The Accuracy of Manual Muscle Testing
Condition: Lying
Study type: Observational

Summary: 
      Manual Muscle Testing (MMT) practiced by over a million practitioners worldwide. However,
      it's accuracy under varying levels of blindness has not yet been considered. This study will
      test this accuracy.

      Study Hypothesis: MMT can accurately distinguish congruent from incongruent statements. Also,
      the accuracy of MMT is positively correlated with practitioner experience.
    

Detailed description: 
      Manual Muscle Testing is a non-invasive assessment tool used by millions of healthcare
      practitioners worldwide for a variety of purposes. First described in the literature by
      Lovett and Wight in 1915, MMT was originally used to assess muscular weakness in polio
      victims. In 1949, physiotherapists Kendall and Kendall refined MMT into an art and science
      with the publication of their benchmark text, Muscles: Testing and Function. This type of MMT
      is still used today to assess neuromuscular integrity.

      In the 1960's, a different use for MMT was described by Dr. George Goodheart. In Goodheart's
      technique, called Applied Kinesiology (AK), MMT is used to evaluate a variety of additional
      functions of the body, apart from neuromuscular integrity. From Goodheart's work, many
      different techniques have emerged which use this second type of MMT. Moreover, it is
      estimated that over one million healthcare practitioners worldwide use this type of MMT:
      medical doctors, dentists, chiropractors, osteopaths, physiotherapists, other health
      professionals - plus even some lay-persons.

      As a result of this divergence, there exists two very different forms of MMT: (1) orthopaedic
      muscle testing to quantify muscle strength and asses neurological integrity, and (2) the
      other type of muscle testing - which called be called "muscle response testing" which is used
      to obtain additional information about a patient. What that information is depends upon the
      MMT system being used and what information is sought. It is this latter form of MMT that this
      proposed study will investigate. Therefore, for the remainder of this application, the term
      "MMT" will be used to refer only to the second type ("muscle response testing").

      The basic premise of MMT is that when there is some aberrant nervous system input to a
      muscle, it is less likely to be able to resist an external force. During a manual muscle
      test, an external force is applied to one muscle or group of muscles which at first causes an
      isometric then an eccentric contraction. Consequently, the muscle being tested is labelled
      "weak" or "strong" based on its ability to resist this external force.

      A number of different techniques use MMT to test the body's physiological response to
      semantic stimuli, which may have both cognitive and emotional components. Monti et al. found
      that a MMT following congruent statements yielded significantly different results compared to
      a MMT following incongruent statements. A congruent statement is one that the person believes
      is true. An incongruent statement is one the person believes is false. The study by Monti et
      al. used self-referential statements similar to this study design, however they used
      statements such as, "My name is (insert one's name)". One criticism of using this type of
      self-referential statements is that in all likelihood both the muscle tester and the muscle
      testee know the verity of the statement, therefore, they are both unblinded, which may have
      introduced biased. While it is generally accepted by those who use this assessment tool that
      some bias exists in MMT, little is currently known about the degree of this bias. Therefore
      the main objective of this study is to investigate the accuracy of MMT to distinguish
      congruent from incongruent statements under varying degrees of blindness.

      A further aim of this study are to explore if practitioner experience correlate with MMT
      accuracy. Caruso and Leisman reported greater MMT accuracy in experienced practitioners
      compared to inexperienced practitioners. Therefore, this study will test the reproducibility
      of these findings.

      There will be two groups of participants selected for this study: (1) Practitioners, and (2)
      Testees - where the Practitioner will perform MMT on the Testee as the Testee speaks a
      statement. The Testee will know if s/he is speaking a true or false statement. However, for
      some statements, the Practitioner will be blind to the verity of the statement.

      Results will be analysed for percent correct - that is, percent of muscle tests which
      accurately predicted the verity of the spoken statement.
    

Observational model: Other
Time perspective: Other
Sampling method: Non-Probability Sample
Study population: 
        1. Practitioenrs - Healthcare providers - healthy adults

          2. Testees - Healthy adults with no prior experience with MMT
      
Keywords: Muscle testing; Kinesiology; Muscles; Complementary and Alternative Medicine; Practitioner Experience; This study is actually not a randomised controlled trial,; but an assessment of diagnostic test accuracy. We will be; looking at the accuracy of MMT to distinguish congruent from; incongruent statements under varying levels of blinding.