Therapeutics 5:179-182, 1982
  26. Haas M, Peterson D, Hoyer D, Ross G. Muscle testing response to provocative vertebral challenge and spinal manipulation: a randomized controlled trial of construct validity. J Manipulative Physiol Ther. 1994 Mar-Apr;17(3):141-8.
  27. Applied kinesiology – Double-blind pilot study. Journal of Prosthetic Dentistry 45:321-323, 1981.
  28. Lüdtke R, Kunz B, Seeber N, Ring J. Test-retest-reliability and validity of the Kinesiology muscle test. Complement Ther Med. 2001 Sep;9(3):141-5. doi: 10.1054/ctim.2001.0455
  29. Hyman R. The mischief-making of ideomotor action. by ideomotor action. The Scientific Review of Alternative Medicine, Fall-Winter issue, 1999.
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