Artículos de investigación
On the reliability and validity of manual muscle testing: a literature review, Cuthbert SC, Goodheart GJ Jr.null
Chiropr Osteopat. 2007 Mar 6;15(1):4.
ABSTRACT: A body of basic science and clinical research has been generated on the manual muscle test (MMT) since its first peer-reviewed publication in 1915. The aim of this report is to provide an historical overview, literature review, description, synthesis and critique of the reliability and validity of MMT in the evaluation of the musculoskeletal and nervous systems.
METHODS: Online resources were searched including Pubmed and CINAHL (each from inception to June 2006). The search terms manual muscle testing or manual muscle test were used. Relevant peer-reviewed studies, commentaries, and reviews were selected. The two reviewers assessed data quality independently, with selection standards based on predefined methodologic criteria. Studies of MMT were categorized by research content type: inter- and intra-examiner reliability studies, and construct, content, concurrent and predictive validity studies. Each study was reviewed in terms of its quality and contribution to knowledge regarding MMT, and its findings presented.
RESULTS: More than 100 studies related to MMT and the applied kinesiology chiropractic technique (AK) that employs MMT in its methodology were reviewed, including studies on the clinical efficacy of MMT in the diagnosis of patients with symptomatology. With regard to analysis there is evidence for good reliability and validity in the use of MMT for patients with neuromusculoskeletal dysfunction. The observational cohort studies demonstrated good external and internal validity, and the 12 randomized controlled trials (RCTs) that were reviewed show that MMT findings were not dependent upon examiner bias.
CONCLUSION: The MMT employed by chiropractors, physical therapists, and neurologists was shown to be a clinically useful tool, but its ultimate scientific validation and application requires testing that employs sophisticated research models in the areas of neurophysiology, biomechanics, RCTs, and statistical analysis.
Comment: This is a landmark study presenting the basic science and clinical research evidence for the reliability and validity of the manual muscle test and applied kinesiology chiropractic technique. The literature review presents the results of more than 100 peer-reviewed studies related to the manual muscle test (MMT) and the applied kinesiology chiropractic technique (AK). Muscle testing, which is the backbone of AK, now has support for its use in the field of chiropractic to diagnose and treat neuromusculoskeletal dysfunction.
Correlation of Applied Kinesiology Muscle Testing Findings with Serum Immunoglobulin Levels for Food Allergies, Schmitt, W., Leisman, G.
International Journal of Neuroscience. 1998; 96:237-244.
Abstract: The pilot study attempted to determine whether subjective muscle testing employed by Applied Kinesiology practitioners, prospectively determine those individuals with specific hyperallergenic responses. Seventeen subjects were found positive on Applied Kinesiology (A.K.) muscle testing screening procedures indicating food hypersensitivity (allergy) reactions. 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. This pilot study offers a basis to examine further a means by which to predict the clinical utility of a given substance for a given patient, based on the patterns of neuromuscular response elicited from the patient, representing a conceptual expansion of the standard neurological examination process. Comment: This study showed a high degree of correlation between AK procedures used to identify food allergies and serum levels of immunoglobulins for those foods. AK methods in this study consisted of stimulation of taste bud receptors with various foods, and observation of changes in manual muscle testing that resulted. The patient was judged to be allergic to foods that created a disruption of muscle function. Blood drawn subsequently showed that patients had antibodies to the foods which were found to be allergenic through AK assessment.
¿Puede el desequilibrio del tobillo ser un factor de riesgo para la debilidad muscular del tensor de la fascia lata?
Zampagni ML, Corazza I, Molgora AP, Marcacci M.J Electromyogr Kinesiol. 2008 1 de mayo.
RESUMEN: Se han investigado factores de riesgo que pueden determinar las lesiones de rodilla y tobillo y las causas son probablemente multifactoriales. Una posible explicación podría estar relacionada con la inhibición temporal del control muscular tras una alteración de la regulación propioceptiva debido a la patología del desequilibrio del tobillo. El propósito de nuestro estudio fue validar un nuevo conjunto experimental para cuantificar dos procedimientos kinesiológicos (Shock Absorber Test (SAT) y Kendall y Kendall's Procedure (KKP)) para verificar si un estímulo subtalus en un tobillo con desequilibrio puede inducir una no- Respuesta apropiada del músculo tensor de la fascia lata (TFL). Quince jugadores de fútbol masculino con desequilibrio de tobillo (AIG) y 14 sanos (CG) fueron probados después de (TEST) antes de una percusión manual en una articulación subtalus (SAT). Se utilizó un nuevo dispositivo a medida equipado con una célula de carga para cuantificar la activación de la fuerza de TFL en posiciones estandarizadas. Se realizaron dos ensayos para cada sujeto, separados por al menos un intervalo de reposo de 4 minutos. En condiciones de NO-TEST tanto AIG como CG mostraron una adaptación progresiva del sujeto a la fuerza impuesta por el operador. No hubo reducción en la fuerza media, la fuerza máxima media y la duración de la fuerza muscular (p> 0,5). AIG presentó diferencias significativas (diferencia media 0,92 +/- 0,46 s, p = 0,000) en la duración de la fuerza muscular en las condiciones de TEST. Nuestros resultados indicaron que los estímulos proprioceptivos "erróneos" procedentes de la articulación subtalus en AIG pueden inducir la inhibición en términos de duración del músculo TFL alterando la estabilidad de la rodilla. Esta evaluación kinesiológica puede ser útil para prevenir lesiones en el tobillo y la rodilla.
Association of manual muscle tests and mechanical neck pain: Results from a prospective pilot study. Cuthbert SC, Rosner AL, McDowall D.
J Bodyw Mov Ther. 2011 Apr;15(2):192-200.
OBJECTIVE: To determine whether there was a statistical difference for manual muscle test (MMT) findings for cervical muscles in subjects with and without mechanical neck pain (MNP), and to use confidence intervals to evaluate the sensitivity and specificity of the MMT in this group of subjects.
CLINICAL FEATURES: Manual muscle strength tests were conducted on two groups of patients who reported to two outpatient chiropractic clinics. In group 1, 148 patients were evaluated for MMT data (50 males and 98 females, average age 37), 127 with "whiplash"-type injuries (average duration 16 weeks) and 21 with non-traumatic chronic neck pain (average duration 36 weeks). In group 2, 100 patients were evaluated for comparative MMT data (39 males and 61 females, average age 38) with no current MNP or remarkable history of MNP.
METHODS: Standardized MMT assessments of the strength of the sternocleidomastoid, anterior scalene, upper trapezius, and cervical extensor muscles bilaterally were performed on all subjects in groups 1 and 2.
RESULTS: In group 1, 139 of 148 patients reporting neck pain also showed positive results in at least one of four MMT tests (sternocleidomastoid, anterior scalene, upper trapezius, and cervical extensors). In group 2, 30 of the 100 patients without MNP showed positive results in one or more of the four MMT tests. Confidence intervals were calculated and showed that, in terms of MMT findings, there was a significant difference between the two groups of patients.
CONCLUSIONS: A symptomatic group of patients with MNP demonstrated significantly increased MMT findings in the form of reduced strength levels compared to a control group. This evidence suggests that the MMT is potentially a sensitive and specific test for evaluating cervical spine muscular impairments in patients with MNP.