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The accuracy of kinesiology-style manual muscle testing to distinguish congruent from incongruent statements under varying levels of blinding: Results from a study of diagnostic test accuracy

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was impossible for most trials to blind subjects or treatment providers to group allocation. Many of the care
programs or interventions varied considerably between groups and only three of the trials included follow-up
of a clinically appropriate duration. Most trials adequately described inclusion and exclusion criteria and
utilized appropriate, clinically useful and clearly defined outcome measures. Only one trial included falls as
an outcome measure, but as a feasibility study no meaningful conclusions could be drawn about the effects of
the intervention on falls. All included trials reported outcomes of functional balance tests or tests that
utilized a computerized balance platform. Seven of the ten included trials reported some statistically
significant improvements relating to balance following an intervention that included a manual therapy
component. The ability to draw conclusions from a number of the studies was limited by poor methodological
quality or very low participant numbers.
Conclusion: There is little to no evidence to support the role that manual therapy may play in preventing
falls and there is only limited evidence to support the role of manual therapy in improving balance.
doi: 10.1016/j.clch.2011.09.019
The accuracy of kinesiology-style manual muscle testing to distinguish congruent from
incongruent statements under varying levels of blinding: Results from a study of diagnostic
test accuracy
§
Anne Jensen *, Richard Stevens, Timothy Kenealy, Joanna Stewart, Amanda Burls
*Corresponding author.
E-mail address: anne.jensen@wolfson.ox.ac.uk
Introduction: Healthcare practitioners have been using muscular strength testing to assess neuromuscu-
loskeletal system integrity since early last century. In the 1970s, another application of manual muscle
testing (MMT), called Applied Kinesiology (AK), was developed by Dr. George Goodheart. Its premise is that a
muscle will be less able to resist a force when there is aberrant nervous input, and muscles are labeled as
either strong or weak accordingly. Since then, other MMT techniques have been developed that assess a
patient’s response to semantic stimuli. Monti et al. found that, following the speaking of congruent
statements, a muscle was able to resist significantly more force compared to after speaking incongruent
statements. A congruent statement is defined as one which the speaker believes to be true, whether or not
their belief reflects actual reality. It was found that congruent statements usually result in a strong MMTs,
while incongruent statements usually result in weak MMTs.
While the reproducibility of this assessment tool has been investigated, its accuracy has not yet been
firmly established. The aim of this study was to estimate the accuracy of MMT to distinguish congruent from
incongruent spoken statements.
Methods: Twenty-five healthcare practitioners who routinely perform MMT in response to spoken state-
ments were recruited. Additionally, 25 healthy test patients (TPs) were recruited who had little/no prior
experience with MMT. The practitioners tested the anterior or lateral deltoid on one side only. On a computer
monitor, TPs were shown pictures of common, emotionally neutral items, and were instructed to make a
simple true statement or a simple false statement about the identity of the object. In the first testing
scenario, practitioners also viewed a computer screen showing either the same picture as the TP or a blank
screen. Immediately following the TP’s statement, the practitioner performed a MMT, and recorded the
result as weak or strong. Each practitioner performed 40 MMTs broken up into 4 blocks of 10 statements each.
In between each testing block, a second scenario was enacted in which the practitioner guessed the verity of
the statement without performing MMT. The primary outcome was the percentage correct in the first testing
scenario when the practitioner’s screen was blank. The secondary outcome was the percentage correct in the
second testing scenario when the practitioner guessed the verity of the TP’s statement without MMT.
Results: A total of 25 unique practitioner—TP pairs were included in the study. The mean accuracy
(18outcome) was 68.8% with 95% confidence interval (CI) of 64.9—72.7%, and with a range of 55.0—87.5%.
The mean accuracy for the guessing/control condition (28outcome) was 48.4% (95% CI 45.0—51.8%). The
years of a practitioner’s MMTexperience and self-ranked MMT expertise did not significantly correlate with a
practitioner’s MMT accuracy.
Abstracts from the WFC’s 11th Biennial Congress 157
Conclusion: Manual muscle testing used to distinguish congruent from incongruent spoken statements is
significantly more accurate than chance and, therefore, its use may have merit in the management of specific
cases. The variation between practitioners, from highest accuracy to lowest, suggests there is much yet to be
learned about the skills involved and possible influencing factors.
doi: 10.1016/j.clch.2011.09.020
Improving flexibility with a mind-body approach: A randomized controlled trial using neuro
emotional technique
§
Anne Jensen *, Adaikalavan Ramasamy, Katie Marten, Michael Hall
*Corresponding author.
E-mail address: anne.jensen@wolfson.ox.ac.uk
Background: General flexibility is a key component of health and wellbeing. A lack of flexibility has been
associated with an increased risk of developing musculoskeletal injuries and athletic underperformance. The
cause of reduced flexibility can be multifactorial, with both physical and mental/emotional etiologies. It has
been previously shown that stretching regularly may quickly improve flexibility; however, when it is
discontinued, gains are promptly lost. An alternative intervention with greater durability is needed. We
hypothesized that Neuro Emotional Technique (NET), a technique previously shown to be effective at
reducing stress, may also be effective at improving general flexibility. The aim of this study was to examine
the effects of NET, a mind-body technique, on general flexibility.
Methods: Forty-five healthy volunteers (23 men and 22 women) were recruited from the general
population. This randomized controlled trial consisted of 1 experimental arm and 2 control arms with 15
participants in each arm. Prior to group allocation, general flexibility of each participant was assessed by a
blind assessor. The primary outcome employed was the change in general flexibility through the Sit-and-
Reach Test (SR) score. Participants also completed questionnaires about demographics; usual water and
caffeine consumption; and activity level. In addition, participants completed an anxiety/mood psycho-
metric. After initial assessment, participants were randomly allocated to a group: (1) experimental group,
received two 20-min sessions of NET; (2) the active control group, receiving two 20-min sessions of stretching
instruction; and (3) the passive control group, receiving no intervention or instruction. Following completion
of all sessions, participants were re-assessed by the same blind assessor.
Results: Forty-three participants completed the study, with one person in the experimental group and one
person in the active control group dropping out due to scheduling difficulties. Baseline data showed each
group to be similar in demographics, usual water and caffeine consumption, and activity level. The mean (SD)
of change in the SR scores for the NET group was +3.1 cm (2.5); for the Stretching Instruction group (active
controls) was +1.2 (2.3); and for the passive controls was +1.0 (2.5). This shows that, while all three groups
showed some improvement, the difference in improvement between the NET group and either control groups
was statistically significant (p<0.05). The difference between active controls and passive controls was not
statistically significant. Usual water or caffeine consumption, activity level or psychometric scores did not
predict or influence outcomes.
Discussion: Findings obtained in this study are unique because few studies have tested the effectiveness of
a mind-body therapy on general flexibility. Limitations of this study include its lack of control for other
potential confounders, such as other dietary influences and sleep amount or quality. In addition, while group
allocation was not divulged, participants may have speculated. Future research in this area should focus on
the acute effects of NETon flexibility, and also should include follow-up assessments to ascertain durability of
effect.
Conclusion: The present findings suggest that NET may have a positive effect on SR test results.
doi: 10.1016/j.clch.2011.09.021
158 Abstracts from the WFC’s 11th Biennial Congress
... We are grateful to all study participants for their contributions, and for the support from Wolfson College (Oxford University), Parker University and those practitioners who offered the use of their facilities during data collection. Portions of this study have been presented in poster or abstract form at scientific conferences [51][52][53][54][55][56][57][58][59]. ...
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Background Manual muscle testing (MMT) is a non-invasive assessment tool used by a variety of health care providers to evaluate neuromusculoskeletal integrity, and muscular strength in particular. In one form of MMT called muscle response testing (MRT), muscles are said to be tested, not to evaluate muscular strength, but neural control. One established, but insufficiently validated, application of MRT is to assess a patient’s response to semantic stimuli (e.g. spoken lies) during a therapy session. Our primary aim was to estimate the accuracy of MRT to distinguish false from true spoken statements, in randomised and blinded experiments. A secondary aim was to compare MRT accuracy to the accuracy when practitioners used only their intuition to differentiate false from true spoken statements. Methods Two prospective studies of diagnostic test accuracy using MRT to detect lies are presented. A true positive MRT test was one that resulted in a subjective weakening of the muscle following a lie, and a true negative was one that did not result in a subjective weakening of the muscle following a truth. Experiment 2 replicated Experiment 1 using a simplified methodology. In Experiment 1, 48 practitioners were paired with 48 MRT-naïve test patients, forming unique practitioner-test patient pairs. Practitioners were enrolled with any amount of MRT experience. In Experiment 2, 20 unique pairs were enrolled, with test patients being a mix of MRT-naïve and not-MRT-naïve. The primary index test was MRT. A secondary index test was also enacted in which the practitioners made intuitive guesses (“intuition”), without using MRT. The actual verity of the spoken statement was compared to the outcome of both index tests (MRT and Intuition) and their mean overall fractions correct were calculated and reported as mean accuracies. ResultsIn Experiment 1, MRT accuracy, 0.659 (95% CI 0.623 - 0.695), was found to be significantly different (p < 0.01) from intuition accuracy, 0.474 (95% CI 0.449 - 0.500), and also from the likelihood of chance (0.500; p < 0.01). Experiment 2 replicated the findings of Experiment 1. Testing for various factors that may have influenced MRT accuracy failed to detect any correlations. ConclusionsMRT has repeatedly demonstrated significant accuracy for distinguishing lies from truths, compared to both intuition and chance. The primary limitation of this study is its lack of generalisability to other applications of MRT and to MMT. Study registrationThe Australian New Zealand Clinical Trials Registry (ANZCTR; www.anzctr.org.au; ID # ACTRN12609000455268, and US-based ClinicalTrials.gov (ID # NCT01066312).
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