Applied kinesiology

This article is about a chiropractic or an alternative medicine method. For the scientific study of human movement, see Kinesiology.
Applied kinesiology
Intervention

A person (right) practicing applied kinesiology
MeSH D018953

Applied kinesiology (AK) is a technique in alternative medicine claimed to be able to diagnose illness or choose treatment by testing muscles for strength and weakness.[1] Applied kinesiologists are often chiropractors, but they may also be naturopathic physicians, physicians, nurses, physical therapists, or veterinarians. 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,[2] and another study has shown that as an evaluative method, AK "is no more useful than random guessing",[3] 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".

Applied kinesiology, as described above, should not be confused with kinesiology, which is the scientific study of human movement.

History and current use

George J. Goodheart, a chiropractor, originated applied kinesiology in 1964[4] and began teaching it to other chiropractors.[5] 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.[6] ICAK now considers 1976 to be the date it was founded and 1973 to be the date that its first chairman took office.[7]

While this practice is primarily used by chiropractors, it is now also used by a number of other practitioners.[8] 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,[9] and has also been used by naturopaths, physicians, dentists, nutritionists, physical therapists, massage therapists, and nurse practitioners. Some basic AK based techniques have also been used/misused by nutritional supplement distributors, including multilevel distributors.[8][10]

Claims

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."[10][11] Treatment modalities relied upon by AK practitioners include joint manipulation and mobilization, myofascial, cranial and meridian therapies, clinical nutrition, and dietary counseling.[12]

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.[13] A weak muscle test is equated to dysfunction and chemical or structural imbalance or mental stress, indicative of suboptimal functioning.[14] 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 extended arm.[15] 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.[11]

"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.[11][13][16] Though its use is deprecated by the ICAK,[17] 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).

"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.[14]

Scientific research

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.[18] 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".[10]

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."[19] 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."[20] 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."[3]

Despite more than four decades of review, RCT (randomized, controlled trials) and other evaluative methods, even invested researchers delivered the following opinion;

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.[21]

Criticism

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.[10][22][23] 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.[10][16] Skeptics have also dismissed AK as "quackery," "magical thinking," and a misinterpretation of the ideomotor effect.[24][25] It has also been criticized on theoretical and empirical grounds,[24] and characterized as pseudoscience.[26] With only anecdotal accounts claiming to provide 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."[19]

In 2014, a randomized, double-blind trial was conducted to evaluate applied kinesiology results. The output of that study equated successful identification of a material via applied kinesiology techniques as statistically no better than chance. The summation of the work concluded that "The research published by the Applied Kinesiology field itself is not to be relied upon, and in the experimental studies that do meet accepted standards of science, Applied Kinesiology has not demonstrated that it is a useful or reliable diagnostic tool upon which health decisions can be based."[27]

Position statements

Allergy diagnosis

In the US, the American Academy of Allergy, Asthma and Immunology[28] and the National Institute of Allergy and Infectious Diseases[29] have both advised that applied kinesiology should not be used in the diagnosis of allergies. The European Academy of Allergology and Clinical Immunology,[30] the National Institute for Clinical Excellence[31][32] of the UK, the Australasian Society of Clinical Immunology and Allergy[33] and the Allergy Society of South Africa[34] 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.[35] 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.[36] 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.[37]

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.[9]

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.[5]

Danish Chiropractic Association

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.[38]

See also

References

  1. ↑ Lüdtke R, Kunz B, Seeber N, Ring J (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.
  2. ↑ Bernstein IL, Li JT, Bernstein DI, Hamilton R, Spector SL, Tan R; et al. (2008). "Allergy diagnostic testing: an updated practice parameter.". Ann Allergy Asthma Immunol 100 (3 Suppl 3): S1–148. doi:10.1016/S1081-1206(10)60305-5. PMID 18431959.
  3. 1 2 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.
  4. ↑ "Innovators - George Goodheart". Web.archive.org. 2011-01-13. Archived from the original on January 13, 2011. Retrieved 2015-12-17.
  5. 1 2 Chiropractic Techniques. American Chiropractic Association. Archived July 28, 2006 at the Wayback Machine
  6. ↑ John Thie, D.C. – 1973 to 1976
  7. ↑ What is the International College of Applied Kinesiology (ICAK)?
  8. 1 2 Applied Kinesiology: Phony Muscle-Testing for "Allergies" and "Nutrient Deficiencies", by Stephen Barrett, MD
  9. 1 2 Job Analysis of Chiropractic (PDF). National Board of Chiropractic Examiners. 2005. p. 135. ISBN 1-884457-05-3. Archived from the original (PDF) on December 17, 2008.
  10. 1 2 3 4 5 "Applied Kinesiology". American Cancer Society. November 2008. Retrieved August 2013.
  11. 1 2 3 "Applied Kinesiology Status Statement". International College of Applied Kinesiology – USA. Archived from the original on 2008-03-22. Retrieved 2008-02-13.
  12. ↑ "What is Applied Kinesiology?". ICAK-USA. Archived from the original on 30 November 2007. Retrieved 5 December 2007.
  13. 1 2 Sims, Judith. "Applied Kinesiology". Gale Encyclopedia of Alternative Medicine. Retrieved 2008-02-13.
  14. 1 2 "Applied Kinesiology: In Retrospect". International College of Applied Kinesiology – USA. Retrieved 2008-02-13.
  15. ↑ Frost, Robert, Applied Kinesiology: A Training Manual and Reference Book of Basic Principles and Practices', p. 4, North Atlantic Books, 2002. available online
  16. 1 2 "Applied Kinesiology". InteliHealth. Retrieved 2008-02-13.
  17. ↑ "International College of Applied Kinesiology – FAQ". International College of Applied Kinesiology – USA. Archived from the original on 2007-08-29. Retrieved 2008-02-13.
  18. ↑ Baggoley C (2015). "Review of the Australian Government Rebate on Natural Therapies for Private Health Insurance" (PDF). Australian Government – Department of Health. Lay summary – Gavura, S. Australian review finds no benefit to 17 natural therapies. Science-Based Medicine. (19 November 2015).
  19. 1 2 Haas, Mitchell; Robert Cooperstein; David Peterson (August 2007). "Disentangling manual muscle testing and Applied Kinesiology: critique and reinterpretation of a literature review". Chiropractic & Osteopathy 15 (1): 11. doi:10.1186/1746-1340-15-11. PMC 2000870. PMID 17716373. Archived from the original on 16 October 2007. Retrieved 2007-11-30.
  20. ↑ Wurlich, B. (2005). "Unproven techniques in allergy diagnosis". Journal of investigational allergology and clinical immunology 15 (2): 86–90. PMID 16047707.
  21. ↑ Cuthbert, S C, Goodheart, G J (March 2007). "On the reliability and validity of manual muscle testing: a literature review". Chiropractic & Osteopathy 2007 15 (1): 4. doi:10.1186/1746-1340-15-4. PMC 1847521. PMID 17341308.
  22. ↑ 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.
  23. ↑ Hyman, Ray (1999). "Psychology and 'Alternative Medicine': the mischief-making of ideomotor action". Scientific Review of Alternative Medicine 3 (2). Archived from the original on 10 February 2008. Retrieved 2008-02-25.
  24. 1 2 Carroll, Robert Todd "These are empirical claims and have been tested and shown to be false". "Applied Kinesiology". The Skeptics Dictionary. Archived from the original on 10 August 2007. Retrieved 2007-07-26.
  25. ↑ Magical Thinking. Skeptic's Dictionary
  26. ↑ Atwood KC (2004). "Naturopathy, Pseudoscience, and Medicine: Myths and Fallacies vs Truth". MedGenMed 6 (1): 33. PMC 1140750. PMID 15208545.
  27. ↑ Schwartz SA, Utts J, Spottiswoode SJ, Shade CW, Tully L, Morris WF, Nachman G. "A double-blind, randomized study to assess the validity of applied kinesiology (AK) as a diagnostic tool and as a nonlocal proximity effect". Explore (NY) 10: 99–108. doi:10.1016/j.explore.2013.12.002. PMID 24607076.
  28. ↑ Bernstein, IL; et al. (March 2008). "Allergy diagnostic testing: an updated practice parameter" (PDF). Annals of Allergy, Asthma & Immunology 100 (3, Supplement 3): S1–148. doi:10.1016/S1081-1206(10)60305-5. PMID 18431959.
  29. ↑ Boyce, JA; Assa'ad A; Burks AW; et al. (December 2010). "Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel." (PDF). The Journal of Allergy and Clinical Immunology 126 (6 Suppl.): S1–S58. doi:10.1016/j.jaci.2010.10.007. PMID 21134576.
  30. ↑ Ortolani C; Bruijnzeel-Koomen C; Bengtsson U; et al. (January 1999). "Controversial aspects of adverse reactions to food. European Academy of Allergology and Clinical Immunology (EAACI) Reactions to Food Subcommittee.". Allergy 54 (1): 27–45. doi:10.1034/j.1398-9995.1999.00913.x. PMID 10195356.
  31. ↑ Centre for Clinical Practice at NICE (February 2011). "Food Allergy in Children and Young People: Diagnosis and Assessment of Food Allergy in Children and Young People in Primary Care and Community Settings". NICE Clinical Guidelines 116. PMID 22259824.
  32. ↑ NICE consults on draft guideline on food allergies in children
  33. ↑ "Unorthodox techniques for the diagnosis and treatment of allergy, asthma and immune disorders". Australasian Society of Clinical Immunology and Allergy. November 2007. Retrieved 7 February 2012.
  34. ↑ Motala, C; Hawarden, D (July 2009). "Guideline: Diagnostic testing in allergy" (PDF). South African Medical Journal 99 (7): 531–535.
  35. ↑ "Global Resources in Allergy (GLORIA) - Module 6: Food Allergy". World Allergy Organization. Retrieved 29 February 2012.
  36. ↑ "Correlation of applied kinesiology muscle testing findings with serum immunoglobulin levels for food allergies". Int. J. Neurosci. 96 (3-4): 237–44. December 1998. doi:10.3109/00207459808986471. PMID 10069623.
  37. ↑ "Food allergy diagnostics: scientific and unproven procedures (PUBMED)". Curr Opin Allergy Clinical Immun 2005 Jun;5(3):261-6. Retrieved 4 September 2014.
  38. ↑ Danish Chiropractic Association position

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