Disentangling manual muscle testing and Applied Kinesiology: critique and reinterpretation of a literature review

Abstract

Cuthbert and Goodheart recently published a narrative review on the reliability and validity of manual muscle testing (MMT) in the Journal. The authors should be recognized for their effort to synthesize this vast body of literature. However, the review contains critical errors in the search methods, inclusion criteria, quality assessment, validity definitions, study interpretation, literature synthesis, generalizability of study findings, and conclusion formulation that merit a reconsideration of the authors' findings. Most importantly, a misunderstanding of the review could easily arise because the authors did not distinguish the general use of muscle strength testing from the specific applications that distinguish the Applied Kinesiology (AK) chiropractic technique. The article makes the fundamental error of implying that the reliability and validity of manual muscle testing lends some degree of credibility to the unique diagnostic procedures of AK. The purpose of this commentary is to provide a critical appraisal of the review, suggest conclusions consistent with the literature both reviewed and omitted, and extricate conclusions that can be made about AK in particular from those that can be made about MMT. 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 MMT for the diagnosis of organic disease or pre/subclinical conditions.

Unnecessary Investigations in Environmental Medicine

“…Our statements regarding indications and inappropriate use (Box 1) are based on the current state of knowledge. There are no scientifically recognized indications for bioresonance, applied kinesiology, or pendulum divination (22,(28)(29)(30)(31)(32)(33)(34)(35)(36).…”

A case series evaluating the accuracy of manual muscle testing for predicting fetal sex

“…14,15 Although MMT is probably not evaluating the veracity of statements or unknown substances, little is understood about what the differential muscle responses might be indicating. Haas et al 10 have suggested that differential muscle responses might be due to distraction or to discomfort. Additional possible explanations for differential response are clinician or patient fatigue, inadequate training of the clinician, autonomic responses, limbic motor responses, automatisms (entrained ideomotor responses), or random events.…”

“…Many studies have been conducted evaluating aspects of nonorthopedic MMT; but most studies of this nature are of poor quality, and few evaluate MMT as a diagnostic modality. 10,11 This article investigates the diagnostic accuracy of the third type of MMT that uses MMT to determine an unknown truth. It is important to consider the diagnostic accuracy of this type of nonorthopedic MMT because clinicians who use it consider it to be an accurate and inexpensive diagnostic tool that can also be used to guide intervention.…”

Common errors and clinical guidelines for manual muscle testing: "the arm test" and other inaccurate procedures

“…Two recent reviews by Haas et al and Hall et al [ 26 , 27 ] are examples of this. Regarding the chiropractic use of the MMT and of AK chiropractic technique, Haas lists seven papers as examples of "AK research" [ 18 - 22 , 24 , 25 ].…”