Applied kinesiology | |
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Alternative therapy | |
MeSH | D018953 |
This article is part of a series on |
Alternative medicine |
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Applied kinesiology (AK) is a pseudoscience-based technique [1] in alternative medicine claimed to be able to diagnose illness or choose treatment by testing muscles for strength and weakness. [2]
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. [3] Another study indicated that the use of applied kinesiology to evaluate nutrient status is "no more useful than random guessing." [4] 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". [5]
George J. Goodheart, a chiropractor, originated applied kinesiology in 1964 [6] and began teaching it to other chiropractors. [7] 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. [8] ICAK now considers 1976 to be the date it was founded and 1973 to be the date that its first chairman took office. [9]
While this practice is primarily used by chiropractors, AK is also used by a number of other practitioners of complementary therapy. 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] Some basic AK based techniques have also been used by nutritional supplement distributors, including multilevel distributors. [5] [11]
Applied kinesiology is presented as a system that evaluates structural, chemical, and mental aspects of health by using a method referred to as muscle response testing or 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." [5] [12] Treatment modalities relied upon by AK practitioners include joint manipulation and mobilization, myofascial, cranial and meridian therapies, clinical nutrition, and dietary counseling. [13]
A manual muscle test in AK is conducted by having the patient use the target muscle or muscle group to resist 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. [14] A weak muscle test is equated to dysfunction and chemical or structural imbalance or mental stress, indicative of suboptimal functioning. [15] 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. [16] 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. [12]
Nutrient testing is used to examine the response of various 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. [12] [14] [17] Though its use is deprecated by the ICAK, [18] 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. [15]
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. [19] 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". [5]
A review of several scientific studies of AK-specific procedures and diagnostic tests concluded: "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." [20] 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." [21] 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 three 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." [4]
Despite more than four decades of review, RCT (randomized, controlled trials) and other evaluative methods, even invested researchers delivered the following opinion: [22]
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.
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. [5] [23] [24] 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. [5] [17] Skeptics have also dismissed AK as "quackery", "magical thinking", and a misinterpretation of the ideomotor effect. [25] [26] It has also been criticized on theoretical and empirical grounds, [25] and characterized as pseudoscience. [27] 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." [20]
In the United States, 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]
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] They describe AK as follows:
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. [7]
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]
Chiropractic is a form of alternative medicine concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially of the spine. It has esoteric origins and is based on several pseudoscientific ideas.
Allergies, also known as allergic diseases, are various conditions caused by hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include hay fever, food allergies, atopic dermatitis, allergic asthma, and anaphylaxis. Symptoms may include red eyes, an itchy rash, sneezing, coughing, a runny nose, shortness of breath, or swelling. Note that food intolerances and food poisoning are separate conditions.
The National Council Against Health Fraud (NCAHF) was a not-for-profit, US-based organization, that described itself as a "private nonprofit, voluntary health agency that focuses upon health misinformation, fraud, and quackery as public health problems."
A radioallergosorbent test (RAST) is a blood test using radioimmunoassay test to detect specific IgE antibodies in order to determine the substances a subject is allergic to. This is different from a skin allergy test, which determines allergy by the reaction of a person's skin to different substances.
Vega machines are a type of electroacupuncture device used in pseudoscientific Vega testing, which proponents claim can diagnose allergies and other illnesses. The forerunner to the Vega test was electroacupuncture according to Voll developed by Reinholdt Voll in the 1950s. Helmut Schimmel modified the technique in the 1970s and presented it under the name Vega test.
Hypereosinophilic syndrome is a disease characterized by a persistently elevated eosinophil count in the blood for at least six months without any recognizable cause, with involvement of either the heart, nervous system, or bone marrow.
Spinal adjustment and chiropractic adjustment are terms used by chiropractors to describe their approaches to spinal manipulation, as well as some osteopaths, who use the term adjustment. Despite anecdotal success, there is no scientific evidence that spinal adjustment is effective against disease.
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Eosinophilic esophagitis (EoE) is an allergic inflammatory condition of the esophagus that involves eosinophils, a type of white blood cell. In healthy individuals, the esophagus is typically devoid of eosinophils. In EoE, eosinophils migrate to the esophagus in large numbers. When a trigger food is eaten, the eosinophils contribute to tissue damage and inflammation. Symptoms include swallowing difficulty, food impaction, vomiting, and heartburn.
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Nambudripad's Allergy Elimination Techniques (NAET) is a form of alternative medicine which proponents claim can treat allergies and related disorders. The techniques were devised by Devi Nambudripad, a California-based chiropractor and acupuncturist, in 1983, drawing on a combination of ideas from applied kinesiology, acupuncture, acupressure, nutritional management, and chiropractic methods.
The Bi-Digital O-Ring Test (BDORT), characterized as a form of applied kinesiology, is a patented alternative medicine diagnostic procedure in which a patient forms an 'O' with his or her fingers, and the diagnostician subjectively evaluates the patient's health according to the patient's finger strength as the diagnostician tries to pry them apart.
Dry needling, also known as trigger point dry needling and intramuscular stimulation, is a treatment technique used by various healthcare practitioners, including physical therapists, physicians, and chiropractors, among others. Acupuncturists usually maintain that dry needling is adapted from acupuncture, but others consider dry needling as a variation of trigger point injections. It involves the use of either solid filiform needles or hollow-core hypodermic needles for therapy of muscle pain, including pain related to myofascial pain syndrome. Dry needling is mainly used to treat myofascial trigger points, but it is also used to target connective tissue, neural ailments, and muscular ailments. The American Physical Therapy Association defines dry needling as a technique used to treat dysfunction of skeletal muscle and connective tissue, minimize pain, and improve or regulate structural or functional damage.
Chiropractors use their version of spinal manipulation as their primary treatment method, with non-chiropractic use of spinal manipulation gaining more study and attention in mainstream medicine in the 1980s. There is no evidence that chiropractic spinal adjustments are effective for any medical condition, with the possible exception of treatment for lower back pain. The safety of manipulation, particularly on the cervical spine has been debated. Adverse results, including strokes and deaths, are rare.
Throughout its history, chiropractic has been the subject of internal and external controversy and criticism. According to magnetic healer Daniel D. Palmer, the founder of chiropractic, "vertebral subluxation" was the sole cause of all diseases and manipulation was the cure for all disease. A 2003 profession-wide survey found "most chiropractors still hold views of Innate Intelligence and of the cause and cure of disease consistent with those of the Palmers". A critical evaluation stated "Chiropractic is rooted in mystical concepts. This led to an internal conflict within the chiropractic profession, which continues today." Chiropractors, including D.D. Palmer, were jailed for practicing medicine without a license. D.D. Palmer considered establishing chiropractic as a religion to resolve this problem. For most of its existence, chiropractic has battled with mainstream medicine, sustained by antiscientific and pseudoscientific ideas such as vertebral subluxation.
The antigen leukocyte antibody test is one that claims to measure adverse reactions to dietary substances. It was created by American Medical Testing Laboratories and is now marketed by Cell Science Systems of Deerfield Beach, Florida. Researched conducted at Yale School of Medicine published in BMJ Open Gastroenterology in 2017 demonstrated improvement for those with irritable bowel syndrome
"These findings reject the null hypothesis and show that a diet guided by leucocyte activation testing results in demonstrable clinical improvement in IBS. These clinical results, associated with a reduction in plasma neutrophil elastase, have implications for better understanding the role of food intolerance and the pathophysiology of IBS."
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Vocal cord dysfunction (VCD) is a pathology affecting the vocal folds characterized by full or partial vocal fold closure causing difficulty and distress during respiration, especially during inhalation.
George Joseph Goodheart, Jr., D.C. was a chiropractor who invented Thought Field Therapy and applied kinesiology.
Psychosensory therapy is a form of therapeutic treatment that uses sensory stimuli to affect psychological and emotional health. In addition, psychosensory therapy is a group of therapeutic techniques that involves applying sensory inputs to treat various behaviors, mood, thoughts, symptoms, and pain. Psychosensory therapy has its roots in traditional Chinese medicine in addition to energy psychology. Some important figures in psychosensory therapy include chiropractor George Goodheart, psychiatrist John Diamond, clinical psychologist Roger Callahan, and Ronald Ruden.
The effectiveness of kinesiology in improving health outcomes in people with a specific clinical condition is unknown. There is insufficient evidence from SRs within this field to reach any conclusion regarding the effectiveness, safety, quality or cost-effectiveness of kinesiology.