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Diagnostic Tools: 'Challenge' and 'Therapy Localization'
Sensorimotor "challenge" is a diagnostic procedure unique to AK that is used to determine the body's ability to cope with external stimuli, which can be physical, chemical, or emotional. Challenge defines a mechanism to test the body's ability to cope with external stimuli, again assessed by muscle testing.34 The use of challenge assessments gives the clinician important clues as to what removes the inhibitions of muscles associated with functional pain syndromes and health problems. The appropriate "challenge" will also remove synergist substitution employed by the patient, particularly during the MMT, because of pain.35,36
After an external stimulus is applied, muscle-testing procedures are done to determine a change in the muscle strength as a result of the stimulus. Through this approach, ineffective therapies that produced no improvements in muscle strength are rejected and only those that elicit a positive muscle response are used. This guides the treatment given to a patient.
Nutritional challenge as used in AK was explored and a literature review given in a recent issue of the Townsend Letter.5 Structural (or joint challenge) has been described in the AK outcomes research literature from the beginning, and all of the evidence for this approach was recently offered.2,3 Cranial challenge has been described in the literature previously.37,38
Psychological challenge has been described by Mollon and Monti and many others.39,40 Monti et al. have shown that if the emotional stress is strong enough, almost any muscle in the body will show the inhibition.40 A review of the published outcomes research in this area offered by Walker, Callahan, and Mollon elaborates on these ideas.16,21,39 Mollon's history of AK's contributions in this area is exhaustive.39
Another procedure unique to AK and allied schools of therapeutics is called therapy localization (TL).41 TL seeks a change of muscle strength when the patient's hand is placed over an area of suspected involvement. The neurophysiology of therapy localization has been updated in two recent textbooks and at the 3rd International Association of Functional Neurology and Rehabilitation Conference.2,3,42 This method is hypothesized to assist the doctor in finding areas that are involved with the muscle dysfunction found on MMT. Pollard et al. in a recent literature review presented some of the research about the AK concept of therapy localization.43 Collectively these data suggest that stimulating the skin and the cutaneomotor reflexes can produce changes in muscle function.
Figure 3: AK Nutritional Challenge
Figure 4: AK Vertebral Challenge
Figure 5: AK Cranial Challenge
Figure 6: AK and Acupuncture Point (Bladder-1)
It is also characteristic of AK assessment procedures to move from the examination of the patient into the treatment almost immediately.44 As a clinician searches for information through the manual muscle test, the appropriate challenge or therapy localization to the responsible tissue or remedy will turn "finding" into "fixing." One treatment modality accompanies another as a rather "custom made" application is created that not only varies from patient to patient but should vary from one session to the next for a particular individual as a condition improves.
Applied Kinesiology's Future in the Management of Stress-Related Illness
Since 1964, the AK model has aimed to integrate the physical, biochemical, and psychosocial manifestations of musculoskeletal pain. This integrative model is overdue in the conceptualization and investigation of neuromusculoskeletal pain and psychological and biochemical imbalances. This model may also provide an evidence-based rationale for the integration and appropriate timing of complementary and alternative medicine (CAM) treatments directed toward physical (biological) impairments, and biochemical and psychological factors. It is suggested that this integrated approach will be the way forward in the management of pain as well as stress-related and lifestyle illnesses, rather than the dichotomous separation of physical, biochemical, and psychological factors that so often occurs in research and practice.
Figure 7: Applied Kinesiology's Integrative Model of Health Care
There are now over 100 papers published in peer-reviewed journals on the methods and outcomes of AK.2-4,45 Few CAM therapeutic methods have been investigated or written about as extensively as AK. There have been 38 separate books published about AK methods since 1964.
Further research and reviews of applied kinesiology are listed at the National Library of Medicine, where AK research has now been given its own MESH heading. It must be cautioned, however, that several muscle testing protocols which have appeared have not adhered to AK protocols and should never be confused with the methods employed in AK.46-49
Gifford's mature organism model demonstrates the importance of a multifactorial understanding of health, showing that physical, environmental, and emotional aspects interrelate.50 Critically, a method of assessment for these interweaving factors is vital.
The Cochrane Collaboration defined CAM as follows:
CAM is a broad domain of healing resource that encompasses all health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period. CAM includes all such practices and ideals self-defined by their users as preventing or treating illness or promoting health and well-being. Boundaries within CAM and between the CAM domain and that of the dominant system are not always sharp or fixed.51
Applied kinesiology offers an important diagnostic tool to supplement those already in place because it unifies within one diagnostic modality – the manual muscle test – the approaches commonly used throughout CAM. In considering how acupuncturists focus upon meridians, physiotherapists upon rehabilitative exercise, naturopaths upon nutrition, and chiropractors upon the joints, AK does not overrule the tenets of any of these approaches, but rather implies that human ailments may be attributed to multiple systems and that the MMT may identify these for the muscle tester educated in its use. This allows for an integrative and interprofessional model of health care to be developed.
Figure 8: Abnormal results of the manual muscle test may indicate abnormal involvement of any of the factors surrounding it. A change in muscle function when specific stimulation is applied to one of these elements also indicates dysfunction of the surrounding factors.
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Dr. Scott Cuthbert is the author of Applied Kinesiology Essentials: The Missing Link in Health Care (2014) and Applied Kinesiology: Clinical Techniques for Lower Body Dysfunctions (2013). Dr. Cuthbert is a 1997 graduate of Palmer Chiropractic College (Davenport) and practices in Pueblo, Colorado. He has published 11 Index Medicus clinical outcome studies and literature reviews, and over 50 peer-reviewed articles on applied kinesiology. He is on the board of directors of the International College of Applied Kinesiology USA.