Validation of the Magnesium Muscle Stretch Test
Condition: Magnesium Deficiency
MeSH terms: Magnesium Deficiency
Study type: Observational

Summary: 
      Professional Applied Kinesiology (PAK) is a system which attempts to evaluate numerous
      aspects of health (structural, chemical, and mental) by the manual testing of muscles,
      combined with other standard methods of diagnosis. It leads to a variety of conservative,
      noninvasive treatments which involves joint manipulations or mobilizations, myofascial
      therapies, cranial techniques, meridian and acupuncture skills, clinical nutrition and
      dietary management, counseling skills, evaluating environmental irritants, and various reflex
      techniques. The expanded validity of the manual muscle test has been extensively
      described.elsewhere, including by one of the Co-Principal Investigators (Anthony Rosner).
      Details of Applied Kinesiology and its adjunctive procedures are prescribed by an
      International College of Applied Kinesiology Board of Examiners, cited for its scholarly and
      scientific activities.

      A convenience sample of 40 patients, ages 18-75, will be administered the magnesium muscle
      stretch test with blood drawn at the time of the individual's visit. For the muscle test,
      uniformity of the examiner's force application is to be confirmed with a force transducer,
      while the clinician's judgment as to whether the muscle test is positive (facilitated) or
      negative (inhibited) will be confirmed by electrogoniometry, the procedures for both the
      force transducer and electrogoniometer having been established by one of the Co-PIs (Anthony
      Rosner) previously. The blood sample is to be submitted to LabCorp for the measurement of red
      blood cell levels of magnesium. Coded results of the muscle test and magnesium blood levels
      are to be correlated by an experienced statistician who is blinded to the patient's identity.
    

Detailed description: 
      A convenience sample of 40 patients, ages 18-75. is to be selected from those attending the
      services of Dr. William Maykel at his office in Auburn, Massachusetts. Consenting patients
      are be given an informed consent form approved by a contract institutional review board
      (PearlIRB), which they are to sign and return indicating that they fully understand the scope
      and logistics of the proposed research with the right to withdraw at any time without
      reprisals. Research subjects will undergo the manual muscle stretch test administered by Dr.
      William Maykel. Specifically, the stretch test is performed as follows:

        1. The patient is seated. The right anterior serratus muscle is tested. The doctor asks the
           patient to hold the right arm straight out at a 90 degree angle with the thumb pointed
           toward the ceiling.

        2. The muscle test is 5/5.

        3. The patient is instructed to raise his or her arm straight up to the ceiling, stretching
           the anterior serratus muscle. The arm is then brought back to the original test position
           at a 90 degree angle with the thumb up.

        4. The muscle is then retested. If it is now 3/5, this represents a positive magnesium
           stretch test.

        5. The procedure is repeated on one or two other muscles to solidify the diagnostic
           presence of insufficient magnesium.

      Immediately afterward, the patient's blood is drawn by a licensed phlebotomist with samples
      submitted to LabCorp to determine red blood cell magnesium contents (and other trace metals
      for future investigations).

      Results of the muscle test (inhibited or facilitated) are to be paired with the respective
      blood magnesium levels and shared with each participant. They will be coded to protect the
      patient's identity identity and submitted to an experienced statistician for correlation, the
      results either supporting or refuting the hypothesis which stated that the muscle stretch
      test is a rapid, inexpensive, and readily available screening test for magnesium deficiency.
      Correlation will be a binary process, based upon (i) normal or deficient levels of magnesium
      based upon the muscle testing, and (ii) normal blood cell ranges of magnesium established by
      the reference laboratory. The identity of patients will be known only to the research staff
      and kept within a locked file in Dr. Maykel's office for 5 years before being discarded. It
      will not be shared in any presentations or publications of research results.
    

Intervention name(s): Applied Kinesiology
Intervention type(s): Diagnostic Test
Intervention description(s): An Applied Kinesiology muscle test will be supplemented by a single blood draw for validation.
Other intervention name(s): :Blood Draw
Observational model: Case-Only
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Routinely scheduled patients of William Maykel, D.C., receiving chiropractic adjustments,
        manual muscle testing, and/or nutritional therapy.
      
Biospecimen description: 
      Whole blood
    
Keywords: Magnesium deficiency; Applied Kinesiology