Abstract
Introduction
Methods
Results
Conclusion
Review
Methods
Operational Definitions and History of the Manual Muscle Test
Results
Research on the Reliability of the MMT
Authors, date | Subjects | Examiners | Design | Findings and statistics |
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Pollard et al55 (2005) ** | 106 volunteers | Novice examiner (5th year) chiropractic student; experienced examiner (15 years MMT experience) | Interexaminer reliability of 2 common muscle tests | Deltoid muscle showed Cohen kappa value (k 0.62) and psoas muscle showed (k 0.67). Good interexaminer reliability shown between experienced and novice examiners. |
Perry et al43 (2004) ** | 16 patients with post-polio syndrome; 18 patients without pathology; 26 patients with signs of hip extensor weakness and post-polio syndrome | Several examiners | Supine MMT of hip extensor strength compared to strength values obtained by traditional prone test of hip extensor muscles in patients with post-polio syndrome | Reliability testing showed excellent agreement (82%). Subjects with pathology had significant differences in mean muscle torque (P < .01) strength. Predictive validity of MMT in patients with symptomatic post-polio syndrome affecting hip extensor muscles was excellent. |
Escolar et al56 (2001) | 12 children with muscular dystrophy | 12 novice and experienced examiners | To determine reliability of quantitative muscle testing (QMT, an instrument for measuring strength) compared to MMT | MMT was not as reliable among novice examiners as QMT. With adequate training of examiners an interclass correlation coefficient > 0.75 was achieved for MMT. |
Caruso and Leisman 36 (2000) | 27 volunteers who knew nothing about MMT or AK | 2 examiners | To show the difference between "weak" and "strong" muscles, using MMT and dynamometer testing | Study showed that examiners with over 5 years experience using AK had reliability and reproducibility (98.2%) when their outcomes were compared. Perception of "inhibition" or weakness made by examiner was corroborated by test pressure analysis using the dynamometer. |
Florence et al 47 (1992) ** | 102 boys aged 5 to 15 years. | Physical therapists | A double-blind, multicenter trial to document the effects of prednisone on muscle strength in patients with Duchenne's muscular dystrophy (DMD). | Reliability of muscle strength grades obtained for individual muscle groups and of individual muscle strength grades was analyzed using Cohen's weighted Kappa. The reliability of grades for individual muscle groups ranged from .65 to .93, with the proximal muscles having the higher reliability values. The reliability of individual muscle strength grades ranged from .80 to .99, with those in the gravity-eliminated range scoring the highest. Concluded that the MMT was reliable for assessing muscle strength in boys with DMD when consecutive evaluations are performed by the same physical therapist. |
Barr et al 42 (1991) | 36 boys (11.7 +/- 3.9 years) with Duchenne or Becker muscular dystrophy. | Upper and lower extremities were evaluated by MMT for function, range of motion, and strength. | The data were analyzed using intraclass correlation coefficients (ICCs). For the interevaluator phase, ICCs for MMT was .90; For the intraevaluator phase, corresponding ICC was .80 to .96. Results confirm and extend observations by others that these assessment measures are sufficiently reliable for use in multiinstitutional collaborative efforts. These results can be used to design clinical trials that have sufficient statistical power to detect changes in the rate of disease progression. | |
Hsieh and Phillips 46 (1990) | 15 asymptomatic subjects | 3 chiropractors | To determine the reliability of manual dynamometry using AK style of MMT, comparing doctor-initiated and patient-initiated MMT | Intratester reliability and correlation coefficients for testers 1, 2, and 3 were 0.55, 0.75, and 0.76 with doctor-initiated method; 0.96, 0.99, and 0.97 when patient-initiated MMT method. The intertester reliability coefficients were 0.77 and 0.59 on day 1 and 2 respectively for doctor-initiated method; and 0.95 and 0.96 for the patient-initiated method. |
Wadsworth et al 45 (1987) | 5 muscle groups on 11 patients | physical therapists | To compare the intrarater reliability of MMT and hand-held dynamometer tests | The correlation coefficients were high and significantly different from zero for four muscle groups tested dynametrically and for two muscle groups tested manually. The test-retest reliability coefficients for two muscle groups tested manually could not be calculated because the values between subjects were identical. Concluded that both MMT and dynamometry are reliable testing methods, given the conditions described in this study. |
Florence et al 34 (1984) | Patients with Duchenne Muscular Dystrophy | physical therapists | To evaluate the (intraobserver) and (interobserver) reliability of MMT evaluation procedures to assess the efficacy of treatment of Duchenne muscular dystrophy. | Showed there was significant improvement in the degree of consistency of a given examiner's MMT scores when the examiner had more clinical experience and training in MMT. Author's concluded that MMT demonstrated reliability for an evaluation method that provided an objective foundation on which to claim if a drug or therapeutic procedure does or does not have an effect in treating Duchenne muscular dystrophy. |
Jacobs 44(1981) | 65 patients with suspected thyroid dysfunction | 2 chiropractors | To compare AK diagnostic findings with laboratory findings | This double-blind study demonstrated an 81.9% agreement between two testers, indicating good inter-examiner reliability. |
Research On the Validity of MMT
Construct and content validity of MMT
Authors, date | Subjects | Design | Findings and statistics |
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Hossain et al 90 (2005) | Literature review | Gait analysis studies reviewed show an orderly sequence of muscle activation – this contributes to efficient stabilization of the joint and effective weight transfer to the lower limb. Gluteus maximus fibres – lying almost perpendicular to the joint surfaces are oriented for this purpose. Biceps femoris is another important muscle that can also influence joint stability by its proximal attachment to sacrotuberous ligament. | Altered pattern of muscle recruitment has been observed in patients with low back pain. Because of its position as a key linkage in transmission of weight from the upper limbs to the lower, poor joint stability could have major consequences on weight bearing. It is proposed that sacro-iliac joint dysfunction can result from malrecruitment of gluteus maximus motor units during weight bearing, resulting in compensatory biceps femoris over activation. The resulting soft tissue strain and joint instability may manifest itself in low back pain. This thesis was also proposed by Janda (1964). 18
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Falla et al 71 (2004) ** | 10 patients with chronic neck pain; 10 controls | To compare activity of deep and superficial cervical flexor muscles during a test of craniocervical flexion. | Showed a strong linear relation between the electromyographic amplitude of the deep cervical flexor muscles and the incremental stages of the craniocervical flexion test for control and individuals with neck pain (P = 0.002). A reduced performance of the craniocervical flexion test is associated with dysfunction of the deep cervical flexor muscles. |
Hodges et al 83 (1996) ** | 15 patients with low back pain and 15 matched control subjects | Subjects performed rapid shoulder flexion, abduction, and extension in response to a visual stimulus. Electromyographic activity of the abdominal, and lumbar multifidus muscles recorded by surface electrodes. | Contraction of transversus abdominis was significantly delayed in patients with low back pain with all movements. The delayed onset of contraction of transversus abdominis indicated a deficit of motor control and is hypothesized to result in inefficient muscular stabilization of the spine. |
Triano et al 91 (1987) ** | 41 low-back pain patients; and 7 pain-free control subjects | To examine relations among some objective and subjective measures of low-back-related disability | Oswestry disability score related significantly (P less than 0.001) to presence or absence of relaxation in back muscles during flexion. Mean trunk strength ratios were inversely related to disability score (P less than .05). Findings imply that myoelectric signal levels, trunk strength ratios, and ranges of trunk motion may be used as objective indicators of low-back pain disability. |
Biering-Sorensen 85(1984) | 449 men and 479 women | The examination consisted of anthropometric measurements, flexibility/elasticity measurements of the back and hamstrings, as well as tests for trunk muscle strength and endurance. | The main findings were that good isometric endurance of the back muscles may prevent first-time occurrence of low back trouble (LBT) in men and that men with hypermobile backs are more liable to contract LBT. Weak trunk muscles and reduced flexibility/elasticity of the back and hamstrings were found as residual signs, in particular, among those with recurrence or persistence of LBT in the follow-up year. |
McNeill T et al 92 (1980) ** | 27 healthy males and 30 healthy females; and 25 male and 15 female patients with low-back pain and/or sciatica. | Maximum voluntary isometric strengths were measured during attempted flexion, extension, and lateral bending from an upright standing position. | The ratios showed that the patients with low back pain and/or sciatica had extension strengths that were significantly less than their strengths in the other types of movements tested. The strength ratios for attempted extension were particularly low for patients with sciatica. Both male and female with LBP and/or sciatica had approximately 60% of the absolute trunk strengths of the corresponding healthy subjects. |
Karvonen et al 77 (1980) | 183 male conscripts. A history of sciatica was reported by 8%, lumbago by 13%, back injury by 13% and low back insufficiency by 63%. | To correlate muscle weaknesses in young men with complaints of LBP | Weak trunk extensors were associated with a history of sciatica; weak trunk flexors with back injuries and with current backache at work/exercise. Weak leg extensors showed associations with a history of low back insufficiency and of sick leave due to the back and with current hip pain. Men with a history of lumbago and of hip and knee complaints performed poorly during 12 min of running. The questionnaire and strength measurements proved suitable for studying low back syndrome in its early stages. |
Addison et al 76 (1980) | 16 male and 17 female patients with chronic LBP | Maximum voluntary trunk strengths in the standing position were measured during attempted flexion, extension, and lateral bending. The trunk strengths of these patients were then compared with those of healthy subjects and with those of patients with low-back disorders who sought treatment as outpatients of a general orthopaedic office practice. | When compared with healthy subjects, the patients seeking hospitalization had significantly smaller strengths during attempted extension relative to their strengths during attempted flexion or lateral bending. |
The Convergent and Discriminant Validity of MMT
Concurrent Validity of MMT
Authors, date | Subjects | Examiners | Design | Findings and statistics |
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Bohannon 95 (2001) | 128 acute knee rehabilitation patients | physical therapist | To compare MMT with hand-held dynamometer measurements of knee extension strength | MMT and dynamometer scores highly correlated (r = 0.768; P < 0.001). Convergent and construct validity of MMT and dynamometry
measurements demonstrated. |
Caruso and Leisman36 (2000) | 27 volunteers with no knowledge about MMT or AK | 2 examiners | To show the difference between "weak" and "strong" muscles, using MMT and dynamometer testing | Study showed that examiners with over 5 years experience using AK had reliability and reproducibility when their outcomes were compared. Perception of "inhibition" or weakness made by examiner was corroborated by test pressure analysis using the dynamometer. |
Lawson and Calderon 48 (1997) ** | 30 asymptomatic volunteers | Medical doctor | 10 upper extremity muscles were tested using AK methods in double-blind conditions. | MMTs of "weak" or "strong" muscles showed significantly different electromyographic measurements and demonstrated a high correlation between testing methods. |
Schwartz et al 96 (1992) | 122 patients with spinal cord injuries at C4–C6 | physical therapists | Relationship between MMT and hand-head myometry compared | Sequential examinations with MMT and myometry were made at 72 hours, 1 week, and 2 weeks post-spinal cord injury and at 1, 2, 3, 4, 6, 12, 18, and 24 months post-injury. Results showed that 22 of 24 correlations between MMT and myometry were significant at p values less than .001. |
Perot et al 57 (1991) | 10 subjects | Chiropractors | To measure and compare both electromyographic and MMT results after proprioceptive techniques to both strengthen and weaken muscles | Response of tibialis anterior muscle to proprioceptive technique showed a significant EMG difference that corresponded to the difference found between "strong" and "weak" MMT outcomes. AK proprioceptive procedure to reduce muscle tone found to correlate with MMT outcomes. |
Hsieh and Phillips 46 (1990) | 15 asymptomatic subjects | 3 chiropractors | To determine the concurrent validity of manual dynamometry using AK style of MMT, comparing doctor-initiated and patient-initiated MMT | Intratester reliability and correlation coefficients for testers 1, 2, and 3 were 0.55, 0.75, and 0.76 with doctor-initiated method; 0.96, 0.99, and 0.97 when patient-initiated MMT method. The intertester reliability coefficients were 0.77 and 0.59 on day 1 and 2 respectively for doctor-initiated method; and 0.95 and 0.96 for the patient-initiated method. |
Wadsworth et al 45 (1987) | 5 muscle groups on 11 patients | physical therapist | To compare the concurrent reliability of MMT and hand-held dynamometer tests | The correlation coefficients were high and significantly different from zero for four muscle groups tested dynametrically and for two muscle groups tested manually. The test-retest reliability coefficients for two muscle groups tested manually could not be calculated because the values between subjects were identical. Conclusion that both MMT and dynamometry are reliable testing methods, given the conditions described in this study. |
Bohannon 97 (1986) | 50 patients | physical therapist | To determine the relationship between MMT word scores and dynamometer force scores using Kendall tau. | MMT scores and dynamometer test scores were significantly correlated (p less than 0.001). Percentage MMT and dynamometer test scores were significantly different (p less than 0.001). These results suggest that the two procedures measure the same variable-strength. |
Marino et al 50 (1982) | 128 patients | physical therapists | To compare MMT findings with hand-held dynamometer (HHD) findings, with precise repetition of the MMT | The MMT and HHD values were within 5% of each other. The average hip abduction and hip flexion scores measured by the HHD were consistent with the examiner's perception of muscle weakness (P less than 0.001). |
Triano and Davis 98 (1976) | 10 patients with "reactive muscle" phenomena described in AK | chiropractor | In patients with reactive muscle pairs (between the rhomboid and deltoid muscles), EMG and MMT findings were compared. | Study demonstrated that the reactive muscle phenomenon is, in fact, a physiologic imbalance of muscle measurable by EMG and MMT and was not a psychologic suggestion or an overpowering of the tested arm by brute force. These data showed that the deltoid-rhomboid "reactive muscle" represents a real physiological phenomenon. |
Predictive Validity and Accuracy of the MMT
Authors, date | Diagnosis | Subjects | Repeated Observations | Treatments | Outcomes |
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Jepsen et al 93 (2006) ** | Upper limb pain | 41 patients, 19 with upper limb pain | MMT, with examiners blinded as to patient pain status. | None | Reduced strength of upper limb muscles was significantly associated with the presence of symptoms. A median odds ratio of 4.0 (2.5–7.7). |
Pollard et al 54 (2006) ** | Low back pain | 67 of 100 patients have low back pain | MMT with therapy localization to an Ileo-cecal valve reflex point | None | Of 67 subjects who reported low back pain, 58 (86.6%) reported a positive test of both low back pain and ICV point test. Of 33 subjects, 32 (97%) with no back pain positively reported no response to ICV point test. Nine (9) subjects (13.4%) reported false negative ICV tests and low back pain, and 1 subject (3%) reported a false positive response for ICV test and no low back pain. The ileocecal valve test as a diagnostic measure of low back pain was found to have excellent measures of sensitivity, specificity and diagnostic competency. |
Niemuth et al 99 (2005) ** | Single leg overuse injury | 30 recreational injured runners (17 female, 13 male) and 30 noninjured runners (16 female, 14 male) served as controls. | Muscle strength of the 6 major muscle groups of the hip was recorded using a hand-held dynamometer. | None | No significant side-to-side differences in hip group muscle strength were found in the noninjured runners (P = 0.62–0.93). Among the injured runners, the injured side hip abductor (P = 0.0003) and flexor muscle groups (P = 0.026) were significantly weaker than the noninjured side. In addition, the injured side hip adductor muscle group was significantly stronger (P = 0.010) than the noninjured side. |
Michener et al 64 (2005) | Shoulder pain | 40 patients with shoulder pain and functional loss | Hand held dynamometer testing performed as MMT for the lower trapezius, upper trapezius, middle trapezius, and serratus anterior muscles. Concurrently, surface electromyography (sEMG) data were collected for the 4 muscles. The same procedures were performed 24 to 72 hours after the initial testing by the same tester. | None | Intraclass correlation coefficients for intratester reliability of measurements of isometric force obtained using an HHD ranged from .89 to .96. The standard error of the measure (90% confidence interval [CI]) ranged from 1.3 to 2.7 kg; the minimal detectable change (90% CI) ranged from 1.8 to 3.6 kg. Construct validity assessment, done by comparing the amounts of isometric muscle activity (sEMG) for each muscle across the 4 muscle tests, revealed that the muscle activity of the upper trapezius and lower trapezius muscles was highest during their respective tests. |
Moncayo et al 100 (2004) | Thyroid associated orbitopathy (TAO) | 32 patients with TAO, 23 with a long-standing disease, and 9 showing discrete initial changes | Positive TL (patient touches area of dysfunction and weakening occurs on MMT) reactions were found in the submandibular tonsillar structures, the tonsilla pharyngea, the San Yin Jiao point, the lacrimal gland, and with the functional ocular lock test of AK. | AK treatment and homeo-pathic remedies | Change of lid swelling, of ocular movement discomfort, ocular lock, tonsil reactivity and Traditional Chinese Medicine criteria including tenderness of San Yin Jiao (SP6) and tongue diagnosis were improved. Clinical trial of 3–6 months showed all relevant parameters improved. |
Rainville et al 101 (2003) | sciatica | 33 patients with L3 or L4 radiculopathy; 10 patients with L5 or S1 radiculopathy | To test quadriceps strength with MMT | None | Knee flexed MMT weakness of the quadriceps showed kappa coefficient of (0.66). Patients with radicular pain caused by L5 or S1 could perform the quadriceps test. Weakness of quadriceps correlated with L3 or L4 radiculopathy. |
Great Lakes ALS Study Group 65 (2003) | amyotrophic lateral sclerosis (ALS) | 63 patients with ALS | Compared test reliability of MMT and maximal voluntary isometric contraction (MVIC) scores among institutions and test validity by comparing change over time between MMT and MVIC. | None | Reproducibility between MVIC and MMT was equivalent. Sensitivity to detect progressive weakness and power to detect this change, however, favored MMT. In multicentered trials, uniformly trained physical therapists reproducibly and accurately measure strength by both MMT and MVIC. The authors found MMT to be the preferred measure of global strength because of its better Pearson correlation coefficients, essentially equivalent reproducibility, and more favorable coefficient of variation. |
Nadler et al 66 (2001) | 13 college athletes with low back pain | Of 163 athletes (100 male, 63 female), 5 of 63 females and 8 of 100 males required treatment for LBP. | A dynamometer incorporated into a specially designed anchoring station was used for testing the hip extensors and abductors. The maximum force generated for the hip abductors and extensors was used to calculate a percentage difference between the right and left hip extensors and abductors. | athletic trainers for LBP unrelated to blunt trauma over the ensuing year | Logistic regression analysis indicated that for female athletes, the percentage difference between the right and left hip extensors was predictive of whether treatment for LBP was required over the ensuing year (P = 0.05). Validity shown that hip muscle imbalance is associated with LBP occurrence in female athletes. Research supports the need for the assessment and treatment of hip muscle imbalance in individuals with LBP. |
Monti et al 103 (1999) | None | 89 healthy college students | To determine the differences in MMT outcomes after exposure to congruent and incongruent semantic stimuli | None | Approximately 17% more total force over a 59% longer period of time could be endured when subjects repeated semantically congruent statements (p < .001). Over all, significant differences were found in muscle test responses between congruent and incongruent semantic stimuli. |
Schmitt et al 104 (1998) | Allergies | 17 subjects | To determine whether subjective muscle testing employed by Applied Kinesiology practitioners, prospectively determine those individuals with specific hyperallergenic responses. | None | Each subject showed muscle-weakening (inhibition) reactions to oral provocative testing of one or two foods 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 A.K. muscle screening procedures. These serum tests confirmed 19 of the 21 food allergies (90.5%) suspected based on the applied kinesiology screening procedures. |
Goodheart 105 (1990) | Imbalanced weight bearing on right and left feet | 40 patients | 40 patients were evaluated for pre- and post-treatment weight balance. | AK examin-ation and treatment | Of the 40 patients, only one had minimal changes in weight upon two scales beneath the feet when both flexing and extending the spine. |
Jacobs et al 44 (1984) | Thyroid dysfunction | 65 patients | Patients evaluated for thyroid dysfunction by MMT, and laboratory testing. | AK and labor-atory examina-tion | MMT ratings correlated with clinical ratings (rs = .36, p < 0.002) and with laboratory ratings (rs = .32, p < 0.005). Correlation between clinical and laboratory diagnosis was .47, p < 0.000. Three AK TL points had a significant correlation with the laboratory diagnosis (p < .05). "AK enhanced but did not replace clinical/laboratory diagnosis of thyroid dysfunction." |
Scoop 106 (1979) | Allergy | 10 subjects | Subjects with unilateral weak muscles were given either a placebo or the nutrient that is hypothesized in AK to be associated with the muscle. Muscle tone was measured by a Jaymar dynamometer and with AK MMT methods. | Nutrition | The increase in muscle tone approximately 10 seconds after ingestion was 21% for the nutrient group and was a statistically significant (p < 0.05) increase in comparison with the placebo group. In the cerebral allergy testing part of the study, a 15% decrease in muscle tone of the pectoralis major clavicular was used as the criterion for cerebral allergy. The muscle testing method was then compared to results obtained by a Philpott-type fast with progressive reintroduction of foods. Correlation between foods identified as provocative by muscle testing and by the fast was .81. Observation of clinical results obtained with muscle testing suggests the method has substantial clinical utility. Pearson Product-Moment Correlation between testers was .91, suggesting that muscle testing is reliable between testers. |
Carpenter et al 107 (1977) | None | 80 students | The muscles hypothesized in AK to be associated with certain organs were tested with an instrument after irritation of the related organs. Then a control muscle was tested. 4 organ muscle associations were evaluated: the eye, ear, stomach, and lung. The stomach was irritated by placing cold water into it; the eye with chlorinated water; the ear with sound of a controlled frequency and decibel rate; and the lung with cigarette smoke. | None | In 80 subjects, a total of 139 organs were irritated. In all cases, the associated muscle weakened significantly after the irritation. The control muscle also weakened, but to a much lesser degree. |
The Emerging Construct in the Research on MMT
Authors, date | Diagnosis | Subjects | Repeated Observations | Treatments | Outcomes |
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Cuthbert 109 (2006) | Motion sickness disorder | 1: 66 yoa female 2: 45 yoa female 3: 9 yoa female | Proprioceptive testing (Freeman-Wyke and Hautant's tests), AK MMT and palpation | Spinal and cranial chiropractic manipulative therapy (CMT) | 1: Able to drive car and ride in a boat and airplane symptom free after 4 visits. 2: Able to drive car symptom free after 6 visits. 3: Able to drive in car symptom free after 4 visits |
Cuthbert et al 110 (2005) | optic nerve neuritis exacerbated by an Arnold-Chiari malformation (Type I) of the cerebellum | 1: 20 yoa female | AK MMT to diagnose vertebral subluxations and cranial lesions; ocular muscle testing, TMJ testing | Cranial and spinal CMT | Patient had lost her vision in the right eye 3 weeks previous to treatment. After 1 visit, patient could see 20–30 on Snellen eye chart. Visual acuity 20-13 after 3rd visit and asymptomatic 3 years later. |
Meldener 111 (2005) | Post-surgical hip dislocation | 1: 75 yoa male | AK MMT to diagnose muscular weakness around hip and throughout the body | AK and CMT therapy, focusing on the connection of the TMJ and occlusion to instability of the hip | No hip dislocation since vertical dimension was increased with new upper dentures on doctor's recommendation. |
Chung et al 112 (2005) | Dental occlusion problems | 7: male 3: female | AK MMT during application of an oral dental appliance | None | AK MMT reliable and repeatable on different days. MMT useful to locate the kinesiologic occlusal position for the fabrication of an oral appliance to treat TMJ disorders. |
Caso 113 (2004) | congenital bowel abnormality related to low back pain. | 1: 29 yoa male | AK MMT to diagnose large bowel dysfunction | CMT and stimulation of Chapman's reflex points by the doctor and the patient at home | Resolution of the patient's low back pain as well as improved bowel function. |
Moncayo et al 100 (2004) | Thyroid associated orbitopathy (TAO) | 32 patients with TAO, 23 with a long-standing disease, and 9 showing discrete initial changes | Positive TL (patient touches area of dysfunction and weakening occurs on MMT) reactions were found in the submandibular tonsillar structures, the tonsilla pharyngea, the San Yin Jiao point, the lacrimal gland, and with the ocular lock test of AK. | AK treatment and homeopathic remedies | Change of lid swelling, of ocular movement discomfort, ocular lock, tonsil reactivity and Traditional Chinese Medicine criteria including tenderness of San Yin Jiao (SP6) and tongue diagnosis were improved. Clinical trial of 3–6 months showed all relevant parameters improved. |
Cuthbert 114(2003) | Down syndrome | 15 children | Informal report by the parents of child's function and health status. | CMT to the spine and cranium, with nutritional support as needed. | Improved fine motor skills; use of the hands and fingers; ability to crawl bilaterally with arms and legs; ability to stand and walk; decrease in tongue thrusting; problems with ears and sinuses were all improved in function as noted by parents, teachers, and doctor. |
Maykel 115 (2003) | Blocked naso-lacrimal canal | 1: 14-month male | AK MMT and informal report of child's function and health status by the parents. | CMT to the spine and cranium | Child treated 5 times over a 6-week period with resolution of his eye problem. |
Weiss 116 (2003) | Menstrual difficulty and exhaustion | 1: 39 yoa female | AK MMT and patient report of condition | Nutritional counseling and CMT to the spine and cranium | Treatment to the sacrococcygeal area with cranial correction and nutritional support improved her energy level and cycling performance. |
Sprieser 117 (2002) | Episodic paroxysmal vertigo | 1: 17 yoa female | AK MMT and patient report of her condition | CMT to the spine and cranium as well as AK/meridian therapy techniques | After 4 treatments and 3 other treatments by a Qi-Gong master the patient remained free of any vertigo at 3 year follow up. |
Leaf 118 (2002) | Severe equilibrium problems | 1: 48 yoa female | AK MMT and patient report of condition | Cervical traction of 6 pounds while patient walked for 15 minutes | After cervical traction-distraction patient was able to stand with her feet together with no body sway and displayed no signs of nystagmus. |
Gregory et al 119 (2001) | women with moderate to severe breast pain | 88: females, predominantly premenopausal, with cyclical and non-cyclical breast pain | AK MMT to diagnose neurolymphatic reflex dysfunction of the large intestine | CMT and stimulation of Chapman's reflex points by the doctor and the patient at home | Immediately after treatment there was considerable reduction in breast pain in 60% of patients with complete resolution in 18%. 2 months after initial treatment, there was a reduction in severity, duration and frequency of pain of 50% or more in 60% of cases (P < 0.01). |
Cuthbert 120 (2001) | Bell's Palsy | 1: female | AK MMT to diagnose cranial, cervical, TMJ, and muscular imbalances | CMT to the spine, TMJ, and cranium | Complete resolution of facial nerve palsy after 6 visits over 14 days. |
Calhoon 121 (2001) | Multiple sclerosis | 1: 43 yoa female | AK MMT and patient report of condition | CMT to the spine, TMJ, and cranium and nutritional support | 26 months after initial visit patient had regained her ability to write and could shower without assistance for the first time in 2 years. |
Mathews et al 122 (1999) ** | Learning disabilities | 10 children compared with a control group of 10 children matched for age, IQ and social background that had not received any treatment over a similar period. | AK MMT examination and sensory challenges; the children were tested before and after treatment by an Educational Psychologist using standardized tests of intelligence to monitor changes in their learning skills. | AK treatment | Educational psychologist's testing demonstrated children treated with AK had an improvement in their learning abilities during the course of 9 to 12 treatment sessions during a period of 6–12 months. |
Masarsky et al 123 (1991) | Somatic dyspnea | 6: males and females | AK MMT examination methods; forced vital capacity (FVC) and forced expiratory volume in one second (FEV-1) measurements pre- and post-treatment (post-treatment measurements taken 3 days later to 1 month later). | AK treatment including neurolymphatic and neurovascular reflexes were employed for the diaphragm muscle; evaluation of the meridian system; cranial manipulation (AK methods); and treatment for inhibited muscles involved in respiration. | All patients reported improvement in their breathing difficulty. 4 of the 6 patients also had improved FCV and FEV-1 between 0.1 and 0.8 liters. |
Goodheart 105 (1990) | Imbalanced weight bearing on right and left feet | 40 patients | 40 patients were evaluated for pre- and post-treatment weight balance. | AK examination and treatment | Of the 40 patients, only one had minimal changes in weight upon two scales beneath the feet when both flexing and extending the spine. |
Masarsky et al 124
| Chronic obstructive pulmonary disease | 1: male | AK MMT examination methods; forced vital capacity (FVC) and forced expiratory volume in one second (FEV-1) measurements pre- and post-treatment, covering an 8-month period. | AK examination and treatment | Improvements were noted in forced vital capacity, forced expiratory volume in one second, coughing, fatigue, and ease of breathing (sign significant at 0.005 level). Improvement was also noted in laryngospasm. |
Jacobs et al 44 (1984) | Thyroid dysfunction | 65: males and females | Patients evaluated for thyroid dysfunction by AK and laboratory testing | None | AK ratings correlated with laboratory ratings (rs = .32, p < .002) and with laboratory ratings (rs = .32, p < .005). Correlation between clinical and laboratory diagnosis was .47, p < .000. 3 AK therapy localizations had a significant correlation with the laboratory diagnosis (p < .05). AK enhanced but did not replace clinical/laboratory diagnosis of thyroid dysfunction. Evidence indicated a significant correlation between certain AK tests and an elevated LDH in the serum. |