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Edited by Scott Cuthbert, D. C. ICAK-USA Research The Following is a Compilation of Applied Kinesiology Research Papers Published in the Collected Papers of the International College of Applied Kinesiology for the year 2005-2006 -- Edited by Scott Cuthbert, D.C. FUNCTION AL SY STEMS APPRO ACH TO CEN TR AL N ER VOUS SYSTEM E VALU ATION Richard Belli, D.C., D.A.C.N.B. AB STR ACT Objective: This study investigates the clinical utility of testing functional systems within the central nervous system, compared to testing individual motor nerves with manual muscle testing. Design: Private practice. Study Subjects: Patients were examined by the treating chiropractor from his existing patient pool. Methods: Chiropractic management was decided on by the treating chiropractor. A series of twelve tests were designed to discover disorders of functional systems within the CNS. The tests described were to evaluate the function of 12 systems: 1) spinal cord, 2) myelencephalon/reticular formation, 3) vagal system, 4) trigeminal motor system-muscles of mastication, 5) vestibulospinal system, and bulbo reticular area, 6) reticular formation, 7) diencephalons and gait locomotion system, 8) mesencephalon, 9) cardiac sympathetic autonomic system, 10) pyramidal system, 11) limbic system, 12) sensory system. Results: This chiropractic approach tests the nervous system after provocation of functional systems instead of sensory challenges to more discreet portions of the body. Conclusion: For chiropractic patients who are not responding to discreet treatment programs, this method of evaluation may be valuable as it tests underlying system problems within the CNS. Nearly all the functional systems have a related motor activity that results in inhibition and facilitation patterns. Case series evaluations of this method should be made. (Collected Papers International College of Applied Kinesiology, 2005-2006;1:1-5) Key Indexing Terms: Kinesiology, Applied; Chiropractic; Muscle Weakness; Nervous System; Evaluation Studies THE ROLE OF THE ANTERIOR FIFTH LUMBAR IN HAMMER TOES AND DISEQUILIBRIUM – A CASE STUDY Harlan Browning, D.C., C.C.N., D.C.B.C.N. AB STR ACT Objective: To discuss a case of foot pain, foot joint subluxation, and hammertoes that produced low back pain and equilibrium problems for 35 years. Clinical Features: A fifty-five year old woman presented with a thirty-five year history of bilateral foot problems and equilibrium problems. Hammertoes were evident preventing the second through fifth toes from contacting the ground when she stood, making her unsteady on her feet. Intervention and Outcome: An anterior L5 subluxation was corrected, as were cervical and thoracic subluxations. The calcaneus and talus bones were manipulated bilaterally and then taped for stability. The author states that an anterior fifth lumbar frequently produces pains below the knee. After treatment, the patient was contacted at her home. She reported that her toes were closer to the ground while standing and her balance had improved. At her follow up visit her toes felt normal to her, and she was able to wear open toed shoes (her feet were "unsightly" and "embarrassing" to her, and so she kept them covered). Over the following three weeks her balance during yoga classes and her foot pain improved. Conclusion: The anterior fifth lumbar subluxation may be responsible for foot dysfunctions. Functional tests in applied kinesiology can be employed to determine whether the involved lumbar subluxation is producing pain and muscle weakness or joint restrictions in the feet. Treatment directed at both the lumbar spine and the feet using applied kinesiology may result in improved function and reduction of pain in the feet. (Collected Papers International College of Applied Kinesiology, 2005-2006;1:7-8) Key Indexing Terms: Kinesiology, Applied; Hallux Valgus; Hammertoe Syndrome; Foot, Pain; Musculoskeletal Manipulations CORRECTION OF CRANIAL NERVE NEUROPATHY USING APPLIED KINESIOLOGY CHIROPRACTIC CARE: A CASE STUDY OF THE TREATMENT OF SYMPTOMATIC ARNOLD-CHIARI MALFORMATION Scott Cuthbert, B.C.A.O., D.C. AB STR ACT Objective: To present an overview of possible effects of Arnold-Chiari malformation (ACM) and to offer chiropractic approaches and theories for treatment of a patient with severe visual dysfunction complicated by ACM. Clinical Features: A young woman had complex optic nerve neuritis exacerbated by an ACM (Type I) of the brain. Intervention and Outcome: Applied kinesiology chiropractic treatment of the spine and cranium was used for treatment of loss of vision and nystagmus. After treatment, the patient"s ability to see, read, and perform smooth eye tracking showed significant and lasting improvement. Conclusion: Further studies into applied kinesiology and cranial treatments for visual dysfunctions associated with ACM may be helpful to evaluate whether this single case study can be representative of a group of patients who might benefit from this care. (Collected Papers International College of Applied Kinesiology, 2005-2006;1:9-18) (J Manipulative Physiological Ther 2005;28:289) Key Indexing Terms: Chiropractic; Vision; Arnold-Chiari Malformation (Type I); Muscle Weakness; Cranial Neuropathies THE TEMPORAL BONE CRANIAL FAULT: A RESUME OF "THE TROUBLE MAKER" WITH A FOCUS ON THE PROPRIOCEPTIVE AND VESTIBULO-OCULAR SYNDROMES Scott Cuthbert, B.C.A.O., D.C. AB STR ACT Objective: To determine whether the temporal bone cranial fault increases difficulties in proprioception, equilibrium, and in the integration of the sensory inputs from the eyes, ears, muscles and joints. Methods: The clinical histories of sixty-five patients with a temporal bone cranial fault were reviewed. These patients underwent a thorough consultation and applied kinesiology examination, which included specific proprioceptive and equilibrium testing to evaluate for problems in this area. The author reviewed the literature on the integration of the vestibular, visual righting, and head-on-neck reflexes, and the importance of their proper integration by the CNS. The neurological integration of these reflexes from peripheral receptors was explored. Results: The temporal bone cranial fault is hypothesized to disturb the geometry and function of the vestibulo-ocular, vestibulo-spinal reflexes. Opto-kinetic reflex disturbances (diagnosed with "ocular lock testing" in applied kinesiology methodology), may also be involved in cranial faults, further disturbing equilibrium function in patients. Conclusion: Cranial faults, muscle inhibitions, vertebral subluxations, and equilibrium syndromes may be associated via the sensory conflict hypothesis, also called dysponesia. Further research into which of these reflex systems is the critical factor in successful treatment is warranted. Cranial evaluation and treatment are a significant component in equilibrium syndromes. (Collected Papers International College of Applied Kinesiology, 2005-2006;1:19-31) Key Indexing Terms: Temporal Bone; Cranial Neuropathies; Chiropractic; Diagnosis; Treatment; Proprioception; Vestibular Function Tests; Vestibular Apparatus MUSCLE ACTI VATION TECHNI QU E Simon J. King, B.App.Sc.(Chiro), D.I.B.A.K. AB STR ACT Objective: This article demonstrated a method of identifying an inhibited muscle by contracting it, and simultaneously testing a normotonic muscle that subsequently becomes inhibited. Methods: The author describes another method for discovery of inhibited muscles in the body that can be used by manual muscle testers (applied kinesiologists). A muscle that is inhibited has aberrations in its muscle spindle functions and sends altered proprioceptive messages into the CNS. These alterations have been shown to cause a decrease in muscle strength. Results: This method allows an examiner to discover muscle inhibitions in the body. There are some muscles in the body that cannot be tested manually. The multifidus and rotators muscles are examples. Asking the patient to contract these muscles and then evaluating a change in strength of an easily tested muscle may reveal inhibitions in these types of muscles. Conclusion: This method of diagnosis for muscle inhibitions can be used to discover what corrective method is appropriate for the muscle. Vertebral subluxations can be diagnosed using this method by challenging vertebrae until the contraction of the inhibited muscle no longer weakens a normotonic muscle. (Collected Papers International College of Applied Kinesiology, 2005-2006;1:43-46) Key Indexing Terms: Kinesiology, Applied; Chiropractic; Diagnosis; Muscle Weakness; Muscle Contraction THE NEUROREGULATORY ROLE OF THE TRIGEMINAL NERVE IN DURAL TORQUE AND THE RECIPROCAL TENSION MEMBRANE Harlan Browning, D.C., D.C.B.C.N., C.C.N. ABSTRACT Objective: To review the neuroanatomy of the cranio-sacral system and its functional integration with the trigeminal nerve via the innervation of the dural membranes. Methods: A discussion of the attachments and movement potentials of the dural membranes, and of the afferent innervation of the dura by the trigeminal nerve, leads to the hypothesis that the trigeminal nerve and nuclei both monitor and coordinate cranial motion. A review of the concepts of dural torque and meningeal tension are given. Results: The anatomical correspondence between the trigeminal nerve, the cranial dura, and the upper three cervical nerves is suggested to be a driving force behind the craniosacral rhythm. Conclusion: This paper hypothesizes that either directly through the meningeal dura, and the muscles of mastication, or indirectly through the neurons of the upper cervical spine, the trigeminal nerve and nuclei are responsible for the craniosacral rhythm. Adequate treatment of the craniosacral system will include examination and treatment of cranial meningeal tensions affecting the trigeminal nerve. (Collected Papers International College of Applied Kinesiology, 2005-2006;1:55-60) Key Indexing Terms: Cranial Neuropathies; Chiropractic; Meninges; Trigeminal Nerve A NEWLY DISCOVERED MUSCLE-ORGAN RELATIONSHIP: THE PECTORALIS MINOR AND THE PAROTID GLAND Stephen C. Gangemi, D.C. ABSTRACT Objective: The research into the correspondence between muscle dysfunction and organ or gland dysfunction has continued throughout the history of AK. A proposed relationship between the pectoralis minor muscle and the function of the parotid glands is discussed. Design: Private practice. Study Subjects: Patients were examined by the treating chiropractor from his existing patient pool. Methods: A discussion of the visceral referred pain (VRP) areas in the body is made. Activating the VRP for the parotid glands (by pinching or rubbing) specifically strengthened the pectoralis minor muscle using manual muscle testing procedures. The relationship of the parotid glands to the immune system, the thyroid gland, and the lymphatic system is described. Results: This method of evaluation for the function of the parotid glands allowed the doctor to diagnose a problem with these two glands, and to discover proper treatment methods (neurolymphatic stimulation, vertebral subluxation correction, or nutritional support). Conclusion: Due to the impact of proper parotid function on an individual"s health, specifically the immune system and the thyroid gland, the observation of an inhibited (or over facilitated) pectoralis minor muscle in relationship to this gland enables the doctor to investigate and treat patients with greater success. (Collected Papers International College of Applied Kinesiology, 2005-2006;1:75-77) Key Indexing Terms: Parotid Gland; Pectoralis Muscles; Chiropractic; Diagnosis; Muscle Weakness THE USE OF LOW LEVEL LASER THERAPY IN TREATMENT OF RECURRENT TEMPORAL BULGE CRANIAL FAULT WITH ATTENDANT DIGESTIVE COMPLAINTS James D. W. Hogg, D.C., D.I.B.A.K. ABSTRACT Objective: The temporal bulge cranial fault (or external temporal cranial fault) is described. Clinical features of this syndrome are described, as well as the traditional AK method of diagnosis and treatment. Design: Private practice. Study Subjects: Patients were examined by the treating chiropractor from his existing patient pool. Methods: In patients who have a recurrence of the temporal bone cranial fault after traditional AK correction methods have been given, the use of low level laser therapy (LLLT) was employed. Results: The author describes LLLT therapy, and its use for cranial nerve problems (cranial nerve X specifically) is explained. A step-by-step clinical protocol for the temporal bone cranial fault and cranial nerve X dysfunction is given. Conclusion: The addition of LLLT to this doctor"s clinical protocol for the temporal bulge cranial fault and associated digestive disturbances enhanced the clinical effectiveness and longevity of correction for his patients. (Collected Papers International College of Applied Kinesiology, 2005-2006;1:79-82) Key Indexing Terms: Laser Therapy, Low-Level; Temporal Bone; Cranial Nerve X; Cranial Neuropathies; Chiropractic ABNORMAL MUSCLE TESTING RESPONSES WITH CEREBELLAR TRANSNEURAL DEGENERATION – A CASE HISTORY Datis Kharrazian, D.C., M.S., F.A.A.C.P., D.A.C.B.N., D.I.B.A.K., C.N.S., C.S.C.S., C.C.S.P. Objective: To discuss the case of a 32-year-old female with multiple chronic disorders that was managed with procedures for the treatment of cerebellar transneural degeneration (TND). Clinical Features: A thorough neurologic, x-ray, MRI, and CT scan examination is described as well as its neurological significance. The complex clinical features of TND are discussed, and the findings in this patient"s examination correlated. Intervention and Outcome: Conservative chiropractic treatment of TND, as well as nutritional support, improved the majority of this patient"s symptomatology. Conclusion: This case demonstrates how TND may lead to unpredictable muscle testing responses. This case history demonstrates how abnormal muscle responses may occur when a neurologically compromised patient performs manual muscle tests that exceed their metabolic threshold. Management of this type of patient may require nutritional treatment for the abnormal bio-chemistry of the motor neuron pools before consistent muscle testing outcomes can be expected. (Collected Papers International College of Applied Kinesiology, 2005-2006;1:83-89) Key Indexing Terms: Spinocerebellar Degenerations; Cerebellar Dysfunction; Neuron Degeneration; Kinesiology, Applied CHIROPRACTIC APPLIED KINESIOLOGY INTEGRATION WITH TMJ DENTAL CARE – TWO CASES David Leaf, D.C., D.I.B.A.K. ABSTRACT Objective: To discuss two cases where TMJ splinting techniques were needed to stabilize the patients" corrections. Clinical Features: A sixteen-year-old female began orthodontic work at age thirteen, when 6 teeth were removed and braces were fitted. The patient had inhibited muscles on the left side of her body producing a staggering gait and inability to run, with severe headaches that limited her attendance in school to two days a week. These symptoms began after dental work was initiated. The second case involved a 57-year- old man who suffered a stroke that left him with poor coordination, loss of strength, speech pattern changes and an inability to coordinate the movement of his eyes so he could not focus or read. Intervention and Outcome: Examination and treatment of the young woman"s cranium provided immediate increase in the strength of the muscles on the left side of her body and a 50% decrease in her headache. However, within two minutes the correction was lost. Placement of a tongue depressor between the teeth on the left following cranial corrections improved the muscle strength to normal, and normalized her gait pattern upon walking. She was referred to a dentist specializing in the equilibration of the TMJ, and fitted with a splint. The combined chiropractic and dental care has resolved all of her symptoms. The second older patient, a stroke victim, also received chiropractic and then dental equilibration care. His vision, reading, and speech patterns improved. Conclusion: These two case reports demonstrate the need for coordinated chiropractic and dental care in the treatment of complex and severe cases of temporomandibular joint disorder (TMD). (Collected Papers International College of Applied Kinesiology, 2005-2006;1:91-93) Key Indexing Terms: Temporomandibular Joint Disorders; Chiropractic; Cranial Neuropathies; Dentistry; Orthodontics, Corrective EFFECTS OF PROPER WALKING ON SPINAL FIXATIONS David Leaf, D.C., D.I.B.A.K. ABSTRACT Objective: A case series of thirty patients between the ages of 18 to 75 who had spinal fixations and decreased rib expansion were chosen for this study. Clinical Features: All patients were measured for 1) spinal flexion, 2) passive arm abduction, 3) lateral bending of the neck and head, 4) rib expansion at the xiphoid process, 5) motion palpation of the spine, and 6) muscle testing for AK correlations with spinal fixations by testing for bilateral inhibition of the deltoid, popliteus, teres major, lower trapezius, psoas, gluteus maximus, and neck extensor muscles. Intervention and Outcome: Treatment consisted of testing and correcting one or more of the following: 1) anterior talus, 2) dropped navicular, 3) lateral cuboid, 4) posterior calcaneus, 5) treatment to strengthen inhibited tibialis posterior, posterior longus, and gastrocnemius muscles. Proprioceptive neuromuscular facilitation (PNF) was applied to the ankle and foot muscles, and proper instructions on walking were given. The patients were then asked to walk for 100 steps on a treadmill and the above tests and measurements were repeated. All but 5 patients showed all spinal fixations corrected, and rib expansion increased an average of 1.3 inches. Spinal flexion increased an average of 3.75 inches. The patients were then asked to walk 30 steps with their previous improper gait pattern, and all but two were found to have their original restrictions return. Conclusion: Normal walking creates patterns of muscle action that normalizes spinal mechanics and rib expansion. (Collected Papers International College of Applied Kinesiology, 2005-2006;1:95-96) Key Indexing Terms: Foot Injuries; Ankle Injuries; Gait; Examination EFFECTIVENESS OF APPLIED KINESIOLOGY PROCEDURES ON FOOT SIZE David Leaf, D.C., D.I.B.A.K. ABSTRACT Objective: To discuss changes in foot size in a convenience sample of 180 people after a combination of common applied kinesiology procedures were employed to the foot and ankle. Clinical Features: 180 students and patients in the author"s practice and seminars had their footprints drawn. First, with their foot placed lightly on the paper and the foot outlined. Second, with their foot bearing their body weight another tracing was drawn with another colored pencil. An increase of more than ¼ inch indicated loss of intrinsic foot support. Only 15% of the participants had a difference of less than ¼ inch weight bearing compared to non-weight bearing. Intervention and Outcome: Applied kinesiology testing and treatment procedures were applied to the muscles, joints, and skin in the ankles and feet of all patients. Skin imbalances were treated using Kinesio tape. Proprioceptive neuromuscular facilitation was given to the ankle and foot muscles. Spinal subluxations from L4 to the sacrum were treated. The patient was then instructed to walk for 30 steps. A new piece of paper and tracing measurement of the foot was taken and compared to the original. Conclusion: In all of the cases who had more than ¼ inch difference non-weight bearing compared to weight bearing, when the above AK protocols were used, the second tracing would show markedly less difference in foot size than the original tracing after AK treatment. (Collected Papers International College of Applied Kinesiology, 2005-2006;1:99-100) Key Indexing Terms: Foot; Foot Joint; Ankle Joint; Chiropractic; Examination CLINICAL RESPONSE TO A NEUROLOGICALLY BASED COMPREHENSIVE CLINICAL PROTOCOL DEVELOPED BY DR. WALTHER H. SCHMITT Kerry M. McCord, D.C., D.I.B.A.K. ABSTRACT Objective: To demonstrate the use of a neurologically based clinical protocol using applied kinesiology techniques developed by Walter Schmitt, a diplomate chiropractic neurologist, on a case series of four patients with dissimilar presenting complaints. The clinical protocol used for examination and treatment is given in the appendix of this paper. Clinical Features: Three adult patients presented with severe pain syndromes, and one child with attention deficit disorder. A comprehensive examination and treatment of these cases using this protocol is described. Intervention and Outcome: The application of this particular applied kinesiology protocol led to a successful resolution of presenting symptomatology regardless of the presenting complaint. Conclusion: Since the presenting complaints of these patients were so varying and diverse, the possible applicability of this clinical protocol to a much wider patient base should be investigated. (Collected Papers International College of Applied Kinesiology, 2005-2006;1:101-115) Key Indexing Terms: Attention Deficit Disorder; Food Allergy; Examination; Kinesiology, Applied; Chiropractic THE BRAINSTEM AND MANUAL MUSCLE TESTING James Otis, D.C., D.A.C.N.B. ABSTRACT Objective: To offer a brief review of muscle physiology, spinal cord function, and the modulating effects of norepinephrine (NE) and serotonin (5HT) on muscle function, with an emphasis on factors that affect muscle test outcomes. Data Sources: Information was obtained from English language medical and scientific journals and medical/physiology textbooks. Key authors indexed included Grillner, Binder, Heckman, Lee, Guyton, Garcia-Rill, and Powers. Methods: A series of five manual muscle test procedures were proposed to evaluate brainstem function; the neuro-physiological relevance of each procedure is given, and expected muscle test outcomes in response to brainstem stimulation are given. Conclusion: In the context of a full neurological exam, specific muscle test procedures are hypothesized to be sensitive, easily administered diagnostic tools for the evaluation of brainstem function. The tests described in this paper are argued to be positive (when given to a typical chiropractic clinic population), due to physiological, reversible brainstem dysfunction. (Collected Papers International College of Applied Kinesiology, 2005-2006;1:129-143) Key Indexing Terms: Reticular Formation; Brain Stem; Norepinephrine; Serotonin; Kinesiology, Applied ENTEROGASTRIC REFLEX: POWERFUL DUODENAL FACTORS THAT INHIBIT THE STOMACH Jose Palomar Lever, M.D., O.S., D.I.B.A.K. ABSTRACT Objective: To discuss the treatment of a case series of 90 patients who had stomach problems. To explain the enterogastric reflex"s relevance to digestive function, and a method for diagnosing an under-active or an over-active enterogastric reflex is described. Clinical Features: All 90 patients were treated with the standard AK protocol, including specific AK procedures for stomach disorders. Out of the 90 patients, 82 were found to have an abnormal enterogastric reflex. Results: Of the 4 patients with an under active enterogastric reflex, 90% improved. In patients with an over-active enterogastric reflex: 48 patients improved 90% of their symptoms; 11 patients improved 70% of their symptoms; 16 patients improved 50% of their symptoms; 3 patients improved 20% or less of their symptoms. Conclusion: The enterogastric reflex has an effect on the digestion of food. When this reflex is disturbed, digestive problems may result. Treatment of this reflex is argued to help patients complaining of digestive problems. (Collected Papers International College of Applied Kinesiology, 2005-2006;1:145-150) Key Indexing Terms: Stomach; Gastric Emptying; Gastrointestinal Agents; Kinesiology, Applied THE CONNECTION BETWEEN HOMOCYSTEINE, THE PSOAS MINOR MUSCLE, AND LOW BACK PAIN Thomas Rogowskey, D.C., D.I.B.A.K. ABSTRACT Objective: A connection between excess levels of homocysteine and bilateral weakness of the psoas minor muscle is proposed. Design: Private practice. Study Subjects: Patients were examined by the treating chiropractor from his existing patient pool. Methods: The metabolism of homocysteine is described. The clinical presentation of an anterior lumbar vertebra is described, and correlated with the biomechanical instability of a bilaterally inhibited psoas minor muscle. Results: In a case series, six patients from the doctor"s practice had bilaterally inhibited psoas minor muscles. In these patients, insalivation of homocysteine weakened a previously facilitated muscle. Insalivation of nutrients that combat excess homocysteine levels (methylcobalamine/B-12, 5- methyltetrahydrofolate/MTHF, folic acid, pyridoxyl-5-phosphate/P5P, serine, betaine, and/or arginine) corrected the bilaterally inhibited psoas minor muscles. A treatment protocol of the anterior lumbar vertebrae, the neurolymphatic reflexes, and the cervical spine problems frequently involved with the inhibited psoas minor muscles is presented. Conclusion: Excess homocysteine has been shown to be a risk factor in cardiovascular disease. This paper describes the musculoskeletal and functional biochemical problems that result from excess homocysteine in addition to the traditionally associated diseases. A treatment protocol is described. Correlating these findings with lab results is an area to be further investigated. (Collected Papers International College of Applied Kinesiology, 2005-2006;1:151-156) Key Indexing Terms: Homocysteine; Psoas Muscles; Low Back Pain; Heart Diseases; Cerebrovascular Accident; Kinesiology, Applied; Chiropractic; Musculoskeletal Manipulations THE NEUROLOGICAL RATIONALE FOR A COMPREHENSIVE CLINICAL PROTOCOL USING APPLIED KINESIOLOGY TECHNIQUES Walter H. Schmitt, Jr., D.C., D.I.B.A.K., D.A.B.C.N. ABSTRACT Objective: This paper presents the clinical protocol developed by the author after 30 years of clinical experience using applied kinesiology techniques. Design: The protocol is described, and then the neurologic and metabolic rationale for the placement of the procedures within the protocol is explained. Study Subjects: Patients were examined by the treating chiropractor from his existing patient pool. Methods: The procedure presented identifies muscle weakness, injuries, systemic nutritional problems, systemic structural problems, cellular metabolic problems, autonomic problems, systemic endocrine problems, autonomic dysfunction, emotional stress problems, local pain problems, and gait assessment. Results: This protocol enables practitioners of various disciplines and practice styles to incorporate these functional neurological assessment procedures into their daily practice. Conclusion: This protocol summarizes the author"s 30 years of contributions to the system of applied kinesiology chiropractic. The organization of his work in the fields of neurology, biochemistry, spinal adjusting, and the diagnosis and treatment of somatic dysfunction is presented. Outcome studies of this method of treatment should be made. (Collected Papers International College of Applied Kinesiology, 2005-2006;1:157-191) Key Indexing Terms: Kinesiology, Applied; Chiropractic; Muscle Weakness; Nervous System; Chemistry, Clinical; Evaluation; Treatment Protocols ADULT ATTENTION DEFICIT DISORDER AND LEARNING DISABILITIES Paul T. Sprieser, D.C., D.I.B.A.K. ABSTRACT Objective: To discuss the author"s experience of treating both children and later adults with attention- deficit disorder (ADD) and learning disabilities. The author reviews a paper he wrote in 1984 on the subject, and then describes later findings that encompass his 41 years of treating the problem. Methods: The neurology and metabolism of the patient with ADD is described. The author describes a cranial fault that he has consistently found in these patients, and its method of diagnosis and treatment are explained. Results: The author has treated this particular cranial fault in 1,500 patients who were classified with learning disabilities. A control group of 250 patients were questioned by the author and determined not to have any type of learning problems. The cranial fault was not present in the 250 members of the control group. The methodology for determining learning disabilities or attention deficit disorder in the patients was not given. Conclusion: The author has used this cranial treatment in 1,500 patients with ADD and learning disabilities, and has evidence from patient response that the correction helps with these disorders. He has begun a study on other students with similar problems who have taken a previous SAT exam that will give a base line score, which will help determine if the cranial fault correction has some bearing on improvements in the test scores. (Collected Papers International College of Applied Kinesiology, 2005- 2006;1:193-208) Key Indexing Terms: Attention Deficit Disorder; Learning Disabilities; Adult Learning Disorders; Treatment; Chiropractic; Kinesiology, Applied GASTROESOPHAGEAL REFLEX DISORDER AND HIATAL HERNIA, A UNIVERSAL PROBLEM Paul T. Sprieser, D.C., D.I.B.A.K. ABSTRACT Objective: To describe gastroesophageal reflex disorder (GERD) and hiatal hernia and their treatment using applied kinesiology methods. A review of the anatomical distortions producing GERD and hiatal hernia is given. Data Sources: Information was obtained from the applied kinesiology published literature and medical/physiology textbooks. Key authors indexed included Goodheart, Walther, and Guyton. Methods: A series of diagnostic tests were described to evaluate for muscular dysfunction of the diaphragm, as well as tests to evaluate problems with the digestive enzymes of the stomach. Structural factors involved in the production of the GERD and hiatal hernia are described, as well as the signs and symptoms to suggest this problem in the patient. Conclusion: The author suggests that diagnosing and correcting the causes of GERD will be more beneficial and longer lasting for the patient than using medications that reduce the symptoms of digestive dysfunction. Studies evaluating outcomes using this treatment method would be valuable. (Collected Papers International College of Applied Kinesiology, 2005-2006;1:209-217) Key Indexing Terms: Hernia, Hiatal; Diagnosis; Treatment; Chiropractic; Kinesiology, Applied ICAK-USA Research The Following is a Compilation of Applied Kinesiology Research Papers Published in the Collected Papers of the International College of Applied Kinesiology for the year 2004-2005 -- Edited by Scott Cuthbert, D.C. APPLIED KINESIOLOGY MANAGEMENT OF MENSTRUAL HEADACHES: A CASE HISTORY Janet Calhoon, D.C., D.I.B.A.K. ABSTRACT Objective: To discuss a case of pre-menstrual headache, low back pain, and mood swings that occur monthly. Clinical Features: One week before her menstrual cycle began, headaches, low back pain, and intense mood swings occurred for the patient. Her husband could accurately predict the first day of her period by the severity of her moods. She experienced a severe headache the first day of her period. Intervention and Outcome: Applied kinesiology spinal corrections were made at one-week intervals for one menstrual cycle, and the physician monitored and guided the patient"s dietary changes. The following structural corrections were made: a naso-sphenoid cranial fault, an upper cervical, cervico-thoracic and thoraco-lumbar fixations, and neurolymphatic reflex treatment for the sartorius muscle. Instructions were given to eliminate aspartame-containing foods. Basic nutritional instructions about proper food combining (found in the AK literature) were given. The next menstrual cycle occurred without symptoms, and neither the patient nor her husband could predict when her cycle would begin. Conclusion: Many other conditions may produce menstrual headaches; therefore it is naïve to think of this as a disorder with a single origin and a single cure. The addition of laboratory testing, nutritional counseling, proper food combining, and the elimination of toxins from the diet were important parts of the entire diagnostic work-up of a patient with menstrual symptoms who was treated successfully using applied kinesiology chiropractic. (Collected Papers International College of Applied Kinesiology, 2004- 2005;1:3-4) Key Indexing Terms: Menstruation Disturbances; Headache Disorders; Case Reports; Treatment; Chiropractic; Kinesiology, Applied APPLIED KINESIOLOGY MANAGEMENT OF MULTIPLE SCLEROSIS – AN ONGOING CASE STUDY Janet Calhoon, D.C., D.I.B.A.K. AB STR ACT Objective: A continuing case study of a 48-year-old female with multiple sclerosis is presented. Clinical Features: A diagnosis of multiple sclerosis from a medical neurologist was confirmed with MRI. The patient first came for treatment after having all of her amalgams removed and undergoing IV chelation therapy with no improvement. After 2 years of AK care she went from not being able to write a check to showering without assistance. The patient was a conditioned athlete at the onset of MS. Intervention and Outcome: The patient"s current major complaint is low back pain and she gets relief with AK treatment. Parasites, toxins, allergies, and heavy metals have been evaluated using a Comprehensive Stool Analysis, ELISA blood test, 24-hour urine and hair analysis. Nutritional counseling was given to the patient. Basic AK treatment methods were employed. She can drive to the doctor"s office now, is able to do mild workouts with Nautilus equipment, can walk with a cane without assistance, and is able to ride her horse and walk her dog for the first time in years. During the six years of treatment with this doctor, she has had no acute exacerbations of MS. Conclusion: Treatment directed to basic structural, chemical, and emotional problems in this patient with multiple sclerosis improved her condition and reduced her pain. Concurrent neuro-radiologic studies are warranted to discover if the care rendered to this patient would benefit other patients with multiple sclerosis. (Collected Papers International College of Applied Kinesiology, 2004-2005;1:5-6) Key Indexing Terms: Multiple Sclerosis; Treatment; Case Reports; Chiropractic; Kinesiology, Applied THE IMPORTANCE OF ABDOMINAL OBLIQUE MUCLES IN CATEGORY 1 Janet Calhoon, D.C., D.I.B.A.K. ABSTRACT Objective: To demonstrate in 30 cases with recurrent category 1 pelvic faults the involvement of the rectus abdominus, internal and external oblique abdominal muscles. Methods: The author describes the anatomical attachments of the abdominal muscles and their relevance to pelvic mechanics. Results: On testing the abdominal muscles in 30 patients with recurrent category 1 pelvic faults, all patients were found to have inhibited abdominal muscles. Correcting the abdominal muscles (using neurolymphatic, neurovascular, neuromuscular spindle cell, golgi tendon organ, or cranial respiratory corrections as indicated by the author"s examination), eliminated the category 1 fault in 26 of the 30 patients. On subsequent visits, the category 1 pelvic fault remained corrected. Conclusion: In category 1 pelvic faults, the importance of the abdominal muscles was demonstrated. Further research using larger patient numbers and a control group is warranted. (Collected Papers International College of Applied Kinesiology, 2004-2005;1:7-8) Key Indexing Terms: Pelvis; Biomechanics; Abdominal Muscles; Muscle Hypotonia; Sacroiliac Joint; Treatment; Chiropractic; Applied Kinesiology APPLIED KINESIOLOGY MANAGEMENT OF TIC IN A PEDIATRIC PATIENT: A CASE HISTORY Cecilia A. Duffy, D.C., D.I.B.A.K. ABSTRACT Objective: To describe the use of applied kinesiology in the management of a 15-year-old female with tic. Clinical Features: The patient had a four-month history of episodic eye tic, consisting of twenty-minute to one-hour episodes of eyelid blinking and rolling of the eyes independently of each other. A complete neurological examination of the patient was described. Intervention and Outcome: The structural corrections made on the patient"s first visit were a category II pelvic fault; 2 nd thoracic spinal subluxation; sphenobasilar and temporal bone cranial fault; left temporomandibular external pterygoid muscle correction; and a bilateral lateral talus. Between her first and second visits the patient had a reduction in the number of episodes of tic. With the diagnosis and treatment of chemical imbalances using applied kinesiology methods (blood glucose counseling and management, and nutritional supplementation to stabilize her blood glucose levels) in addition to the structural corrections, the prodromal episodes of the tic and the tic itself were corrected. Conclusion: This 15-year-old with a transient motor tic disorder was managed successfully using applied kinesiology methods. Further studies on larger groups of patients with tics (including Tourette"s syndrome) are called for to evaluate whether this method of treatment would be successful with larger groups of patients and other types of tics. (Collected Papers International College of Applied Kinesiology, 2004-2005;1:17-20) Key Indexing Terms: Tic Disorders; Blood Glucose; Treatment; Case Reports; Kinesiology, Applied; Chiropractic APPLIED KINESIOLOGY MANAGEMENT OF URINARY INCONTINENCE IN A PEDIATRIC PATIENT: A CASE HISTORY Cecilia A. Duffy, D.C., D.I.B.A.K. AB STR ACT Objective: To describe the case of a 12-year-old female with urinary incontinence successfully treated using applied kinesiology technique. Clinical Features: A12-year-old female with a five-month history of urinary incompetence following emergency appendectomy surgery presents with stress incompetence, as well as occasional total incompetence. There were small incision scars at the umbilicus, above the pubis, and over the right lower quadrant associated with the appendectomy. Intervention and Outcome: Correction of structural faults of the left sacroiliac, right occiput, thoracolumbar junction, and trigger point therapy that strengthened the left gluteus maximus muscle were made. Palpation of the left levator ani muscle with Valsalva maneuver revealed bulging (indicating inhibition of the left levator ani muscle), and was corrected using neurolymphatic reflex treatment. Valsalva maneuver also inhibited the gluteus medius muscle and was corrected using a uterine lift (or superior pubic lift) correction. The urinary incompetence was corrected after the first correction. Conclusion: Successful management of a 12-year-old child with applied kinesiology is described. The conservative approach should be considered before more invasive procedures are pursued in patients with urinary incompetence. (Collected Papers International College of Applied Kinesiology, 2004-2005;1:21- 22) Key Indexing Terms: Urinary Incontinence; Urinary Incontinence, Stress; Treatment; Case Reports; Chiropractic; Kinesiology, Applied EFFECTS O F PUMPIN G THE LI VER IN TWO C ASE HISTORIES Daniel H. Duffy, Sr., D.C., D.I.B.A.K. AB STR ACT Objective: To present two case histories in which a manipulative maneuver to the liver produced improvement in the patients presenting problems. Clinical Features: The first patient underwent a detached retina surgery that resulted in vertical diplopia of that eye. The method for diagnosis of this problem is described. The second patient was a 37-year-old pregnant female (24 weeks gestation) experiencing hemorrhoidal pain. Intervention and Outcome: Postural examination, manual muscle testing, and temporosphenoidal line examination were used to diagnose a problem with the pectoralis major (sternal division) muscle, which is associated in applied kinesiology with the liver. After manually manipulating the liver (the method of treatment is described), the vertical diplopia in the first patient, and the hemorrhoidal pain in the second were both improved. Conclusion: These case histories suggest that manual treatment of the liver may benefit cases with varying symptomatology. No firm conclusion can be reached from the results of a case study, although it does suggest that applied kinesiology chiropractic care may provide benefits for patients with liver disorders. Further studies into other conditions that might respond to this therapy are warranted. (Collected Papers International College of Applied Kinesiology, 2004-2005;1:25-26) Key Indexing Terms: Liver; Hemorrhoids; Treatment; Case Reports; Chiropractic; Kinesiology, Applied CASE STUDY: SEVERE RIGHT ARM NEURALGIA AND WEAKNESS FOLLOWING SURGERY David Leaf, D.C., D.I.B.A.K. ABSTRACT Objective: To present a patient who was unable to clasp objects with his right hand after right kidney surgery. Diagnosis and treatment using applied kinesiology resolved this patient"s disability Clinical Features: A 67-year-old male had an MRI evaluation before his release from the hospital, but it was negative. 4 weeks later the patient presented with no improvement and with his fingers limited to a flexed position; 5 degrees of wrist flexion and extension; 30 degrees of shoulder flexion and abduction. Manual muscle testing of the hand was impossible due to lack of muscle response. With the arm passively elevated however he could make a fist and flex and extend his wrist 40 degrees. Intervention and Outcome: AK testing methods are described that revealed a thoracic outlet syndrome and cervical spinal disc injury. Treatment using strain-counterstrain and trigger point techniques to the cervical muscles were given. Cervical disc (imbrication) corrections at C5 and C6 were made; omega -3 fatty acid imbalances were treated nutritionally; and topical ibuprofen on the cervical nerve roots was done at home for 3 days. Sleeping position instructions were given. After 3 visits at one-week intervals the patient"s grip strength was 40 lbs., and he made continued progress in arm flexibility with home exercises. Conclusion: This case demonstrated methods of muscle testing to determine multiple sites of injury to the upper extremity following trauma. Injuries to the cervical spine, thoracic outlet, elbow and wrist were all contributing to this patient"s problem. Specific treatment to each of these areas was successful. (Collected Papers International College of Applied Kinesiology, 2004-2005;1:29-31) Key Indexing Terms: Intervertebral Disc; Thoracic Outlet Syndrome; Shoulder Impingement Syndrome; Brachial Paresis; Treatment; Case Reports; Kinesiology, Applied THE PROPER FITTING OF SUPPORTS AND THEIR EFFECT UPON MUSCLE STRENGTH David Leaf, D.C., D.I.B.A.K. ABSTRACT Objective: Determine the effects of pressure applied by orthopedic support stockings on the strength of muscles. Methods: Analytic survey. A trial of manual muscle testing was conducted on a convenience sample of 25 normal subjects. The peroneus longus and brevis, peroneus tertius and tibialis anterior all tested normotonic. A sphygmomanometer was applied to the mid-calf region. The instrument was inflated at 10- degree increments and the muscles were retested. Tests were done with the examiner and the subject blinded from the pressure recordings. Results: In all individuals at 10, 20, and 30 mm of pressure the muscles maintained their normal strength. When the pressure was increased to 40 mm, 19 of 25 subjects had failure of the peroneus longus and brevis. In all individuals, 50 mm of pressure caused inhibition of all muscles on testing. Conclusion: A non-symptomatic group demonstrated significant weakening of muscles at defined values with the application of specific pressures to the calf muscles. When applying support, care should be taken to ensure that the support is not so tight as to cause inhibition of the underlying muscles. (Collected Papers International College of Applied Kinesiology, 2004-2005;1:33-34) Key Indexing Terms: Stockings, Compression; Evaluation Studies; Kinesiology, Applied THE USE OF MANUAL MUSCLE TESTING TO ASSESS FUNCTIONAL INTEGRATION OF HIGH-THRESHOLD VERSUS LOW-THRESHOLD ALPHA MOTOR NEURONS James Otis, D.C. Abstract Objective: To offer a brief review of muscle testing physiology, and the distinction between pre-loaded and post-movement muscle tests, and the neurological implications of these differing tests. Data Sources: Information was obtained from English language medical and scientific journals and medical/physiology textbooks. Key authors indexed included Binder, Heckman, Lee, Guyton, Powers, and the applied kinesiology methods of Dr. Walter Schmitt. Methods: Pre-loaded muscles tests are performed with 2 seconds of light pressure to elicit an isometric contraction prior to applying the test. The muscle physiology and neurological implications of an inhibited pre-loaded muscle test is described. Post-movement muscle tests are performed after the muscle has been lengthened or shortened through at least a quarter of its range of motion. The muscle physiology and neurological implications of an inhibited post-movement muscle test is described. Conclusion: In the context of a full neurological exam, two muscle test procedures are explored that are hypothesized to be distinguishable from the standard AK manual muscle testing method. Concurrent neuro-radiological, EMG, or other diagnostic studies should be conducted to evaluate this hypothesis and its clinical relevance. (Collected Papers International College of Applied Kinesiology, 2004-2005;1:35- 43) Key Indexing Terms: Muscles; Musculoskeletal Physiology; Diagnostic Techniques, Neurological; Evaluation; Kinesiology, Applied APPLIED KINESIOLOGY AND PROPRIOCEPTION: A NON-INVASIVE APPROACH TO EQUILIBRIUM AND BALANCE DISORDERS Scott C. Cuthbert, D.C. ABSTRACT Objective: To describe the importance of proprioception and proprioceptive testing to chiropractic diagnosis and treatment, and especially in patients with equilibrium disorders due to sensory conflict. A convenience sample of five representative cases is presented involving patients with balance disorders, ranging in age from 6 to 83. Clinical Features: A discussion of the hypothesis of sensory conflict and proprioceptive disorders as a causative factor in cases of disequilibria was given. Specific diagnostic tests and clinical rationales for the chiropractic diagnosis and treatment of patients with equilibrium disorders were presented. Intervention and Outcome: Following applied kinesiology spinal, extremity, muscular, and cranial manipulative treatment the five patients were able to move and operate normally without clumsiness, falling, dizziness, or nausea. The evaluation of these patients" responses to treatment was determined by the doctor"s observation, the patients" subjective description of symptoms while being active, the Visual Analog Scale for Neck and Associated Pain, and applied kinesiology chiropractic physical assessment tools. Conclusion: Further studies into chiropractic manipulative treatments for sensory conflict and proprioceptive dysfunctions associated are indicated. The hypothesis of sensory conflict as the cause of equilibrium and balance disorders should be explored more fully by other chiropractic physicians and researchers. The method of examination and treatment described here should be studied with a larger sample of symptomatic patients to evaluate the value of these methods to other patients with equilibrium disorders. (Collected Papers International College of Applied Kinesiology, 2004-2005;1:47-64) Key Indexing Terms: Musculoskeletal Equilibrium; Proprioception; Sensation Disorders; Diagnostic Tests; Vestibular Function Tests; Kinesiology, Applied; Chiropractic THE L5-S1 FIXATION REVISITED Cecilia A. Duffy, D.C., D.I.B.A.K. and John M. Heidrich, D.C., D.I.B.A.K. ABSTRACT Objective: To review the method of diagnosis for a fixation of the L5-S1 vertebrae in applied kinesiology. In AK, spinal fixations are a condition in which there is a lack of normal motion between vertebrae. Data Sources: George Goodheart originally described an L5-S1 fixation frequently correlating with a unilateral teres major muscle inhibition. Methods: A unilateral teres major muscle inhibition may strengthen with therapy localization to the L5- S1 region. Therapy localization is a procedure of placing the patient"s hand over an area of suspected involvement, then using muscle testing procedures to determine any change in strength. Proper manipulation of the L5-S1 motor unit will strengthen the teres major muscle originally found weak. Conclusion: This fixation complex and analysis procedure is valuable in cases of difficult cervical or shoulder problems, as well as with chronic, tonic, clonic, intermittent torticollis, according to the authors. Concurrent radiologic studies and larger patient samples would be valuable to investigate this finding more thoroughly. (Collected Papers International College of Applied Kinesiology, 2004-2005;1:65-66) Key Indexing Terms: Manipulation, Spinal; Lumbosacral Region; Diagnosis; Kinesiology, Applied; Chiropractic IODINE AND TYROSINE: THE MOST MISUSED NUTRITIONAL SUPPORT FOR THE THYROID Datis Kharrazian, D.C., M.S., F.A.A.C.P., D.A.C.B.N., D.I.B.A.K., C.N.S., C.C.N., C.S.C.S., C.C.S.P. ABSTRACT Objective: To discuss the negative impacts tyrosine and iodine supplementation may have on thyroid gland function. Methods: A review of the published studies on tyrosine is made and showed little improvement in thyroid hormone levels. Tyrosine supplementation may increase catecholamine hormone levels which may suppresses thyroid hormone production. Excess iodine intake is suppressive on thyroid hormone synthesis. In the United States, the salt has been iodized, and so caution in supplementing patients with more iodine is advised. Results: Reviewing nutritional and biochemical studies on tyrosine and iodine supplementation suggests that these nutrients are overused in the treatment of thyroid gland problems. When these two supplements cause an all-muscles-strong phenomenon on AK testing, a condition of sympathetic dominance should be suspected. Conclusion: The author suggests that iodine and tyrosine should be used with caution in the treatment of patients with thyroid gland disturbances, especially with patients who are under a stress response and/or exposed to excess amounts of sodium in their diet. When testing patients with these supplements, an all- muscles-strong evaluation should be made to avoid iatrogenic problems. Further case studies of these hypotheses should be made. (Collected Papers International College of Applied Kinesiology, 2004- 2005;1:75-76) Key Indexing Terms: Thyroid Gland; Thyroid Function Tests; Hypothyroidism; Tyrosine; Iodine; Dietary Supplements; Evaluation; Kinesiology, Applied NUTRITIONAL SUPPORT FOR THE THYROID: A BRIEF REVIEW Datis Kharrazian, D.C., M.S., F.A.A.C.P., D.A.C.B.N., D.I.B.A.K., C.N.S., C.C.N., C.S.C.S., C.C.S.P. ABSTRACT Objective: To offer a brief review of thyroid gland physiology, and several well-known nutritional and herbal compounds that support the thyroid gland"s metabolism. Data Sources: Information was obtained from English language medical, nutritional, and endocrine scientific journals and textbooks concerning the thyroid gland. Methods: A review of the following nutrients on the thyroid gland was made: withania somnifera, vitamin A, vitamin D, selenium, zinc, iodine, the guggulsterones compounds in Commiphora, and other anti-oxidant nutrients. Conclusion: Many compounds are important in supporting thyroid metabolism and are described. This paper suggests that nutrients that help quench peroxidation directly and indirectly via glutathione synthesis can be helpful in optimizing thyroid hormone metabolism. Further outcome studies into these factors are necessary. (Collected Papers International College of Applied Kinesiology, 2004-2005;1:77- 80) Key Indexing Terms: Thyroid Gland; Hypothyroidism; Dietary Supplements; Kinesiology, Applied LOW-TECH INDICATORS OF DECREASED BLOOD OXYGEN LEVELS David Leaf, D.C., D.I.B.A.K. ABSTRACT Background: Measurement of blood oxygen levels has become increasingly prevalent in the chiropractic profession over the past 10 years. Correlating low blood oxygen levels with chiropractic tests would be valuable. Objective: A relationship between weak grip strength as measured with a pinch meter between the second and third fingers and reduced blood oxygen levels below 96 (using a Pulse-Oxygen meter) is hypothesized. Design: Private practice. Methods: 20 patients were chosen from the author"s practice who had decreased grip strength and decreased blood oxygen levels and whose symptoms worsened with activity. The symptoms listed were fatigue and loss of muscle strength. A control group of 10 patients who did not have symptoms were tested also. Both groups were asked to march in place with their knees up to horizontal for 90 seconds, and the blood oxygen test was repeated. In the symptomatic group, 18 of 20 patients had their blood oxygen levels drop by an average of 3% or more after exercise. In the control group, the blood oxygen level dropped by 1%. Results: For patients with low blood oxygen readings, decreased pinch strength, and lowered oxygen levels after exercise, a treatment protocol to increase respiratory function was employed. This consisted of normalization of rib, diaphragm, cervical spine, phrenic nerve, and oral and nasal breathing functions. Treatment rendered to the symptomatic group resulted in an increase in the pinch meter measurements and a 1% reduction of oxygen levels after exercise in all but 1 of the 20 cases. Conclusion: In patients who are suspected of having low blood oxygen levels and have weakness or fatigue with activity, a simple screening test and clinical protocol is suggested. Further tests for evaluating and treating low blood oxygen levels in chiropractic practice are needed. (Collected Papers International College of Applied Kinesiology, 2004-2005;1:83-85) Key Indexing Terms: Respiratory System; Anoxia; Diagnostic Techniques; Clinical Protocols; Diaphragm; Phrenic Nerve; Ribs; Kinesiology, Applied; Chiropractic CASE STUDY: SEVERE ADRENAL STRESS SYNDROME AS A CAUSE OF ANXIETY IN A 17-YEAR-OLD CAUCASIAN FEMALE Tyran Mincey, D.C. ABSTRACT Objective: To discuss the assessment, diagnosis, and chiropractic management of a 17-year-old female with anxiety. The relationship of hypoadrenia to anxiety disorders is hypothesized. Clinical Features: This patient complained of anxiety, nausea, amenorrhea, and fatigue (for seven years), and had been undergoing medical treatment with the drug Paxil for 15 months. The patient demonstrated orthostatic hypotension (Ragland"s sign) and a low breath-holding time (below 40 seconds). A salivary Adrenal Stress Index (ASI) measuring free cortisol demonstrated elevated A.M. cortisol levels and borderline midnight levels. Intervention and Outcome: A modification of the patient"s diet to correct the carbohydrate to protein ratio (75% of her calories were from carbohydrates). Treatment to the upper cervical spine (injury-recall technique, developed by Dr. Walter Schmitt), spinal manipulation determined by applied kinesiology testing, the addition of essential fatty acid (flax seed oil), adrenal gland nutritional support, probiotic supplementation, and treatment for candida albicans were given. After 6 months of treatment, the author reports that her anxiety, nausea, fatigue, and amenorrhea were corrected. Method of determining the patient"s status was not described. Conclusion: This paper suggests the importance of adequate treatment for adrenal stress disorder in cases of anxiety and fatigue. A larger patient cohort and single treatment protocols would help determine which therapy would be most beneficial in cases with anxiety disorder. (Collected Papers International College of Applied Kinesiology, 2004-2005;1:87-88) Key Indexing Terms: Anxiety Disorders; Amenorrhea; Adrenal Insufficiency; Nutrition Therapy; Case Reports; Kinesiology, Applied; Chiropractic THE IMMUNE SYSTEM: UNDERSTANDING T-HELPER CELLS Eric Pierotti, D.C., D.O., Ch.D (Adel) ABSTRACT Objective: The relevance of T lymphocytes to the response of the immune system is reviewed. A clinical finding of bilateral weakness of the infraspinatus or the middle deltoid muscle after challenging the mid- sternal area is correlated with T-helper 2 and T-helper 1 cell excess. Data Sources: Information was obtained from English language medical and scientific journals and medical/physiology textbooks relating to the immune system. Methods: A review of the standard AK methods of treatment for the immune system is given, as well as suggestions for nutritional support for immune system dysfunction. The key nutrients are identified and their mode of action discussed. Conclusion: This paper suggests that a key to correcting immune dysfunction is to balance the Th1 to Th2 ratio. A clinical protocol for diagnosis and treatment are outlined. The outcomes for patients receiving these treatment methods should be reported. (Collected Papers International College of Applied Kinesiology, 2004-2005;1:93-105) Key Indexing Terms: Immune System; T-Lymphocytes, Helper-Inducer; Clinical Protocols; Kinesiology, Applied SECONDARY GAIT REFLEXES OF THE HAND William H. Tolhurst, D.C. ABSTRACT Objective: To describe acupuncture treatment points on the hands that improve paired muscle group function on opposite sides of the body. These muscle groups are hypothesized to be active during ambulation and gait. Clinical Features: 10 patients from the author"s practice are examined who had weaknesses of muscles that are facilitated simultaneously in ambulation. Intervention and Outcome: The paired muscle groups that would test weak when tested together were as follows. The infraspinatus and/or teres minor and the contralateral piriformis muscles; the supraspinatus and contralateral tensor fascia lata; the teres major and contralateral gracilis; the biceps brachii and contralateral biceps femoris; the wrist flexors and contralateral soleus; and the subscapularis and contralateral pectineus muscles. Weaknesses in testing these muscles are successfully treated with acupuncture point stimulation (method of treatment was not described). Conclusion: The specific correlations between paired muscle weakness on testing and the acupuncture point treated by the author were not described, so this protocol could not be repeated as presented. The value of reflexes on the hands in relationship to paired muscle weakness in the muscles of ambulation should be explored more fully with treatment methods and outcome measurements more clearly identified. (Collected Papers International College of Applied Kinesiology, 2004-2005;1:109-112) Key Indexing Terms: Gait; Reflexes; Diagnostic Techniques; Clinical Protocols; Kinesiology, Applied; Chiropractic OVERACTIVE MERIDIANS AND FOOD SENSITIVITY TESTING Paul T. Sprieser, D.C., D.I.B.A.K. ABSTRACT Objective: To describe the effect of nutritional supplementation in patients with over-active meridians using applied kinesiology diagnostic methods. Clinical Features: A case series of 1,236 patients showing meridian involvement was evaluated, 827 women and 409 men. Intervention and Outcome: The over-active meridian identified using applied kinesiology methods was tested using the appropriate nutritional substances for the involved meridian (organ concentrates, vitamins or minerals). Treatment to the over-active meridian using non-nutritional methods (mid-day/mid-night law, connecting point, and other methods commonly used in AK) eliminated the need for nutritional support for the over-active meridian(s). Conclusion: During allergy or food sensitivity testing, the author cautions that nutritional treatment to an organ that has an over-active meridian may give a false-positive test during manual muscle testing because the nutrients may be reacting to the over-active meridian. The author suggests that appropriate treatment of all general meridian involvements will improve allergy and food sensitivity evaluations. A study including concurrent laboratory testing of patients with these problems and their outcomes from treatment would be valuable. (Collected Papers International College of Applied Kinesiology, 2004- 2005;1:115-116) Key Indexing Terms: Acupuncture; Meridians; Food Hypersensitivity; Outcome Assessment (Health Care); Kinesiology, Applied THE NEW ALARM POINTS FOR THE GOVERNING AND CONCEPTION VESSELS Paul T. Sprieser, D.C., D.I.B.A.K. ABSTRACT Objective: To present two new locations for the alarm points of the governing vessel (GV) and conception vessel (CV) meridians. Clinical Features: 110 patients were evaluated who had involvement of the governing and/or the conception vessel. The traditional alarm point for the governing vessel is GV-1 and for the conception vessel is CV-24. In applied kinesiology, the pulse point for the GV and CV is located on the palm surface of the forearm near the base of the thumb. The superficial point is the conception vessel and the deep point is the governing vessel. The associated muscles for these meridians are the teres major for the governing vessel and the supraspinatus for the conception vessel. Intervention and Outcome: The author consistently found over activity of the governing vessel and under activity in the conception vessel. This was surmised by testing the teres major (strong) and the supraspinatus (weak). Therapy localization to the new alarm points for the governing vessel CV-22, and conception vessel CV-2, would correct this pattern of testing. Conclusion: Two other alarm points are hypothesized for the governing and conception vessel meridians. Evaluation of this hypothesis using electro-diagnostic and other types of equipment for meridian evaluation would be valuable. (Collected Papers International College of Applied Kinesiology, 2004- 2005;1:119-120) Key Indexing Terms: Acupuncture Points; Meridians; Diagnosis; Kinesiology, Applied ICAK-USA Research The Following is a Compilation of Applied Kinesiology Research Papers Published in the Collected Papers of the International College of Applied Kinesiology for the year 2003-2004 -- Edited by Scott Cuthbert, D.C. ENDOMETRIOSIS: A CASE STUDY Glen P. Alis, D.C. and Supna Alis, D.C. ABSTRACT Objective: To discuss a case of symptomatic endometriosis in a female successfully treated with applied kinesiology chiropractic care. Clinical Features: A 25-year-old female presented with severe abdominal pain and cramping with her menstrual cycle, especially in the lower right quadrant. She also experienced pain with intercourse. This pain had been present for 2 months, and was rated a 10 on a pain scale of 1 to 10 (10 being worst). Her menstrual cramps had been present since the age of 12. A medical diagnosis of endometriosis had been given, and laproscopic surgery to remove endometrial and scar tissue were performed. Six months after the surgery, the symptoms returned with the same severity. Intervention and Outcome: AK examination revealed an open ileocecal valve, subluxations at the L3 and L5 vertebrae, and sacral misalignment. Chiropractic adjustments were made 1-2 times per week for one month. Orthostatic hypotension was found on initial examination. A diagnosis of estrogen dominance was made. Digestive supports and progesterone cream was given, and dietary modifications were made eliminating white flour and sugar, coffee and colas from her diet. An exercise program was begun to increase her strength and endurance. After one month her symptoms decreased significantly so that she did not have to miss work due to menstrual pain. She now feels minor bloating and discomfort with her menses but does not need medication for relief. Conclusion: This paper describes a method for treatment of a patient with endometriosis. Its applicability to other patients with this condition should be explored. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:1-2) Key Indexing Terms: Menstruation Disturbances; Endometriosis; Case Reports; Treatment; Chiropractic; Kinesiology, Applied MEDIAL EPICONDYLITIS: A CASE STUDY Glen P. Alis, D.C. ABSTRACT Objective: To describe a case of medial epicondylitis in a tennis player that was limiting his ability to play due to pain. The relevance of gait testing for elbow pain is explained. Clinical Features: A 48-year-old male presented with right medial elbow pain of six months duration. He played tennis 4-5 times a week, and his pain was definitely worse with his forehand and serve. After an hour of play, the sharp pain in his medial elbow prevented him from playing further. He received 2 cortisone shots that did not alleviate the problem. He was taking 4 Ibuprofen per day in order to continue playing. Intervention and Outcome: On initial examination, Cozen"s test was positive, as was a medial ligament stress test of the elbow. Manual muscle testing showed inhibition of the right bicep, right supraspinatus, right pronator quadratus, left popliteus, left tibialis posterior, and left rectus femoris, and these were treated. Subluxations of the T8 vertebrae and the left navicular bone were corrected. A nutritional supplement for ligament injury was given. Gait testing demonstrated improper muscle coordination, and after AK treatment for this problem the tenderness in the elbow was improved. The concept of ligament interlink in AK is presented, and in this case it improved the interaction between his left knee and right elbow. Dietary changes to improve his inflammatory response related to hypoadrenia were made. After 7 treatments over a 6-week period the patient felt 85% improved (patient"s self-assessment), and was able to play tennis for 2 hours with only slight discomfort. Conclusion: The value of this method of treatment for other cases of medial epicondylitis, especially in tennis players, should be investigated. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:3-4) Key Indexing Terms: Tennis Elbow; Tendinitis; Case Reports; Treatment; Kinesiology, Applied FUNCTIONAL TESTS AND TREATMENTS FOR MALE MENOPAUSE AND PENILE DYSFUNCTION Eugene Charles, D.C., D.I.B.A.K. ABSTRACT Objective: To review the male menopause and its symptomatology, and to offer methods of testing for endocrine imbalances. The nutritional needs related to the treatment of male menopause, prostatic hypertrophy, and penile dysfunction are described. Data Sources: Information was obtained from English language medical and scientific journals and medical/physiology textbooks. 36 articles related to the subject of this paper are listed in the references. Methods: A review of scientific literature regarding the vitamins, minerals, and herbs in the treatment of sexual dysfunction, prostate health, and aging in men is given. The review given suggests that zinc, essential fatty acids, saw palmetto, adrenal hormones, licorice, ginseng, and nitric oxide are needed for prostate health and adequate sexual performance. Symptom patterns and specific tests are described that purport to identify the need for these nutrients in the symptomatic patient. A male version of the Kegel exercises was described to alleviate mechanical pressures on the prostate and bladder. Conclusion: The functional tests offered in this paper do not diagnose a disease process but seek to identify functional problems with the pelvic and urogenital muscles, hormones, and biochemical impairments to the organs of the reproductive system in older males. Concurrent EMG, urological, and other diagnostic studies should be conducted concurrently to evaluate this method of diagnosis and treatment of male menopause, prostatic hypertrophy, and penile dysfunction. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:5-16) Key Indexing Terms: Andropause; Impotence; Prostatic Hyperplasia; Biochemical Phenomena, Metabolism, and Nutrition; Treatment; Chiropractic; Kinesiology, Applied OBJECTIVIZATION OF MANUAL MUSCLE TESTING THROUGH ANALYSIS OF THE DYNAMIC FORCE SPECTRUM Tatiana N. Chernysheva, M.D., Vladimir I. Korenbaum, Ph.D., Tatiana P. Apukhtina ABSTRACT Background: To study a new instrument designed to objectively measure manual muscle testing outcomes. Design: To design a force transducer EMG that measures the amplitude of low-frequency (less than 2 Hz) effort in the tested muscle. The portable dynamic force transducer that was used in the experimental trial was described. Method: 8 volunteers were recruited for testing. Therapy localization to specific reflexes was employed during the tests. The sequence of reflex points used was unknown to the examiner and the patient. Changes in muscle strength in the thumb and middle finger of the same hand were tested using the instrument. The same TL sequence to the same reflexes was then employed while testing the middle deltoid muscle using the instrument. In this test, the upper flange of the transducer was held by the examiner"s hand and the lower flange was put on the bend of the patient"s arm during the middle deltoid test. Results: When the examiner tested the eight patients" middle deltoid muscle after reflex stimulation, there was a 73.7% (K2 = 0.47) agreement between the instrumental reading of an inhibited muscle after therapy localization and the examiner"s reading. When the instrument was used alone to measure the muscle response of the thumb and middle finger, there was poor agreement 65.5% (K1 = 0.31). Conclusion: In the first measuring sequence there were several muscles involved in the test (thumb and middle finger), whereas in the second the middle deltoid was the only muscle tested. This study has research design and methodological problems that make understanding or reproducing its protocols problematic. The translation from Russian was poor. A future study should refine the framing of the research question, improve the method of testing, describe the results more clearly, and enlarge the number of participants. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:17- 22) Key Indexing Terms: Muscle Weakness; Evaluation Studies; Research Design; Instrumentation; Kinesiology, Applied CASE STUDY: ECZEMATOUS DERMATITIS AND THE DEEP TENDON REFLEX EXAMINATON Robert Ciprian, D.C. ABSTRACT Objective: A patient who sought chiropractic care for right ankle, knee, and low back pain was also successfully treated for eczematous dermatitis. Clinical Features: A 28-year-old male presented with basketball injuries to his right ankle, knee, and low back. For the past 1.5 years there was also an eczematous dermatitis present that was being treated with a topical prescription cream without success. The area of dermatitis and the medication prescribed were not given. Intervention and Outcome: Standard applied kinesiology care for a pelvic category III, category II, right lateral tibia, right lateral talus, right inferior navicular, right superior 1 st cuneiform and right lateral cuboid were corrected. The deep tendon reflex examination of Dr. Richard Belli was employed for residual low back pain, and treatment to L3 (posterior left subluxation listing) improved the patient"s low back, knee, and ankle pain. After the patients third visit, the pain in the ankle, knee and low back were improved, and the dermatitis had disappeared. Conclusion: This case demonstrated that structural corrections to spinal and extremity joints improved a patient with eczematous dermatitis. Further research on the mechanism of this type of therapy and larger patient cohorts would be valuable to evaluate if this system of treatment would be of benefit to larger groups of patients with eczematous dermatitis. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:23-24) Key Indexing Terms: Eczema; Treatment; Case Reports; Chiropractic; Kinesiology, Applied CASE STUDY: MULTIPLE SCLEROSIS Robert Ciprian, D.C. ABSTRACT Objective: To discuss the treatment of a female patient with multiple sclerosis who had been wheel chair bound for 2 years. Clinical Features: A 28-year-old female presented with low back pain. She was wheel chair bound. She showed considerable atrophy of the lower extremities, and had a decreased L4 reflex. Her toenails were discolored, brittle and flaking, and she had a fungal infection. On consultation it was discovered that the fungal infection began just before she started having the symptoms of multiple sclerosis. Intervention and Outcome: Treatment of a category III pelvic fault and treatment of the ileocecal valve reflexes were employed with spinal adjustments to positive areas of challenge. Nutrients given (using standard AK protocol) were: calcium lactate, Spanish black radish, Zymex II, SF 722 (10-undecylenic acid from castor oil). Nutritional instruction to remove sugar, wheat, corn, dairy, soy and fermented foods was given, and instructions to eat whole foods were advised. After 5 months of chiropractic care she was able to get out of her wheel chair and perform the activities of daily living and able to go to the bathroom by herself and to stand up in the kitchen sink to wash the dishes. Her L4 reflex was normal, she had a healthier appearance to her toenails, her digestion was improved, her lower extremity strength was improved ("60%," method of determining this not given), and 90% decrease in low back pain. Physical therapy was advised at this time to help improve the atrophy in her lower extremities. Conclusion: A number of other case reports on the treatment of functional disabilities in patients with multiple sclerosis using AK chiropractic methods are in the literature, and this research should be expanded. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:25-26) Key Indexing Terms: Multiple Sclerosis; Treatment; Case Reports; Chiropractic; Kinesiology, Applied APPLIED KINESIOLOGY MANAGEMENT OF NOCTURNAL ENURESIS: A CASE STUDY Cecilia A. Duffy, D.C., D.I.B.A.K. ABSTRACT Objective: To present the case of a 4-year old male who was successfully treated for nocturnal enuresis that had been present every night of his life. Clinical Features: This boy had never had a dry night and would also lose bladder control while napping during the day. He was otherwise toilet trained during waking hours. Intervention and Outcome: The patient was treated using applied kinesiology protocol eight times over a 5-month period. Manual muscle testing revealed a conditionally inhibited upper trapezius that became conditionally facilitated upon oral insalivation of Cataplex B (Standard Process Labs). The L5 and T4 vertebrae were anterior; a category II pelvic fault and sphenobasilar inspiration assist cranial fault were corrected. The volume of liquids the child consumed was to be recorded. 2-weeks later the child had 5 dry nights, and the daytime bedwetting was resolved. The patient had never experienced a dry night to this point. ADH levels were evaluated for diabetes insipidus, and were negative. Instructions to limit water consumption to 4 ounces per hour with no water consumption after 6 p.m. were given. An adrenal supplement was given also. Bilateral foot pronation was corrected. If the boy did not drink water after 6 p.m., the nighttime enuresis problem remained corrected. Conclusion: It appears that patients with nocturnal enuresis do undergo chiropractic treatment in practice. Consequently, this should be an area of research importance. More clinical trials using reliable diagnostic criteria and outcome measurements are needed. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:27-29) Key Indexing Terms: Enuresis; Manipulations, Spinal; Case Reports; Kinesiology, Applied THE INTRAOSSEOUS SUBLUXATION, ASSOCIATED POINTS OF ACUPUNCTURE, AND REDOX PROBLEMS Daniel H. Duffy, Sr., D.C., D.I.B.A.K. ABSTRACT Objective: The aim of this paper was to review the intraosseous subluxation described in applied kinesiology methods and to suggest that this subluxation is present at the associated points of meridians indicated by alarm point diagnosis. Methods: A review of the intraosseous subluxation, its examination and treatment, and its hypothesized relationship to the cranial rhythmic impulse, the Governing Vessel and Bladder meridians, and many other factors are discussed. A review of the author"s own experience with measurable improvements in patients" performance after correction of this subluxation is given. Results: The beneficial, often immediately observable results from the correction of the intraosseous subluxation was hypothesized to be related to the improvement in the function of meridians whose alarm points are affected by the intraosseous subluxation. Conclusion: Search for an intraosseous subluxation at the associated point of the involved meridian was recommended whenever acupuncture meridian imbalance is diagnosed using AK methods. Intraosseous subluxations should be considered a potential cause of meridian imbalances in patients. Clinical trials to evaluate this hypothesis are needed. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:31-36) Key Indexing Terms: Acupuncture Points; Meridians; Clinical Protocols; Manipulation, Spinal; Kinesiology, Applied ACID-BASE METABOLISM: A STUDY TO EVALUATE DIFFERENT MEASUREMENT METHODS (INCLUDING SUMMARY OF 5 CASE HISTORIES) Hans Garten, MED, D.I.B.A.K. ABSTRACT Objective: In this study a comparison is made of methods of acid-base measurements using the blood gas analysis method of Astrup, urine acid titration according to Sander, lactate measurement in venous blood, and the sensory provocation methods from applied kinesiology. Therapy for acid-base disturbances is described. Methods: The importance of the acid-base physiology in the blood is discussed, and a review of the literature on the various methods of measuring acid-base balance is given. The signs and symptoms of acidosis and alkalosis are described. Methods for diagnosing hyperacidic and hyperalkaline conditions in patients using applied kinesiology sensory provocation and manual muscle testing responses are delineated. 246 patients were part of this study, 190 of whom were patients at the pain therapy section of the department for anesthesiology and operative intensive care medicine of the Justus-Liebig-University in Giessen. 5 detailed case studies and applied kinesiology evaluation and treatment are described, and their outcomes are matched to the acid titration urinary tests of Sander. Results: Applied kinesiology sensory provocation testing was found to be the most consistently effective method for evaluating the specific acid-base imbalances of patients and the method that best enabled the physician to design a therapeutic program to improve their acid-base balance. Conclusion: Using specific chiropractic and nutritional therapy it was possible in these patients to reduce several types of metabolic stress that led to decreased acid elimination. This was one sign of correction of acid-base imbalances. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:41- 68) Key Indexing Terms: Acid-Base Imbalance; Acidosis; Alkalosis; Biochemical Phenomena, Metabolism, and Nutrition; Clinical Protocols; Urinalysis; Hematologic Tests; Kinesiology, Applied CASE STUDY: CHRONIC SEVERE CONSTIPATION CAUSED BY ASYMPTOMATIC L3-4 INTERVERTEBRAL DISC SYNDROME AND CLOSED ILEOCECAL VALVE William Maykel, D.C., D.I.B.A.K. ABSTRACT Objective: To describe the applied kinesiology management of a patient who had never moved his bowels and who had depended upon a weekly enema for his entire life. Clinical Features: A 13-year-old boy presented who had never moved his bowels on his own since birth. Medical x-rays were taken for diagnosis and treatment with mineral oils had not been effective. Intervention and Outcome: Physical examination revealed a bilateral sprain/strain of the sacroiliac joints, with a compression of the L3-4 intervertebral disc. The L3 vertebra was anterior, and there was a positive challenge suggesting a closed ileocecal valve. Palpation of the gallbladder showed tenderness, and the patient was counseled to eat beet greens. A correlation between bilaterally weak pectoralis clavicular muscles and hypochlorhydria was made. Intersegmental traction to the L3-4 disc along with corrective stretching exercises were given. He was told to increase his water-soluble fiber with papaya and apples, and told to avoid milk, corn, soy and wheat that were found to cause muscle inhibition with oral nutrient challenge. Correction to the lumbosacral spine and the closed ileocecal valve, along with nutritional treatment, corrected this young boy"s bowel pattern and by the fourth visit he was moving his bowels daily. Conclusion: Normalization of the lumbosacral plexus outflow to the gastrointestinal tract and specifically the ileocecal valve is hypothesized to be the effective factor in the treatment of a severe, life-long constipation. Many patients experience chronic constipation that visit chiropractic offices, and so further evaluation of this method of treatment is warranted. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:69-70) Key Indexing Terms: Constipation; Ileocecal Valve; Lumbosacral Plexus; Case Reports; Manipulations, Spinal; Kinesiology, Applied CASE STUDY: CORRECTION OF SEVERE HIATAL HERNIA COMPLAINTS IN A PATIENT WITH A CONGENITAL FAILURE OF SKELETAL MUSCLE GROWTH WITH RESULTANT SEVERE SCOLIOSIS William Maykel, D.C., D.I.B.A.K. ABSTRACT Objective: To describe the chiropractic care of a patient medically diagnosed with Werdnig-Hoffman disease (a spinal muscular atrophy), who had been unable to hold down food for five months previous to chiropractic treatment, and to discuss issues clinically relevant to this disorder. Clinical Features: A 13-year-old male with a medical diagnosis of Werdnig-Hoffman disease (type I, infantile) presented for chiropractic care related to a severe hiatal hernia. The patient was wearing a body cast made out of semi-dense foam, and presented in an electric wheelchair that he could operate with digital controls. At the age of 18-months the child received applied kinesiology cranial treatment that helped with his extreme weakness at the time. This allowed him to hold his head up and start to have normal bowel movements. The child had been previously given a prognosis of death before age 2. For 5 months prior to the treatments in this report, he would regurgitate his food with copious amounts of liquid upon eating just a few bites. Occasionally he could eat one meal within a two-day period. Intervention and Outcome: Due to the lack of muscle development in this child, surrogate testing as developed in applied kinesiology methods allowed for the AK evaluation of skeletal misalignment in this boy. Bilateral sacroiliac subluxations with a right inferior sacral base, right L3, left L4, right L5, C1 right, C2 left, C3 right were corrected. T9-L1 were found anterior with the ribs bilaterally lateral. A positive challenge to the diaphragm muscle was discovered. Origin-insertion technique and muscle spindle cell technique along with related neurolymphatic reflexes were performed to strengthen the diaphragm, abdominal, and major pelvic muscles. The patient responded well to the interventions a nd was able to swallow an entire meal without side effects. He was treated through age 18, and graduated from college with a major in psychology and a minor in special education. Conclusion: In the remarkable outcome presented in this case report, there is evidence of precise biomechanical and neurological individuality. As a result, this patient only responds to a singular form of adjusting and may have failed to respond to others. Apparently, this young man with type I, infantile Werdnig-Hoffman disease was in this category. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:71-73) Key Indexing Terms: Spinal Muscular Atrophies of Childhood; Hernia, Hiatal; Muscle Weakness; Manipulation, Spinal; Kinesiology, Applied CASE STUDY: CRYPTORCHIDISM CORRECTION WITH CONSERVATIVE CHIROPRACTIC APPLIED KINESIOLOGY William Maykel, D.C., D.I.B.A.K. ABSTRACT Objective: To describe the case of an infant with a congenital right inguinal hernia and undescended testicle (cryptorchidism) who received chiropractic treatment prior to surgery. Clinical Features: The parents of a nine-month old child sought a second opinion for their child diagnosed one week earlier with a right inguinal hernia and undescended testicle. The child was born vaginally without difficulty, although he was six weeks premature. Intervention and Outcome: Due to the age of this child, surrogate testing as developed in applied kinesiology methods allowed for evaluation of skeletal misalignment in this infant. A bilateral sacroiliac sprain was corrected using gentle respiratory adjustments to correct the misaligned pelvic joints. The author describes a right inferior sacral base, right L3, left L4, right L5, C1 right, C2 left, C3 right vertebral subluxation complex to arise with the sacroiliac sprain, and these were corrected also. The thoracolumbar junction was also rotated at T10-12, and corrected. These corrections were performed one week apart with complete resolution of the cryptorchidism after the second visit. Conclusion: There are indications that patients suffering from cryptorchidism (undescended testicle) may benefit from a holistic chiropractic approach that not only includes examination and care to the primary areas of complaint (e.g. inguinal hernia and undescended testicle) but also potentially from significant pelvic subluxation concomitants. Since surgery is the only current approach, and the applied kinesiology method is conservative and cost-effective, further validation studies should be undertaken due to the global increase in this condition. (Collected Papers International College of Applied Kinesiology, 2003- 2004;1:75-76) Key Indexing Terms: Cryptorchidism; Hernia, Inguinal; Manipulations, Spinal; Case Reports; Chiropractic; Kinesiology, Applied THE PINEAL CRANIAL FAULT Paul T. Sprieser, D.C., D.I.B.A.K. ABSTRACT Objective: This study investigates a hypothesized relationship between a particular cranial fault, the pineal gland, and melatonin metabolism. Design: Prospective case series. 78 patients recruited from the practice of the treating clinician. Intervention and Outcome: The patients" tensor fascia lata muscles were tested supine, with simultaneous crossed thumb therapy localization (TL) to the cruciate suture of the maxillary bones. In these patients, an inhibition of the muscle was found with therapy localization and a particular phase of respiration (inspiration or expiration) would negate the inhibition. A particular cranial vector of correction would be sought in these patients, the contact point being from the center of the palate with the index finger and an open hand contact on both mastoid processes simultaneously. The direction of correction for both hands would be the direction that caused the greatest muscle inhibition on challenge. A figure 8 motion of the palate hand, and a clockwise or counter clockwise motion of the hand on the occiput for 40 seconds were needed to achieve correction. It was also found that pineal gland and melatonin nutritional extracts would also negate the positive TL to the cruciate suture. Conclusion: The results of this prospective case series indicate that this particular cranial fault may be associated with the pineal gland and melatonin metabolism. Specific biochemical measurements and more precisely documented outcomes from the treatment given should be measured and described in future studies. Further research into this method of evaluation and treatment, and into the proposed physiology of the mechanisms involved is warranted. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:75-76) Key Indexing Terms: Pineal Gland; Melatonin; Case Reports; Musculoskeletal Manipulations; Kinesiology, Applied CRITERIA FOR ACCURATE MANUAL MUSCLE TESTING AS USED IN APPLIED KINESIOLOGY PRACTICE Hans Boehnke, D.C., D.I.B.A.K. ABSTRACT Introduction: For years, applied kinesiology chiropractors have used the term muscle tests as one of their most important methods for examining patients. There are a number of descriptions of the basic manual muscle test in AK, and this paper presents them and attempts to delineate their differences. Purpose: To seek a nomenclature for three differing types of muscle tests presently in use by applied kinesiologists, and to seek consensus in the terminology used to describe manual muscle testing outcomes. This paper seeks to investigate the rationale behind three differing forms of muscle testing and to present possible theories for their existence and their clinical value. The three types of muscle testing described are: Examiner Started Manual Muscle Testing (EsMMT), Patient Started Manual Muscle Testing (PsMMT), and Patient Started sub-maximum Manual Muscle Testing (PsMMTsm). The criteria used to determine manual muscle testing outcomes are described. Discussion: While there have been no definitive studies comparing the use of these different types of manual muscle testing as a diagnostic and treatment modality, there have been some reported case studies which support its value. Conclusion: Future research is necessary to further understand these differing types of manual muscle testing methods that are already partially accepted in the applied kinesiology chiropractic community. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:89-97) Key Indexing Terms: Terminology; Muscle Weakness; Kinesiology, Applied; Chiropractic DIFFERENTIAL DIAGNOSIS USING APPLIED KINESIOLOGY METHODS IN A CASE OF LONG-TERM HEAD PAIN Scott C. Cuthbert, D.C. ABSTRACT Objective: A patient presenting with constant, daily headaches for the previous 7 years that had been increasing in severity is successfully treated with applied kinesiology chiropractic care. The patient had numerous causative components to her symptomatology, and the methods used to diagnose these varying factors are described. Clinical Features: A 56-year-old nurse presented with constant, worsening headaches after several severe automobile accidents. In the first one 7 years previous, she was rear-ended and her car was thrown 70 feet forward. She heard a loud popping in her spine that made her think she had broken her neck. For 7 ½ months after the first accident she was unable to work or to lift her head from the pillow. Intervention and Outcome: Hautant"s and Freeman-Wycke"s proprioceptive tests revealed postural embarrassment. Dramatic muscle weakness on testing was found (Grade 3 as graded in the Guides to the Evaluation of Permanent Impairment, 4th Edition by the American Medical Association). Cranial corrections strengthened the sternocleidomastoid and deep neck flexor muscles, removed positive challenges to the TMJ, removed the positive ocular lock, finger-to-finger, finger-to-nose, Hautant"s and Freeman-Wycke"s tests, and allowed for manipulation of the patient"s occiput and cervical spine. An upper cervical fixation, T1-T2 subluxation, treatment to the foot, and a category II pelvic fault were corrected. At the end of the patient"s first treatment her headache was gone. This was the first time she had felt no head pain in over 7 years. Over the next 2 weeks the headaches stayed at the 1-2 level on the VAS, and after 8 visits all of her symptomatology was gone. Conclusion: This case demonstrated that mechanical faults, especially when present for long periods, could disturb proprioceptive signaling from the eyes, the cervical spine, and the vestibular mechanism. Evaluation and treatment of these mechanisms were possible using AK methods, and were successful in resolving intense symptoms relatively quickly. Consequently, further investigation of this type of chiropractic treatment for patients with severe, long-term head pain is warranted. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:113-117) Key Indexing Terms: Headache Disorders; Pain, Intractable; Whiplash Injuries; Cranial Neuropathies; Proprioception; Case Reports; Musculoskeletal Manipulations; Kinesiology, Applied; Chiropractic THE ANTERIOR-INFERIOR SACRUM: SUTHERLAND"S DEPRESSED SACRUM REVISITED Scott Cuthbert, D.C. ABSTRACT Objective: To review the anatomy, etiology, and symptoms associated with an anterior-inferior sacral subluxation and to discuss the diagnosis and treatment of this condition using applied kinesiology methods. A historical parallel to the importance of this sacral fault in the writings of William Garner Sutherland, D.O. is presented. Data Source: The following were searched for information relevant to the anterior inferior sacral subluxation: the AK literature, the writings of Major Bertrand DeJarnette, D.O., D.C., William Garner Sutherland, and the Index to Chiropractic Literature. Results: The anterior-inferior sacral subluxation is frequently found in new mothers. Post-partum neurosis and depression are frequently improved by correction of this sacral fault in the literature reviewed. Production of this fault may occur traumatically with falls onto the buttocks, or during delivery of a child when the pelvic diameter is increased and the ligaments of the pelvis are relaxed. Mother"s in the lithotomy position during delivery may strain the sacral base anteriorly and inferiorly, especially when the obstetrician applies traction to the baby"s head. Conclusion: A definitive diagnosis can best be made using the clinical tests described in this paper, and conservative treatment can be effective in treating this musculoskeletal problem of the pelvis. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:119-124) Key Indexing Terms: Sacrum; Sacroiliac Joint; Pelvic Pain; Pelvic Floor; Treatment; Kinesiology, Applied; Chiropractic THE PIRIFORMIS MUSCLE AND THE GENITO-URINARY SYSTEM: THE ANATOMY OF THE MUSCLE-ORGAN-GLAND CORRELATION Scott Cuthbert, D.C. ABSTRACT Objective: To review the anatomy, etiology, and symptoms associated with the genito-urinary system and to discuss the diagnosis and treatment of problems associated with it using applied kinesiology methods. The consistency in AK of specific muscle dysfunction with specific organ or gland dysfunction is described. Data Source: The following were searched for information relevant to the genito-urinary system and its chiropractic evaluation and treatment: MEDLINE, the AK literature, chiropractic, osteopathic and medical textbooks, and the Index to Chiropractic Literature. Results: Because of the communication systems in the body between the nervous, circulatory, and muscular tissues, a disturbed portion of the musculoskeletal system may impair the function of other tissues and organs. In the paper the focus was on the genito-urinary system and its communication with the nerves and blood vessels of the piriformis muscle area. In AK, each of the endocrine organs has been given specific diagnostic tests, therapeutic protocols, nutritional correlations, and treatment monitoring methods. The endocrine organs are controlled by the nervous system, and this is hypothesized to be the reason chiropractic has been helpful with several endocrine-related disorders. Conclusion: The hypothesis of this paper is that using manual muscle testing, the physician may evaluate and work directly with the position, motion, innervation, nutritional needs, and tissues of the genito- urinary organs and their adjacent and supportive tissues. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:125-140) Key Indexing Terms: Urogenital System; Urogenital Abnormalities; Diagnosis, Differential; Musculoskeletal Manipulations; Kinesiology, Applied; Chiropractic THE OTHER 49% OF THE 51%er Stephen C. Gangemi, D.C. ABSTRACT Objective: In applied kinesiology manual muscle testing, a 51%er occurs when the patient therapy localizes to one of the 5-factors of the I.V.F. and a muscle weakens. The 5-factors of the I.V.F. that may need treatment include the nerve, the blood vascular, lymphatic, cerebrospinal fluid, and acupuncture meridian systems. Another reason for the 51%er phenomenon is described. Methods: The hypothesis of this paper is that a muscle that tests strong, but weakens with TL to one of the I.V.F. factors, weakens due to an injury that needs to be treated using Injury Recall Technique, a method developed by Dr. Walter H. Schmitt to remove the memory of trauma from tissues. The 51%er may also be due to a need to treat an immune system problem first. Results: The method of testing for an I.R.T. related 51%er muscle is to perform autogenic facilitation (stretching the muscle spindle cell). If the muscle does not strengthen, then an injury is suspected and I.R.T. evaluation performed. The immune system involvement is suspected if autogenic facilitation strengthens the muscle as it should, yet immune system muscles are found weak or are made weak using the visceral referred pain (VRP) challenges described by Dr. Schmitt. Conclusion: A 51%er indicates that the muscle should not be treated until the reason for the 51%er phenomenon in the muscle is resolved. The reasons for the 51%er findings are hypothesized to be injuries and/or immune issues and that should be treated first. Treating the injuries and/or immune system involvements first will either resolve the 51%er muscle phenomenon, or resolve the muscle inhibition altogether. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:163-165) Key Indexing Terms: Muscle Weakness; Diagnosis, Differential; Treatment; Kinesiology, Applied; Chiropractic THE THYMUS VISCERAL REFERRED PAIN AREA Stephen C. Gangemi, D.C. ABSTRACT Objective: Somatovisceral and viscerosomatic reflexes are well accepted in the research literature. Visceral referred pain (VRP) areas on the body wall exist for most of the organs of the body. The location of the thymus gland"s VRP is proposed. Methods: The neurolymphatic reflex (NL) for the thymus gland, as reported by Dr. Walter H. Schmitt, is over the right 4th-6th ribs between the axillary and midmamillary lines. The VRP area for the thymus is reported to be over the right first rib area both anterior and posterior. Results: If there is positive TL to the NL for the thymus, then determining whether the organ needs more sympathetic or parasympathetic stimulation is determined. Muscle weakness as a result of rubbing the VRP for the organ indicates a need for a net parasympathetic response, and muscle weakness as a result of pinching the VRP for the organ indicates a need for a net sympathetic response. Conclusion: The thymus gland, along with the spleen and the gut associated lymph tissue (GALT), account for the majority of the immune system. A hypothesized VRP for the thymus gland is described, and a method for evaluating the thymus gland"s functional state is offered. Outcome studies for this method of evaluation and treatment are necessary. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:167-168) Key Indexing Terms: Thymus Gland; Reflex, Abnormal; Diagnosis, Differential; Treatment; Kinesiology, Applied; Chiropractic INJURY RECALL TECHNIQUE REVISITED James D.W. Hogg, D.C., D.I.B.A.K. ABSTRACT Objective: To present three cases where the Injury Recall Technique (I.R.T.) of Dr. Walter H. Schmitt was employed successfully. Methods: The I.R.T. addresses withdrawal reflex muscular imbalances that may persist in patients long after the original injury. The protocol for diagnosis and treatment using I.R.T. are described. Results: A patient with a thick, ropy, and tender to palpation scar from a cesarean section surgery 16- years previous was treated with I.R.T. 6 months later the scar was barely palpable and no longer tender to pressure, and after treatment there was long lasting improvement in her abdominal muscle strength. A second patient had extensive scoliosis surgery, with a scar from T3 to L5 that produced numbness along the length of the scar. I.R.T. treatment was given to her and the numbness was relieved. A third patient had three corneal transplants. After the last surgery, he had a "wrinkle" across his field of vision. I.R.T. treatment was given to both eyes. Three weeks later the patient reported that his vision had gone blurry a few days before for 30 minutes and then cleared. He reported that the "wrinkle" across his visual field was gone and his eyesight was better than it had been since the last surgery. Conclusion: The author"s report suggests that I.R.T. is useful when applied to poorly healed areas of scar tissue. Patients visiting chiropractors frequently have surgical scar tissue, and so this method of treatment warrants further investigation and outcome studies. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:169-172) Key Indexing Terms: Cicatrix; Pain; Treatment; Kinesiology, Applied; Chiropractic ADRENAL AND INSULIN RELATED DISORDERS: MORE COMPLEX THAN WE THOUGHT Datis Kharrazian, D.C., M.S., D.A.C.B.N., C.N.S., C.C.N., C.S.C.S., C.C.S.P. ABSTRACT Objective: To present information regarding the complex web of physiological alterations that take place with adrenal and insulin related disorders. The interactions between insulin and cortisol and their impact on human physiology when abnormal are described. The clinical methods of evaluating these hormonal phenomena, and a review of the scientific literature in regard to natural compounds that help support these patterns of imbalance are described. Methods: 238 references from the medical, physiological, pathological, endocrine, nutritional, biochemical, pharmacological, and neurological scientific literature are cited and reviewed. Results: Due to the complexity of insulin and cortisol related disorders a number of vicious cycles and imbalances are created that have a major impact on human physiology. A review of the natural compounds that improve insulin resistance and adrenal function are given, and specific tests developed in AK and using other biochemical assays for evaluating the functional state of the adrenal glands and the pancreas are reviewed. Conclusion: Insulin resistance and blood sugar handling disorders affect 25-35% of western populations, and contribute to diabetes, cardiovascular disease, sleep apnea, hormone metabolism disorders, obesity, and certain types of cancer. This problem is multi-factorial, and so it is naïve to think of adrenal and insulin related problems as having a single origin and a single cure. Outcome studies of this method of treatment using concurrent bio-chemical testing on the patients treated would be invaluable. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:173-201) Key Indexing Terms: Adrenal Insufficiency; Metabolic Syndrome X; Insulin; Cortisol; Biochemical Phenomena, Metabolism, and Nutrition; Clinical Protocols; Treatment; Kinesiology, Applied; Chiropractic AN INTERESTING INTERLUDE – A CASE STUDY George N. Koffeman, D.C., D.I.B.A.K. ABSTRACT Objective: To describe the case of a 67-year-old man who had been in a coma for 22 days following severe head trauma. The case is described chronologically and his response to chiropractic treatment is reported. Methods: The doctor visited the patient in the hospital; he had pneumonia and a tracheal tube inserted as well as a stomach tube for feeding. A diagnosis of massive brain damage had been given. Due to the patient"s inability to respond, his wife was tested as a surrogate for manual muscle testing response. TL found positive contacts at the neurovascular (NV) reflex on the left frontal bone, a stress receptor for the supraspinatus on the left, and a cranial adjustment (described as "hemispheric" and determined by the height of the eye sockets) was given. Results: Within 2 minutes of receiving this treatment, the respiratory rate fell to 19 from 33 per minute, heart rate dropped to 89 from 128, and the rhythm became regular, where it had been spiking every 6 to 10 beats. The next day the patient recognized the doctor and the patient signaled to him by squeezing his left hand. The previous day"s surrogate testing routine was now negative. A left-sided temporal tap correction with the suggestion of complete and rapid recovery was given to the patient. The next day the patient had made so much progress that he was moved to a rehabilitation hospital. The patient was still completely paralyzed on the right side – arm and leg. A NV reflex near the junction of the sphenoid, temporal, and parietal bones on the side opposite of the paralysis was treated for over 20 minutes. At 21 minutes the patient reached up and removed the doctor"s hand with his left hand. 15 minutes later, he bent his right elbow and laced his fingers together with his left hand and crossed his right leg over his left at the ankle. 15 days later the tracheal tube had been removed, and he was eating on his own. After 2 months the patient was going to physical therapy 2-3 times per week. He is given chiropractic treatment once per week. His right arm still has spastic flexion paralysis and did not respond fully. Conclusion: Surrogate testing is used with patients who are unable to perform manual muscle testing. In this case, treatment determined using surrogate testing appeared to assist this patient recover from partial paralysis and coma. Further treatments of patients in this condition, often considered hopeless, may be warranted. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:203-205) Key Indexing Terms: Coma; Case Reports; Treatment; Kinesiology, Applied; Chiropractic NEUROTOXICITY AND ELEVATED HOMOCYSTEINE: THE ROLES PLAYED BY HOMOCYSTEIC ACID, ASPARTATE AND GLUTAMATE AND ACTIVATED FORMS OF FOLIC ACID, VITAMIN B-12, AND VITAMIN B-6 Walter H. Schmitt, D.C., D.I.B.A.K., D.A.B.C.N. ABSTRACT Background: High concentrations of homocysteine and homocysteic acid (a neurotoxin) and low concentrations of nutrients necessary for its conversion are frequently observed in subjects with neurological symptoms. Objective: To describe applied kinesiology methods for diagnosing imbalances in homocysteine levels, and to offer methods for treatment. Methods: In patients with neurological problems related to elevated homocysteine levels, patients were found to have muscle inhibitions following oral insalivation of homocysteine. The metabolism of homocysteine is described, as well as the nutrients necessary for the conversion of homocysteine into amino acids. The procedure for diagnosis and treatment of these factors is described. Results: The three-pronged approach of nutritional supplementation, neurotoxic substance elimination, and the use of Visceral Challenge Technique help return difficult patients to normal function. The VCT was described in a previous paper for the ICAK, 1999-2000;1:141-148. Conclusion: The author warns that patients with neurological symptoms related to elevated homocysteine/homocysteic acid are sensitive to aspartame and glutamate. Avoidance of these substances, for these patients, is necessary for full recovery. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:211-215) Key Indexing Terms: Homocysteine; Neurotoxicity Syndromes; Biochemical Phenomena, Metabolism, and Nutrition; Clinical Protocols; Treatment; Kinesiology, Applied; Chiropractic THE SOMATIC WINDOW ON NEUROLOGICAL FUNCTION – PART 2. INDUCING PATTERNS OF OVER FACILITATION TO EVALUATE CORTICAL HEMISPHERIC DOMINANCE PATTERNS Walther H. Schmitt, D.C., D.I.B.A.K., D.A.B.C.N. ABSTRACT Objective: To outline procedures for assessment and treatment of cerebral cortical hemispheric imbalances. The author, a diplomate chiropractic neurologist, describes the neurological, somatic, and muscle testing consequences of cortical hemispheric imbalances. Methods: The assessment of cortical functional status may be assessed by Weber"s test, comparing passive range of motion right to left, right to left pupillary light response, and many other autonomic assessments. Right cortex challenges are inducing right brain activity (humming/music); right nostril olfaction; meaningful left distal extremity movement; left visual field stimulation (eyelights). Left cortex challenges are inducing left brain activity (counting/math); left nostril olfaction; meaningful right distal extremity movement; right visual field stimulation (eyelights). After the cortex challenge, manual muscle tests are performed to assess the functional neurological state of the cortex. Results: The side of hemispheric dominance will demonstrate increased muscle tone on the same side (demonstrated by failure of autogenic inhibition to the muscle, as described by Richard Belli, D.C.). Right sided cortex dominance will produce an open ileocecal valve finding (also increased parasympathetic function on the right); and left sided cortex dominance will produce an open Houston Valve finding (also increased parasympathetic function on the left). Conclusion: The integration of applied kinesiology principles with the principles of chiropractic neurology may help the physician to get a more complete view of a patient"s cortical neurological status. In so doing, these therapies are suggested to help the patient achieve their optimal improvement in neuron metabolic function, and to overcome the problems created by cortical hemispheric dominance. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:217-226) Key Indexing Terms: Dominance, Cerebral; Autonomic Nervous System; Diagnostic Techniques and Procedures; Clinical Protocols; Treatment; Kinesiology, Applied; Chiropractic THE SOMATIC WINDOW ON NEUROLOGICAL FUNCTION – PART 3. ENCEPHALIC TRANSNEURAL DEGENERATION: THE CAUSE OF MANY TMJ PROBLEMS AND BILATERAL JOINT PROBLEMS Walter H. Schmitt, D.C., D.I.B.A.K., D.A.B.C.N. ABSTRACT Objective: To review the concepts of transneural degeneration (TND). Assessment and treatment procedures for this problem are outlined. The paper primarily focuses on the clinical effects of TND that arise from the mesencephalic nucleus of the trigeminal nerve and the parabrachial nucleus of the brainstem. The neuroanatomy of the mesencephalon is reviewed. Methods: TND is an established metabolic phenomenon that affects many motor functions that are commonly identified by AK MMT procedures. TND is associated with the metabolic effects on neurons when they no longer receive adequate stimulation of their cell membrane receptors to keep the neurons metabolically healthy, such as occurs in cases of deafferentation. Results: Restoration of TND neurons to normal metabolism depends on supplying the neurons with: 1) oxygen, 2) fuel (glucose and substances necessary for its oxidative phosphorylation), and 3) stimulation. Since the TMJ significantly relates with the mesencephalon, AK challenges to the TMJ are suggested to evaluate mesencephalon status. If TL to the TMJ is positive, and the TL is negated by a) slow stretch of the contralateral distal flexors, b) ipsilateral cortical activity, c) contralateral hemifield stimulation, d) oxygen, or e) mesencephalon homeopathic supplement, then mesencephalon treatment for TND is initiated. Treatment involves a) slowly stretching the patients contralateral distal flexors (toes and ankle, fingers and wrist), b) patient performs ipsilateral cortex activity (humming, math), c) perform contralateral hemifield stimulation (Eyelights), d) patient is instructed to move the TMJ through all ROMs. Following mesencephalic rehabilitation procedure, recheck challenge procedure. Conclusion: A disturbed mesencephalon due to TND explains many TMJ symptoms that are often bilateral in nature, with mental/emotional sequelae autonomic in nature, and related to difficult stomatognathic symptoms. Outcome studies of this treatment method are warranted considering the neurological importance of the areas discussed in this paper. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:227-233) Key Indexing Terms: Spinocerebellar Degenerations; Neuron Degeneration; Mesencephalon; Diagnostic Techniques and Procedures; Treatment; Kinesiology, Applied; Chiropractic REOCCURRING PITCH PATTERN AND THE FRONTAL FAULT Paul T. Sprieser, D.C., D.I.B.A.K. ABSTRACT Objective: To present the hypothesis that the PRY-T distortion pattern will recur in some cases until a subtle frontal bone cranial fault correction is made that the author reports will eliminate the recurrence. Methods: This study is a retrospective analysis of 25 cases that had recurring PRY-T distortions. The PRY-T is an AK examination technique of the major body modules and their ability neurologically to function individually and together. It is an acronym derived from an airplane"s attitudes: pitch, roll, yaw, and tilt. In these cases, the author searched for faults that still remained in these patients and found that a subtle cranial fault of the frontal bone was present, using the Eye Into Distortion method of testing. When the pitch pattern was discovered, the doctor had the patient TL the involved side of the frontal bone. This negated the positive pitch test, and suggested to the author the connection between PRY-T and frontal cranial faults. Results: The author has found that recurring modular distortions in patients, diagnosed using the PRY-T method in AK, frequently correlated with frontal cranial faults and that once the cranial fault was corrected, recurrence of the PRY-T was eliminated. Conclusion: The presence of a subtle frontal bone cranial fault in patients with recurring PRY-T modular distortions was reported. Correction of the frontal bone cranial fault improved the treatment outcomes for these patients. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:235-236) Key Indexing Terms: Musculoskeletal Abnormalities; Clinical Protocols; Diagnosis; Treatment; Kinesiology, Applied; Chiropractic SUPRASPINATUS MUSCLE AS AN INDICATOR OF BRAIN SEROTONIN LEVELS Paul T. Sprieser, D.C., D.I.B.A.K. ABSTRACT Objective: To present the hypothesis that the supraspinatus muscle may be inhibited bilaterally in patients with low serotonin levels and depression, general anxiety syndrome, obsessive-compulsive disorders, and phobias. Patients taking serotonin reuptake inhibitors (SSRI) like Prozac may have this physical finding also. A discussion of the biochemistry of serotonin and its function in the brain is presented. Methods: This study is a retrospective analysis of 226 patients, 132 females and 94 males. The patients were asked to bring the medication that they had been prescribed for their psychological problems that included Zoloft, Wellbutrin, Paxil, Prozac, Effexor, Remeron, Elavil, Norpramin, Depakote, and Tofranil. The author also tested St. John"s Wart and SAMe. Results: The author found the supraspinatus muscle to be inhibited bilaterally in each of the patients. The muscle was found to strengthen when the proper medication or alternative therapy was put in the patient"s mouth. The method of assuring whether the supplement, therapy, or medication was the "proper therapy," and whether the psychological condition was ameliorated, were not described. Conclusion: In this study using the supraspinatus muscle on a select population, a correlation was established between bilateral weakness of this muscle and patients with a clinical profile of depression and low serotonin levels. There was no definite correlation in this study between changes in these patients" supraspinatus muscle function and professional psychological testing to demonstrate their improved psychological state. This test may offer mental health practitioners another objective tool to measure their progress with treating patients with mental disorders. Further study of this clinical information is needed to identify the clinical relevance of this finding. (Collected Papers International College of Applied Kinesiology, 2003-2004;1:237-239) Key Indexing Terms: Serotonin Uptake Inhibitors; Depression; Case Reports; Muscle Weakness; Diagnosis; Treatment; Kinesiology, Applied; Chiropractic ICAK-USA Research The Following is a Compilation of Applied Kinesiology Research Papers Published in the Collected Papers of the International College of Applied Kinesiology for the year 2002-2003 -- Edited by Scott Cuthbert, D.C. 50 ARTHRITIS – A CASE STUDY John Erdmann, D.C. ABSTRACT Objective: To discuss a case of symptomatic arthritis of the left hip and knee in a male successfully treated with applied kinesiology chiropractic care. Clinical Features: This patient had experienced gout one year previous, and was taking two blood pressure medications, a herpes medication as needed, and glucosamine-chondroitin supplements. A symptom survey form was completed and found cardiovascular and parasympathetic areas to be primary. The method for determining this, or a discussion about the symptom survey"s validity as a measurement tool, is not described. An acoustic Cardio Graph showed a depressed S1 sound in all valves, and a decreased separation of the heart sounds at the aortic valve. Another observation, "liver and adrenal stress predominant in the mitral valve area" was not explained. A positive Ragland"s sign, and an acidic urinary and oral pH were present, as well as a positive zinc tally test. Intervention and Outcome: The patient was adjusted on three visits in a two-week period focusing on spinal fixations. Kidney meridian acupressure and vitamin A supplementation was given. Chiropractic adjustments were given to the occiput, C1, L3 and sacrum, including Category I and II pelvic blocking. Cardio-Plus (S.P.), HCl acid, and zinc supplementation were also dispensed to the patient. Patient was restricted from eating corn as identified by a supraspinatus muscle weakening to lingual tasting of corn. On the second visit, the patient reported slight improvement. After three visits, the patient had no arthritic pain in his knees and hips. 3 weeks later the patient showed significant improvements on the Acoustic Cardio Graph and the patient remained symptomatic. Conclusion: Because applied kinesiology treats the entire person, the discovery of the precise mechanism of clinical improvement in a case like this one is difficult. However, there are many simultaneous physiological problems occurring in our patients, and it may be that treatment of all of these are required to restore the patient to full function. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:15-16) Key Indexing Terms: Arthritis; Knee; Hip; Case Reports; Treatment; Chiropractic; Kinesiology, Applied LOW ENERGY – A CASE STUDY John Erdmann, D.C. ABSTRACT Objective: To discuss a patient presenting with numerous symptoms including low energy, shoulder, knee and heel pain. 51 Clinical Features: This 36-year-old male had asthma since childhood, flat feet, and is lactose intolerant. A symptom survey form found environmental and food sensitivity, B vitamin need, and adrenal dysfunction. An Acoustic Cardio Graph discovered aortic and mitral valve agitation associated with allergy and "adrenal spikes," indicating possible cortisol imbalance. Ocular lock testing was positive, with positive TL to the atlas vertebra. Intervention and Outcome: The patient was adjusted 9 times. The right acromio-clavicular joint was adjusted, the proximal ulnar and lunate bones also. Both feet were adjusted, with fascial flush and spindle cell techniques to the plantar fascia. The feet were taped after adjustment and the patient was instructed to tape his feet for the following 2 weeks. Nutritional support to the adrenal glands was given. He was instructed to avoid dairy, sugar, bread, and drink more water. By the 3 rd visit the patient had no knee or heel pain. On the 8th visit, the patient remained free of pain with increased energy. Conclusion: Because applied kinesiology treats the entire person, the discovery of the precise mechanism of clinical improvement in a case like this one is difficult. However, there are many simultaneous physiological problems occurring in our patients, and it may be that treatment of all of these are required to restore the patient to full function. The use of the "standard symptom survey form" and the Acoustic Cardio Graph in patient evaluation and treatment should receive further research since they were helpful in the case described here. (Collected Papers International College of Applied Kinesiology, 2002- 2003;1:17-18) Key Indexing Terms: Abnormalities, Multiple; Case Reports; Treatment; Chiropractic; Kinesiology, Applied HIDDEN SUBLUXATIONS George N. Koffeman, D.C., D.I.B.A.K. ABSTRACT Objective: To describe a method of discovering subluxations that remain in the patient after all major corrections have been made. Clinical Features: Using a DeJarnette (the founder of Sacro-Occipital Technique) occipital and upper trapezius chart, a method of therapy localization was devised to discover subluxations that, in the author"s experience, eliminated the subjective complaints patients sometimes have after major spinal corrections. Intervention and Outcome: When a patient complains of a persisting pain after treatment, the author advises palpation of the upper trapezius and occipital fibers described in S.O.T. Where tenderness is elicited, the patient is asked to TL this point. If it weakens, the doctors challenges from coccyx to the occiput to find the area that abolishes the TL weakness. Correction of the subluxation found will abolish positive TL to the occipital or trapezius fiber. According to the author, this removes persisting pains in the patient by discovering and correcting remaining subluxations. Conclusion: This system of analysis and treatment should be evaluated with outcome studies and other objective measurements of response to the treatment outlined here. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:23-24) 52 Key Indexing Terms: Clinical Protocols; Manipulation, Spinal; Kinesiology, Applied COMMENTS ON UTILIZING SOME OF THE CONCEPTS OF JANDA David Leaf, D.C., D.I.B.A.K. ABSTRACT Objective: To discuss the applied kinesiology application of one of the findings of Vladimir Janda in his book "Muscles as a Pathogenic Factor in Back Pain." Clinical Features: Weakness of the flexor and/or extensor hallucis muscles of the foot can produce a short stride and a failure of the patient to toe-off during the gait cycle. According to Janda, a kinematic chain of muscles will be short or hypertonic as a result of mechanical problems. This can be demonstrated using AK MMT methods. This foot problem may produce hypertonicity of the gastrocnemius, hamstrings, thigh adductors, rectus femoris, iliopsoas, tensor fascia lata, some of the trunk extensors, especially in the upper lumbar and neck region, quadratus lumborum, the sternoclavicular portion of the pectoralis major, the upper part of the trapezius, levator scapulae, and flexors of the upper extremity. Intervention and Outcome: Correction of the weak foot muscles, followed by proprioceptive neuromuscular facilitation (PNF) activity to normalize and repattern the ankle and foot produces reflex normalization of the above muscles with resultant increased range of motion. Common foot problems causing the failure of normal great toe function include a posterior calcaneus, anterior talus, and separation of the tibia and fibula both proximally and distally. Conclusion: The importance of foot evaluation and treatment for total body treatment is an important concept in applied kinesiology therapy, and is confirmed by some of the findings of Vladimir Janda. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:25-26) Key Indexing Terms: Foot Injuries; Muscle Hypertonia; Muscle Hypotonia; Gait; Treatment; Chiropractic; Kinesiology, Applied THE CHANGE OF THE ASYMMETRY OF RESTING CALCANEAL STANCE POSITION BY APPLIED KINESIOLOGY Seung Won Lee, M.D., Ph.D., D.C., Je Woon Lee, M.D., Francis I. Park, D.P.M. ABSTRACT 53 Objective: To demonstrate the correction of asymmetry of the resting calcaneal stance position (RCSP) by the intervention of applied kinesiology. Clinical Features: A multidisciplinary clinic of AK, podiatry, and orthopedics selected 40 patients (11 males, 29 females) with RCSP asymmetries of more than 3 degrees who also had low back, pelvic, and lower extremity symptoms. Any patient with significant pathology that might contribute to RCSP problems was excluded from this study. Intervention and Outcome: AK methods were used to treat the problems found including correction of muscles and joints of the spine, cranium, pelvis and lower limb, and gait problems. For the 40 patients, the mean asymmetry in the RCSP was 4.45 degrees. After AK treatment for 2 weeks there was an average change in RCSP of 1.62 degrees. It was found that patients who did not have significant change in RCSP after AK treatment had structural asymmetry that should be treated with the prescription of orthotic support. Conclusion: AK has traditionally held that leg length inequality may produce, on the long leg side, foot pronation, internal tibial rotation, medial knee joint degenerative changes, medial rotation of the pelvis, iliopsoas tightness, piriformis tightness with sciatic impingement, etc. AK intervention may be beneficial not only for the structural asymmetry of the foot but also for some of the functional consequences that may be occurring as a result of this foot problem in some patients. This precise, elegant study should be repeated with a larger patient population and a control group for outcome comparisons. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:27-32) Key Indexing Terms: Foot Deformities, Congenital; Foot Diseases; Evaluation Studies; Treatment; Chiropractic; Kinesiology, Applied MIGRAINE HEADACHES AND FOOD SENSITIVITIES – A CASE HISTORY Robert A. Ozelio, D.C., D.I.B.A.K. ABSTRACT Objective: To discuss a patient with migraine headaches successfully treated with the identification and elimination of food sensitivities using applied kinesiology chiropractic care. Clinical Features: A 30-year-old male presents with intermittent and unpredictable migraine headaches. The patient also had non-migraine headaches several times a week. The patient completed a diet log for 7 days and he consumed a large quantity of dairy and wheat. Intervention and Outcome: Muscular, cranial, and spinal manipulative therapy was employed following AK methods. AK methods to identify food sensitivities were also employed. The suspected food that was irritating the patient was placed in his mouth, and if a strong muscle weakened, the patient was considered to be potentially sensitive to that food. The patient proved to be sensitive to dairy and wheat. Removing these from his diet made some improvement for his headaches. He also consumed olive oil every day, and he was tested and found sensitive to olive oil, an unusual finding in the population. His headaches stopped completely after eliminating the olive oil. Other oils, such as butter, coconut butter and other fats were used instead. 54 Conclusion: In this patient, it was important to check for food sensitivity. The patient proved to be sensitive to a food item that is not usually written about in textbooks. The author suggests that doctors keep an open mind when evaluating food sensitivities, as this may be necessary to achieve success. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:35-36) Key Indexing Terms: Migraine; Tension Headache; Food Hypersensitivity; Food Analysis; Treatment; Chiropractic; Kinesiology, Applied NEW TOOL FOR DX & TX OF SWITCHING Jose Palomar Lever, M.D. ABSTRACT Objective: To present a new method of diagnosis for the problem called "switching" in applied kinesiology, and a case series report is presented on 200 random patients using this method. Clinical Features: Switching (also called neurologic disorganization) is of particular concern in the examination of patients because when switching is present, erroneous information may be derived from various testing procedures. A review of the standard AK methods for determining if a person is neurologically disorganized is presented. The method presented by the author does not require TL to points on the body, which prevents false-positive or false-negative test results due to the presence of other physical problems in the area of TL. Intervention and Outcome: Using the principles developed in the "Brain Gym Handbook," the author presents two images to the patient. The images are either two parallel lines, or two crossed lines in the shape of an X. 200 patients with positive TL to K-27 were also evaluated using this method. 164 of these patients had unpredictable muscle responses to testing. The character of these unpredictable findings was not described. These same 164 patients with positive TL to K-27 and unpredictable muscle responses on testing also showed a positive "X" and "ll" test, meaning that a previously strong indicator muscle remains strong after viewing the "ll" image and/or becomes weak with "X." Conclusion: Treatment is directed toward the factor that corrects the positive visual test. Correcting neurological disorganization makes manual muscle testing outcomes more predictable, thereby improving accurate diagnosis and treatment. The relationship of this method of diagnosis and treatment to specific patient morbidity and dysfunction will require further research. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:37-40) Key Indexing Terms: Diagnostic Techniques, Neurological; Evaluation Studies; Treatment; Chiropractic; Kinesiology, Applied CASE HISTORY: ILEOCECAL VALVE AND HIDDEN CERVICAL DISC 55 Bruce Shin, D.C. ABSTRACT Objective: To discuss a case of low back pain with sciatica with no history of trauma, except a recent bump of the patient"s head against a wall. Clinical Features: A 55-year-old female complains of sudden onset of low back pain and sciatica. Normal lumbar ROM was noted, but with stiffness; Kemp"s sign was negative, but the straight leg raise test was positive on the right due to tight hamstrings. During AK examination, diagnosis of an open ileocecal valve and a hidden cervical disc were made. A few days prior to the onset of the back pain the patient had a night of abnormal alcohol intake and nuts at a bar. Intervention and Outcome: Chapman"s reflexes for the open ICV were stimulated at upper 3" of the right arm, posterior lamina of C3, inferior to the right ASIS, the Bennett"s neurovascular reflex for the ICV between the ASIS and umbilicus. The Luo points at KI-5 on the right and BL 58 on the left were stimulated. Vertebral subluxations of C5 and L1 were challenged and adjusted accordingly. Due to the bump on her head a few days prior to the low back pain onset, the ICV stress receptors were challenged and adjusted. A hidden cervical disc was located at the level of C3, and adjusted. This correction relieved the calf pain almost instantly. All of the originally weak muscles found on examination were now strong. Conclusion: In some patients, biochemical disturbances may be seriously affecting the structural components in the body. Subluxations and other tissue aberrancies found in AK examination may disrupt the biochemistry of the body and may also cause subluxations to recur. A thorough, whole-body examination may be needed to adequately correct cases with low back pain and sciatica. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:41-42) Key Indexing Terms: Low Back Pain; Sciatica; Ileocecal Valve; Intervertebral Disc Displacement; Treatment; Chiropractic; Kinesiology, Applied CASE HISTORY: SHOULDER PAIN AND THE 24-HOUR CLOCK Bruce Shin, D.C. ABSTRACT Objective: To discuss the benefits of examining the meridian system of traditional Chinese medicine for a case of shoulder pain. Clinical Features: A 40-year-old female presents with right shoulder pain of a few weeks duration. No trauma to the shoulder was revealed in the patient"s history. Movement of the shoulder produced a mild "boring" pain. The drop arm test, shoulder apprehension, and Wright"s test were all negative. The only muscle weakness was in the subscapularis on the right. Pulse point TL diagnosis was positive at the left distal pulse point. Correlating muscles of the small intestine and heart were tested, showing only a weak right subscapularis. The alarm point for the heart did not strengthen the muscle. 56 Intervention and Outcome: The examiner went backwards on the 24-hour clock, classically described in traditional Chinese medicine, to the lung alarm point, which strengthened the weak subscapularis muscle. T3 was challenged and corrected. LI-6, the Luo point, was stimulated to balance the flow of energy. The patient"s shoulder pain was resolved by the end of treatment. Conclusion: The author points out that symptoms anywhere in the body may be connected to the meridian system. Meridians carry energy from one meridian to the next every 2 hours. If there is a blockage in the energy to prevent proper flow, symptoms can occur. Pulse point diagnosis is recommended as a part of the regular AK diagnostic workup of every patient. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:43-44) Key Indexing Terms: Medicine, Chinese Traditional; Shoulder Pain; Meridians; Acupuncture Therapy; Treatment; Chiropractic; Kinesiology, Applied A NEW EPIDEMIC OF KNEE INJURIES: A.C.L. IN WOMEN ATHLETES Paul T. Sprieser, D.C., B.S., D.I.B.A.K. ABSTRACT Objective: To present information on the increase in anterior cruciate ligament knee injuries in women, and to present additional information about some of the overlooked causes and treatment methods for this sometimes devastating injury. Clinical Features: Research literature is reviewed, and some of the causative factors in women are listed: wider hips, hormonal changes at certain times of the menstrual cycle, the smaller size of the A.C.L. and of the notch through which it connects to the femur in the upper leg. Women also begin to play sports at a later age, tend to land in a more upright position than men when jumping, with their knees turned more inwardly. When jumping and cutting, women depend more on the quadriceps muscles which pulls the shinbone forward and tightens the anterior cruciate ligament, while men rely more on their hamstrings which provide more backward draw and pressure on the posterior cruciate ligament. Muscular factors that control the angle of pull into the knee joint complex during activity are described. The importance of balance in the vastus medialis and vastus lateralis muscles for proper patella tracking is cited as critical factors in balanced function of the knee. The balance of the divisions of the hamstrings is also of great importance in this problem. The sartorius and gracilis, popliteus, tensor fascia lata and gluteus maximus muscles are also reviewed in relationship to this problem. Intervention and Outcome: Several particular tests developed in AK are invaluable in correcting injuries to the knee. These are: reactive muscles, ligament stretch reactions, repeated muscle activation patient induced problems, contributing foot problems, category 2 pelvic faults, TMJ dysfunction that is often related to the category 2 pelvic fault, and cranial faults that can lead to muscular weakness with respiration. Conclusion: Using traditional orthopedic and AK diagnosis and treatment methods for A.C.L. injuries and for their prevention increase the success for physicians who treat this problem. It is suggested by the 57 author that treatment of athletic women using these methods would greatly reduce the likelihood of A.C.L. tears. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:45-49) Key Indexing Terms: Anterior Cruciate Ligament; Knee Injuries; Diagnosis, Differential; Treatment; Chiropractic; Kinesiology, Applied ADOLESCENT CASE STUDY: APPLIED KINESIOLOGY AS AN ADJUNCTIVE PROTOCOL IN AN ACUTE CERVICODORSAL SPRAIN/STRAIN (SHEARING) INJURY Juli Tooley, D.C., D.I.C.C.P. ABSTRACT Objective: To describe the case of a young female with a sprain-strain injury that produced acute left neck, shoulder, and arm pain. Clinical Features: An 11-year-old female was pushed off a fire hydrant the previous day. She caught her fall on an adjacent fence that created a strain in her left shoulder and left neck. On examination, left cervical rotation was very painful and limited, and left shoulder abduction was slightly limited. All the muscles of her neck and left shoulder were facilitated, except for the levator scapula. A strengthening effect occurred with TL to the insertion of the Golgi tendon organ and the insertion of the muscle. Oral nutrient testing of a supplement for ligament support produced strengthening of the muscle also. When the patient was asked to visualize the event and the boy who pushed her off the fire hydrant, a previously strong indicator muscle became inhibited. Intervention and Outcome: Chiropractic manipulative therapy was given to the 6 th cervical, 12th thoracic, and 5th lumbar vertebrae. Origin/insertion technique was applied to the insertion of the left levator scapula (i.e. approximating the origin and insertion). The Golgi tendon organ of the left levator scapula was corrected by directing pressure toward the belly of the muscle. The emotional neurovascular reflexes were contacted and the patient asked to "picture" the incident and the boy who pushed her until an equal pulse was felt under the author"s fingertips. The patient was given a nutritional support for ligament injury. Immediately following the origin/insertion and GTO technique to the left levator scapula muscle and adjustment of the 6 th cervical vertebrae, the patient could actively rotate her head equally in both directions, and the pain was gone with full range of motion in the arm and shoulder restored. Conclusion: Whole body treatment involving the structural, chemical, and emotional components affecting a patient may sometimes be needed. The author argues that AK allows the physician to diagnose the need for such treatment, supply the treatment, and observe whether or not the results of treatment have been effective in solving the patient"s problem. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:51-54) Key Indexing Terms: Sprains and Strains; Shoulder; Neck; Diagnosis, Differential; Treatment; Chiropractic; Kinesiology, Applied 58 "BASIC AK" APPLIED TO AN EXISTING PATIENT: PULSE POINTS UNCOVER "THE WEAKEST LINK" CASE STUDY Juli Tooley, D.C., D.I.C.C.P. ABSTRACT Objective: To present the case of a female with back pain and left thumb pain that was successfully treated in one visit using AK meridian therapy procedures. Clinical Features: A 52-year-old female with left dorsolumbar and thumb pain presented with no history of trauma (back pain rated at 7-8, and thumb pain 4-5 on a 1-10 scale). The patient has a severe S-type scoliosis that developed in early childhood and has been under chiropractic care for most of her life. Pulse point diagnosis was employed to locate her primary deficient meridian. In AK, there are 6 traditional pulse points that TL on each wrist, 3 superficial and three deep. The scanning of pulse points utilizing MMT and TL ascertains which meridian is currently the patient"s weakest link and directs treatment toward improving this factor. The active pulse point in this case was the kidney and bladder meridians. Muscles related to these meridians – tibialis anterior for the bladder and psoas for the kidney – were tested. The psoas was found inhibited on the left, and TL to the left kidney alarm point caused the left psoas to become strong. Intervention and Outcome: The tonification point for the kidney meridian (KI7) was stimulated for 15- 20 seconds using a low frequency infrared laser. The associated point for the kidney on the spine at the L2/L3 level was found subluxated and corrected with a chiropractic adjustment. The extraspinal articulation closest to the tonification point for the kidney on the left ankle showed a subluxation of the talus, which was adjusted. The left psoas muscle tested strong after this treatment. The patient experienced an immediate increase in dorsolumbar ROM and a marked decrease in pain that was now a 0 or 1 on the 1-10 scale. Conclusion: This case demonstrated that using AK methods of MMT, TL, and pulse point diagnosis could help diagnose the cause of a patient"s discomfort and impaired function. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:55-58) Key Indexing Terms: Back Pain; Acupuncture Therapy; Diagnosis; Treatment; Chiropractic; Kinesiology, Applied APPLIED KINESIOLOGY TO DIAGNOSE AND TREAT A CASE OF CHRONIC LOW BACK PROBLEMS: CASE STUDY John K. Wittle, B.S.N., D.C. ABSTRACT Objective: To present a case of chronic low back pain following an injury in 1975 that was successfully ameliorated using AK therapy. 59 Clinical Features: A male patient was injured playing basketball in 1975, and was put in traction at that time. Since then he has experienced episodes of acute low back spasm caused by very slight movements: in the presentation described here, bending over to plug a cord into his laptop computer produced his acute low back pain, with a left antalgic lean and abnormal gait. Intervention and Outcome: A right lateral L5 disc correction (diagnosed using AK MMT methods), as well as a T7 and left occiput subluxation corrections were made. Reflex treatment and muscle work were performed for the psoas muscles and the right multifidus. Oral nutrient testing showed a need of nutrients for an inflammatory problem and disc support with additional selenium. Patient was seen one-week later reporting improvements. "This was the quickest resolve I"ve ever had." The L5 disc was adjusted again as well as a category II pelvic fault. The following week the patient showed no disc involvement and continued improvement. He was seen 4 additional times in a 5-month period dealing primarily with category II faults. He reported feeling great with only occasional discomfort even with stress. Conclusion: With the use of AK as a diagnostic method, the patient has experienced the most beneficial results in the 25 years since his original injury. The use of AK in cases of low back injury as a result of trauma may result in improved treatment outcomes for the chiropractic physician. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:65-66) Key Indexing Terms: Low Back Pain; Intervertebral Disc Displacement; Case Reports; Diagnosis; Treatment; Chiropractic; Kinesiology, Applied REVIEW OF THE AK MUSCLE TESTING PROCESS Donald C. Baker, D.C., N.M.D. ABSTRACT Objective: This paper reviews several basic aspects of AK MMT processes, related scientific studies, basic definitions and terminology relating to MMT. Clinical Features: Three types of MMT are occasionally described in the AK literature. Type 1 testing is when the physician begins the test and the patient resists this force. In Type 2 testing, the patient comes to a maximum contraction at which time the physician adds additional force. In Type 3 testing the patient is not allowed to come to maximum force; before he does so, the physician applies additional force attempting to move the muscle into eccentric contraction. Graphical representations of these three types of tests are presented, and a mathematical model of the three types of MMT is described. Intervention and Outcome: Mathematically or graphically, what is being measured during a MMT is the differential of force with respect to displacement. A differential of force with respect to displacement would be the slope of the curve of force versus displacement on a graph that measured the muscle test. If the muscle "locks" there would be little change in displacement for a relatively large change in force. The quality being measured during an AK MMT is a dynamic curve of neuromuscular function; it is not a static value such as the muscle"s absolute contractile strength. 60 Conclusion: Goodheart, Walther, Gerz, Schmitt, Maffetone, and many others have noted that speaking of "muscle strength" alone does not characterize all the variables of an AK MMT. Further, attempts to objectify AK MMT results with instruments that simply measure muscle strength have met with limited success. The reason appears to be that you cannot evaluate a dynamic process (e.g. dF/dx, the rate of change of force with respect to displacement) with a single static measurement like that produced by a force transducer. Guyton states that the contractile strength of a muscle is a single value not descriptive of a dynamic process. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:69-74) Key Indexing Terms: Myography; Review Literature; Terminology; Research Design; Chiropractic; Kinesiology, Applied EXCESS TISSUE ACIDITY CO-EXISTING WITH REDUCED PARIETAL CELL HYDROCHLORIC ACID SECRETION Donald C. Baker, D.C., N.M.D. ABSTRACT Objective: This paper considers whether excess tissue acidity and hypochlorhydria may co-exist. AK clinical procedures to diagnose and treat this functional pattern are described. Clinical Features: Aldosterone deficiency is one possible cause of mild tissue acidosis. The function of aldosterone is the reabsorption of sodium and the secretion of potassium by the kidneys. A secondary function of aldosterone is the secretion of hydrogen ions by the kidney tubules. The reduced section of hydrogen ions in cases of aldosterone deficiency (caused by adrenal stress disorders) may reduce the secretory action of the parietal cells in the stomach. Receptors for aldosterone have been found in the stomach. The relationship between adrenal function and the stomach based on the work of Hans Selye is described. A hypothesis linking aldosterone disturbances to lowered hydrochloric acid levels and excess acidity in the extracellular fluids of the body is made. Intervention and Outcome: In clinical practice this may mean that there are situations where the patient should be advised to reduce tissue acidity (by recommending alkaline ash diet, supplementation with alkaline ash minerals, etc.), and at the same time the patient may need supplementation with hydrochloric acid with meals in order to assist gastric function. Conclusion: It is proposed in this paper that a finding of excess tissue acidity does not rule out hypochlorhydria, or vice versa. (Collected Papers International College of Applied Kinesiology, 2002- 2003;1:75-78) Key Indexing Terms: Achlorhydria; Hydrochloric Acid; Hydrogen-Ion Concentration; Buffers; Diagnosis; Treatment; Chiropractic; Kinesiology, Applied 61 APPLIED KINESIOLOGY AND DOWN SYNDROME: A STUDY OF TWELVE CASES Scott C. Cuthbert, D.C. ABSTRACT Objective: A case-series of 12 children with Down syndrome is presented. This study describes these children"s histories, their clinical findings, and their evaluation and treatment using applied kinesiology methods. Clinical Features: Down syndrome is the most common readily identifiable cause of intellectual disability, accounting for almost one-third of all cases. It occurs equally in all races with an overall incidence of approximately 1 in 800 births. Congenital heart disease affects 40% of these babies. Severe congenital heart disease remains a major killer of children with Down syndrome, despite advances in surgical treatment. In the absence of a congenital heart defect, the majority of patients can expect to live into their sixth decade. Up to 15% of children with Down syndrome will have radiological evidence of instability of the atlanto-axial joint, but in only a handful of cases will this instability result in an impingement of the spinal cord with resultant neurological signs. It occurs equally in all races with an overall incidence of approximately 1 in 800 births; approximately 4,000 children with Down syndrome are born each year. Children with Down syndrome will be developmentally slower than their siblings and peers and have intellectual functioning in the moderately disabled range, but the range is enormous and the distance from their peers is the crucial factor. This is why the author argues that chiropractic therapeutics can make a profound difference. Intervention and Outcome: Following applied kinesiology spinal and cranial bone treatment these children"s ability to move, to crawl, to breathe through breathe through the nose, to use their hands and feet together and their tongue with improved fine motor skills showed significant improvement. Conclusion: Further studies into applied kinesiology and cranial bone manipulative treatments for Down syndrome are indicated to evaluate whether this case study can be representative of a group of patients who might benefit from this care. (Collected Papers International College of Applied Kinesiology, 2002- 2003;1:83-94) Key Indexing Terms: Down Syndrome; Child; Outcome Assessment (Health Care); Treatment; Chiropractic; Kinesiology, Applied APPLIED KINESIOLOGY AND THE MYOFASCIA Scott C. Cuthbert, D.C. ABSTRACT Objective: To describe the importance of myofascial dysfunction to human function, and to present the AK methods of evaluation and treatment of myofascial dysfunction. 62 Clinical Features: A major source of complexity in the practical application of applied kinesiology procedures is that no muscle exists in isolation, and frequently no single factor produces weakness on MMT. If a muscle has been weak for a long time, there will probably be many of the 5 factors of the IVF that are active in the muscle as well as the local muscle dysfunction. The additional problems are likely due to the body"s adaptation to the original factor causing the problem. It has been consistently demonstrated in applied kinesiology that muscular dysfunction is not a simple, localized musculoskeletal disorder. Rather, it ties local musculoskeletal dysfunctions to a variety of other phenomena including pain, increased neurologic confusion, autonomic arousal, visceral dysfunction and disease and, by implication, decreases in the effectiveness of the endocrine and the immune systems. Intervention and Outcome: The distinct methods of diagnosis in AK for the different myofascial problems originally described by Drs. Travell, Jones, Rolf, and Fulford are presented. Their treatment using a mechanical devise, called the percussor, is described. Conclusion: Myofascial changes occur when mechanical, chemical, or emotional stresses remain in place in the patient"s body for extended periods. What begins as changed muscle tone as the body adapts to these stressors progresses to structural changes in the connective tissue elements that surround and supplement the muscle fibers involved in the adaptation. The suggestion is made that to effectively repair the faulty "tissue tone" that is found in chiropractic patients then we must effectively repair the imbalanced myofascia that is present. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:95-103) Key Indexing Terms: Fascia; Myofascial Pain Syndromes; Diagnosis; Therapeutics; Chiropractic; Kinesiology, Applied GASTROINTESTINAL DISORDERS: AN UPDATE AND A REVIEW Datis Kharrazian, D.C., M.S., C.N.S., C.C.N., C.S.C.S., C.C.S.P. ABSTRACT Objective: To present the complex interactions that takes place between the gastrointestinal track and the other major systems in the body, and to review diagnostic methods and treatment strategies. Clinical Features: An extensive review of the research literature shows how gastrointestinal inflammation may impair the function of the thyroid gland; induce insulin insensitivity, adrenal stress syndrome, hypoglycemia; disturb the citric acid cycle and electron transport chain; up-regulate the immune system; induce megablastic anemia; cause DNA damage, produce oxidative stress, autoimmune disease, estrogen dominance; and produce depression, neurodegenerative disease, cardiovascular disease, intestinal permeability and food sensitivities. The metabolic pathways of these mechanisms are elaborated. Intervention and Outcome: A review of the functional medical tests related to the gastrointestinal tract is given. The author argues that the combination of laboratory tests and AK evaluations give the clinician many other objective tools to make the diagnosis and to evaluate treatment effectiveness. Many treatment options are discussed, and the most effective are ones that include dietary and lifestyle changes, nutritional and herbal supplementation (even pharmaceutical medications at times), and treatments that 63 optimize neurological inputs involving different aspects of the 5 factors of the IVF. A "4R Program" is delineated, which stands for remove, reinoculate, replace, and repair the gastrointestinal tract. Conclusion: This elegant literature review shows that gastrointestinal disorders have far reaching impacts on human physiology. Every major system suffers when the gastrointestinal tract is not healthy. The tools in AK and functional laboratory tests help clinicians assess and treat these dysfunctions. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:117-136) Key Indexing Terms: Gastrointestinal Tract; Intestinal Diseases; Diagnostic Techniques, Digestive System; Treatment; Chiropractic; Kinesiology, Applied MALE HORMONE DISORDERS – UNDERSTANDING ANDROPAUSE Datis Kharrazian, D.C., M.S., C.N.S., C.C.N., C.S.C.S., C.C.S.P. ABSTRACT Objective: To review male hormone disorders and the clinical signs and symptoms of andropause; the influence of testosterone on human physiology; male hormone laboratory profiles; and AK and nutritional protocols to manage male hormone disorders. Clinical Features: The term andropause refers to the time when the production of androgen dominant hormones declines. A review of its symptoms and signs is given. The most common cause of functional andropause occurs when the ratio between serum levels of testosterone and estrogen changes. This problem may be due to increased levels of xenoestrogens and exotoxins in the environment, increased stress, decreased essential fatty acids in our diets, and decreased hepatic detoxification. The identification of andropause is commonly overlooked because there is a slow and gradual drop of testosterone compared to the female menopause. In addition, the managed-care health system does not look favorably into routinely measuring hormone levels in men who do not have serious endocrinological dysfunction. The influence of testosterone upon: 1) cardiovascular function, 2) energy and red blood cell production, 3) bone density, 4) the prostate, 5) body mass, 6) the libido, 7) mood and depression, is described in detail. Intervention and Outcome: Male hormone laboratory testing (salivary male hormone profile) is outlined. AK MMT also provides the clinician with information that cannot be evaluated by laboratory tests, such as which systems are a priority in therapy or which nutrients will be the most effective for the patient. A vitamin B6 deficiency is described that may explain why there are symptoms of estrogen dominance. Treatment to modify estrogen metabolism; stimulate testosterone synthesis; optimize the pituitary-hypothalamic axis; improve gastrointestinal dysfunction; optimize liver detoxification; and dietary advise for andropause are described in depth. Conclusion: Male hormone disorders may be one of the most overlooked dysfunctions in health care today. This paper offers protocols for the evaluation and treatment of this sometimes unrecognized and untreated condition that affects ½ of the population. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:137-156) 64 Key Indexing Terms: Andropause; Testosterone; Estrogen; Dehydroepiandrosterone; Diagnostic Techniques, Endocrine; Treatment; Chiropractic; Kinesiology, Applied THE TRANSVERSE ABDOMINAL – THE FORGOTTEN MUSCLE David Leaf, D.C., D.I.B.A.K. ABSTRACT Objective: This paper describes the importance of the transverse abdominal muscle and presents a MMT that can be used to measure the strength of the muscle. Treatment for the muscle"s inhibition and an exercise program for strengthening the muscle are described. Clinical Features: The MMT of the transverse abdominal is performed by elevating the legs of the supine patient until they are flexed 15 degrees or approximately 12 inches off the table, and then the legs are moved 10 degrees off the center line of the patient"s trunk. The test pressure is directed to bring the legs to the centerline of the table. Intervention and Outcome: The most common cause of weakness found by the author is an imbalance of the ribs to which the muscle is attached. In cases of low back problems, the diaphragm (rib expansion) and the muscles of the pelvic floor should be tested and corrected if inhibited. AK treatment of these factors is reviewed. Instructions are given for this muscle"s rehabilitation that has the patient expire and pull their umbilicus toward their spine and hold it for a count of ten, to be repeated five times a day. Conclusion: The function of the transverse abdominal is essential to the stabilization of the lumbar spine. Imbalances of the inner and outer muscle systems of the pelvis are effectively corrected by these methods. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:157-159) Key Indexing Terms: Abdominal Muscles; Diagnosis; Treatment; Chiropractic; Kinesiology, Applied THE SUGGESTIVE INDICATION OF ORTHOTIC APPLICATION IN EXCESSIVE PRONATION OF THE FOOT FOR APPLIED KINESIOLOGISTS THROUGH THE MULTIDISCIPLINARY APPROACH Seung Won Lee, M.D., Ph.D., D.C., Je Woon Lee, M.D., Francis I. Park, D.P.M. ABSTRACT Objective: To identify when the application of a permanent semi-rigid orthotic will be necessary in cases of excessive foot pronation syndromes. 65 Clinical Features: 50 patients (14 males, 36 females) were selected from a combined chiropractic, podiatric, and orthopedic medical practice who had excessive pronation of the foot as well as symptoms and signs in the spine, pelvis, or feet. AK and podiatric measurements diagnosed the excessive foot pronation. The total range of motion of the subtalar joint was measured using podiatric standard methodology. The shock absorber test, weight bearing test, gait analysis, and biomechanical examination of single limb stance was done on the initial examination of every patient. Intervention and Outcome: All patients were treated with standard, whole body AK treatments for 2 months. Two groups were delineated from the study"s results. 23 patients achieved significant correction of both excessive pronation with improved symptoms and signs by AK intervention with or without temporary use of a modular type of semiflexible orthotic support. 27 patients were not successful by the treatment of AK methodology but were recommended long-term application of semi-rigid orthotic support. The differentiating factor that was consistent with these two groups was the total range of motion in the subtalar joint. The 23 patients successfully treated with AK had an average subtalar ROM of 42.30 +/- 6.74 degrees. The 27 patients requiring semi-rigid orthotic support had an average subtalar ROM of 55.59 +/- 7.99 degrees. The angle of single limb stance of the 23 patients was 9.39 +/- 2.81 degrees and that of the 27 patients was 11.70 +/- 2.14 degrees. Conclusion: From this comprehensive study on chiropractic treatment of foot dysfunction, is was concluded that more than 50 degrees of passive range of motion of the subtalar joint will be correlated with the application of orthotic support in patients with excessive foot pronation. Larger patient numbers in a controlled clinical trial should be conducted to confirm these findings. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:161-170) Key Indexing Terms: Flatfoot; Pes Planus; Orthotic Devices; Podiatry; Treatment; Chiropractic; Kinesiology, Applied SYMPHYSIS PUBIS DYSFUNCTION: THE LYNCHPIN IN UNEXPLAINED LUMBO-PELVIC SYMPTOMS Eric Pierotti, D.C., D.O., Ch.D (Adel) ABSTRACT Objective: To introduce the author"s discovery of a specific muscle inhibition related to several specific symphysis pubis subluxations with corrective and rehabilitative procedures offered. Clinical Features: The biomechanics of the symphysis pubis and pelvis is reviewed. The author correlates a bilateral weakness of the quadriceps muscle group with a number of symphysis pubis subluxations. The test for this has the patient supine, the leg flexed to 45 degrees and the knee in full extension. The opposite leg remains flat on the examining table. A posterior tilt of the pelvis will be found on postural examination in these cases. In 50 patients with symptoms of symphysis pubis subluxations (urinary frequency and urgency, dysuria and dyspareunia, and pain in the pubic area, usually associated with trauma to the area or with diastasis of pregnancy), this bilateral inhibition of the quadriceps muscle was found. TL to the pubis will negate the weakness of the quadriceps group test. The etiology of this finding is explained by pregnancy because within 24 hours of parturition the blood levels of relaxin 66 reduce markedly and ligaments begin to tighten regardless of joint position, even if the symphysis is in a separated or sheared position. Intervention and Outcome: A specific protocol for correction of this subluxation is given, as well as rehabilitative exercises. Conclusion: The author states that this condition is multifactorial, and that the protocol offered here is the structural component of this problem. The chemical and emotional sides of this condition should be evaluated and corrected as well. Because the number of women who experience back pain after pregnancy and who see chiropractors for the problem, further research into this method of therapy should be conducted. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:171-182) Key Indexing Terms: Pubic Symphysis Diastasis; Pregnancy; Sprains and Strains; Diagnosis; Treatment; Chiropractic; Kinesiology, Applied NO-STUFF STUFF: STRUCTURAL PATTERNS OF CHEMICAL IMBALANCES: WHAT TO DO WHEN YOU FORGET YOUR TEST KIT Walter H. Schmitt, Jr., D.C., D.I.B.A.K., D.A.B.C.N. ABSTRACT Objective: To present concepts from the author"s work on "links between the nervous system and the body chemistry" showing specific sensory receptor challenge procedures that parallel oral challenges with hormones, neurotransmitters, neurotransmitter-related drugs, and nutrients (vitamins, minerals, and amino acids). Clinical Features: AK assessment is a series of sensory receptor based diagnostic challenges followed by the measurement of subsequent motor activity (MMT outcomes). Clinical decisions on what therapies to administer are based on sensory receptor challenges and MMT outcomes which, combined with other assessment procedures (history, laboratory, other exam findings, etc.), guide the clinician on what is most appropriate for that patient. Articles are reviewed that were written in the 1980s showing parallels between specific neuromuscular and postural patterns (MMT outcomes) and specific biochemical patterns in the patient. The specific sensory receptor challenges and their interpretation from that body of research are summarized. Intervention and Outcome: The concepts/challenges reviewed are: "Centering the spine"; GV21 challenges; 4 body quadrant and electrolytes; TMJ protrusion and retrusion challenges; autonomic challenges; epinephrine challenge; endocrine Chapman"s reflexes and tonic labyrinthine reflexes challenges; visceral referred pain challenges; fats and nitric oxide challenges; type 2 and 3 ligament receptor challenges; and foods, chemical, and heavy metal challenges. Conclusion: This paper demonstrates that there are links between the nervous system, the muscular system, and body chemistry. The links may be observed by specific sensory receptor challenges and subsequent MMT outcomes that parallel gustatory challenges. Controlled clinical trials of these concepts are warranted. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:183-191) 67 Key Indexing Terms: Biochemistry; Diagnostic Techniques, Endocrine; Lingual Nerve; Chiropractic; Kinesiology, Applied THOUGHT FIELD THERAPY AND ITS ASSOCIATED EFFECTS ON THE AUTONOMIC NERVOUS SYSTEM Paul T. Sprieser, D.C., B.S., D.I.BA.K. ABSTRACT Objective: To demonstrate the effect of Thought Field Therapy (TFT) by measuring its effects on the autonomic nervous system. Clinical Features: TFT is the discovery of Roger Callahan, Ph.D., who uses MMT methods for the treatment of emotional problems such as phobia, anger, bad habits, anxiety, guilt, grief, depression, obsessive-compulsive disorders. A presentation of the premises and protocols of TFT is given. Intervention and Outcome: 106 patients participated in this study, 64 females and 42 males. Five autonomic nervous system measurements were made before and after TFT treatments. These were passive range of motion of the hip joints bilaterally, blood pressure, pulse rate, oral pH, and body temperature. The results were as follows. Median ROM before TFT was 89.62 degrees, and 107.66 degrees after treatment. Every patient showed an improvement in ROM. The blood pressure change was a median decrease in systolic pressure of 4.03 mm Hg, and 4.68 mm Hg decrease in diastolic pressure after TFT. Pulse rate changes showed a median decrease of 4.8 beats. The median oral pH changes were not given. An average temperature increase of .728 degrees occurred in 70 patients, and a decrease of .428 degrees in 28 patients. Conclusion: According to this author"s interpretation of the measurements used, TFT has a beneficial effect on the autonomic nervous system of patients. The author reports anecdotally that this system of therapy has positive emotional effects on his patients also. The mathematical presentation of this study should be repeated with greater controls and with other blinded physicians conducting the therapy to determine the effect of this treatment system in other clinical settings. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:203-215) Key Indexing Terms: Emotions; Mental Disorders; Mental Healing; Treatment; Kinesiology, Applied MIGRAINES: A THEORY AND TREATMENT PROTOCOL Steven Zodkoy, D.C., D.A.C.B.N., C.C.N., C.N.S. 68 ABSTRACT Objective: To present a theory and treatment protocol for patients with migraine headaches. Clinical Features: A review of the clinical and nutritional literature related to migraine is presented. This review demonstrates that an accumulation of endotoxins and exotoxins may overburden the liver in migraine cases, followed by an increase in the blood levels of these toxins that act as a stimulus to the intracranial vascular system producing the headaches. This literature review suggests also that nutritional deficiencies of magnesium, superoxide dismutase, and tryptophan are present in migraine patients, and oral supplementation of these nutrients have proven to be an effective prophylactic. Dietary factors including artificial coloring, flavoring, caffeine, alcohol, and preservatives are triggering mechanisms that also and require liver detoxification. Intervention and Outcome: The author states that positive TL to the liver alarm point is positive in these patients. The nutrient testing described in this paper are: zinc tally, salivary pH, urine pH, vitamin C urine test, calcium urine test, Koenigsburg test for the adrenal glands, 3-hydroxy indol indican urine test (bowel dysbiosis), and cellular oxidation-reduction in urine (aldehyde formation from free radicals). Patients with this pattern of liver detoxification problems with migraines caused by endotoxins and exotoxins will be positive on these tests. Nutritional supplementation approaches found by the author to be effective in these patients are presented. Conclusion: A review of the nutritional literature on migraine shows that nutritional supplementation may be effective in the treatment of migraine headaches. Controlled clinical trials using this method of diagnosis and treatment are needed since millions of patients suffer from this painful, sometimes debilitating condition. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:233- 240) Key Indexing Terms: Migraine Disorders; Review Literature; Diagnostic Techniques, Digestive System; Nutrition; Treatment; Kinesiology, Applied A NEW TECHNIQUE THAT CORRECTS CRANIAL FAULTS AND TMJ DYSFUNCTION IN ONE ACTION Paul T. Sprieser, D.C., B.S., D.I.B.A.K. ABSTRACT Objective: To present a method of treatment that corrected numerous cranial faults in this study population that are described in AK. Clinical Features: 250 patients who were diagnosed with cranial faults or TMJ dysfunction were chosen for this study. Intervention and Outcome: The author placed his hands behind the patient"s head and asked the patient to press their neck and head into extension while breathing in. Then the patient was asked to press their neck and head into flexion while exhaling. The author resisted this movement, and the patient repeated 69 this movement 5 times. The author found that this simple technique corrected the standard types of cranial faults described in AK. Conclusion: The individual presentations of these cases were not described, nor the method of evaluation precisely outlined so that bias, error, inconsistency, etc. could be ruled out. However, this simple method of treatment is claimed to have far-reaching positive benefits upon patients, and so clinical trial more objectively designed should be conducted. (Collected Papers International College of Applied Kinesiology, 2002-2003;1:243-245) Key Indexing Terms: Diagnostic Techniques, Neurological; Evaluation Studies; Treatment; Chiropractic; Kinesiology, Applied 70 ICAK-USA Research The Following is a Compilation of Applied Kinesiology Research Papers Published in the Collected Papers of the International College of Applied Kinesiology for the year 2001-2002 -- Edited by Scott Cuthbert, D.C. 71 APPLIED KINESIOLOGY MANAGEMENT OF MULTIPLE SCLEROSIS – A CASE HISTORY Janet Calhoon, D.C., D.I.B.A.K. ABSTRACT Objective: An ongoing case study of a 43-year-old female with multiple sclerosis is updated. Clinical Features: A diagnosis of multiple sclerosis from a medical neurologist was confirmed with MRI. The patient first came for treatment after having all of her amalgams removed and undergoing IV chelation therapy with no improvement. She was using a cane on one side and the support of her mother"s arm on the other. The patient"s current major complaints are pain in the tailbone, right shoulder, and right neck. Hair analysis showed that the mercury level remained unchanged after the amalgam removal and chelation therapy, and arsenic levels decreased slightly. The nutrient levels of magnesium, sodium, manganese, chromium, selenium, and cobalt all decreased; calcium and zinc increased. Intervention and Outcome: Oral nutrient challenges were tested and mineral supplementation given. Nutritional counseling was given to the patient, and instructions on food combining offered. Basic AK treatment methods were employed that treated problems in the biochemical and structural areas. After 2 years of AK care she went from not being able to write a check to showering without assistance. The patient was a conditioned athlete at the onset of MS. Conclusion: Treatment directed to basic structural, chemical, and emotional problems in this patient with multiple sclerosis improved her condition and reduced her pain. Concurrent neuro-radiologic studies are warranted to discover if the care rendered to this patient would benefit other patients with multiple sclerosis. (Collected Papers International College of Applied Kinesiology, 2001-2002;1:1-2) Key Indexing Terms: Multiple Sclerosis; Treatment; Case Reports; Chiropractic; Kinesiology, Applied CASE HISTORY: CERVICALGIA, TINNITUS, AND PERIODONTOSIS Marcello Caso, D.C. ABSTRACT Objective: To present the case of a female with cervical pain and tinnitus of 18 months duration that was co-treated using AK and an oral surgeon. Clinical Features: A 52-year-old female presented with cervicalgia and incessant tinnitus of 18 months duration, especially in the right ear. The condition developed suddenly, 2 weeks after the implantation of a left inferior bridge by her dentist. The implant procedure was difficult for the patient, and there was a crack in the bridge that had to be repaired. Previous therapies of hypnosis and psychological evaluation, acupuncture, physical therapy, massage and chiropractic were of small benefit to her. An orthodontist made a bite splint for her, which she was using at the time of her visit to the author"s office, without benefit. 72 Intervention and Outcome: Evaluation of the bite for pre-contacts, by means of dental occlusion paper, revealed an anterior pre-contact at the incisors. AK MMT evaluation showed that the bite splint was not helping the patient, and the dentist agreed and made a new one for her. The AK neurologic tooth protocol was treated at the second pre-molar on the left. This was the first tooth of the bridge that was created 18 months prior. Injury Recall Technique was also applied to this tooth. Following the first treatment, palpatory pain of the oral musculature and cervical ROM were both improved. The relief was short lived. This treatment approach was done twice more, with only short-lived results. The author believed, because of the recurring problems, that some type of oral pathology should be ruled out. Another set of films was performed and a large, expansile, lytic lesion was found under the tooth in question. Oral surgery to repair the periodontosis was performed, as well as repair of the bridge. Several weeks after the surgery, the patient presented with a 50% decrease in cervical pain, as well as a decrease in the tinnitus. Conclusion: Muscular inhibitions that are present on repeated office visits that do not respond to therapy should always be followed up by a more complete examination, occasionally using the expertise of other health professionals. (Collected Papers International College of Applied Kinesiology, 2001-2002;1:3-5) Key Indexing Terms: Periodontitis; Tinnitus; Neck Pain; Dental Care; Treatment; Case Reports; Chiropractic; Kinesiology, Applied CASE HISTORY: CHAPMAN"S NEUROLYMPHATIC REFLEXES, CONGENITAL INTESTINAL ABNORMALITY, AND BOWEL EVACUATION TIME. Marcello Caso, D.C. ABSTRACT Objective: To describe the applied kinesiologic evaluation of Chapman's neurolymphatic (NL) reflexes in the management of a male with a congenital bowel abnormality and its role in the manifestation of low back pain. The theoretical foundations of these reflexes will be elaborated upon and their clinical applications discussed. Clinical Features: A 29-year-old man presented with chronic low back pain. Radiographs of the patient's lumbar spine and pelvis were normal. Magnetic resonance imaging (MRI) demonstrated a mild protrusion of the fifth lumbar disk. Oral anti-inflammatory agents, cortisone injections, and chiropractic manipulative therapy provided little relief. Though generally in robust health, the patient was aware of a congenital intestinal abnormality diagnosed when he was a child; it was thought to be of no consequence with regard to his current back condition. Intervention and outcome: The patient's history, combined with applied kinesiology examination, indicated a need to direct treatment to the large intestine. The essential diagnostic indicators were the analysis of Chapman's neurolymphatic reflexes, coupled with an evaluation of the traditional acupuncture meridians. The primary prescribed therapy was the stimulation of these reflexes by the patient at home. This intervention resulted in the resolution of the patient's musculoskeletal symptomatology, as well as improved bowel function. 73 Conclusion: The remarkable outcome from the application of this relatively simple, yet valuable, diagnostic and therapeutic procedure represents a thought-provoking impetus for future study and clinical application. (Collected Papers International College of Applied Kinesiology, 2001-2002;1:7-9) Key Indexing Terms: Gastrointestinal Disease; Low Back Pain; Chiropractic Manipulation; Treatment; Kinesiology, Applied H.I.V. – THE ACHILLES HEEL OF A.I.D.S. Heath Motley, D.C. ABSTRACT Objective: To make the argument that the HIV-AIDS hypothesis is scientifically unproven, and the treatment of carriers of HIV-AIDS with cytotoxic DNA chain terminators originally designed to kill growing human cells for chemotherapy, like AZT, has been a failure. Data Sources: A literature synthesis of the work of Duesberg is presented. Results: This paper proposes that American and European AIDS is caused by the long-term consumption of recreational and anti-HIV drugs like AZT. The evidence presented here includes: 1) AIDS is restricted to intravenous and oral users of recreational drugs and AZT; 2) AIDS is 87% male, because males consume this share of recreational drugs; 3) AIDS occurs in newborns, because mothers use recreational drugs during pregnancy; 4) AIDS is new in America, because AIDS is a consequence of the recreational drug use and of AZT prescriptions that started in 1987; 5) AIDS occurs only in a small fraction of recreational drug users, because only the highest life-time dose of drugs causes irreversible AIDS- defining diseases - likewise only the heaviest smokers get emphysema or lung cancer; 6) AIDS manifests as specific diseases in specific risk groups, because each group has specific drug habits. For example, pulmonary Kaposi's sarcoma is exclusively diagnosed in male homosexuals who inhale carcinogenic alkyl nitrites; 7) AIDS does not occur in millions of HIV-positive non-drug users, and there are thousands of HIV-free AIDS cases, because AIDS is not caused by HIV; 8) evidence is cited showing that AIDS is stabilized, even cured, if patients stop using recreational drugs or AZT - regardless of the presence of HIV. The drug-HIV hypothesis predicts that AIDS is an entirely preventable and in part curable disease. Conclusion: This paper suggests that the solution to AIDS could be as close as a very testable and affordable alternative to the HIV hypothesis - the drug-AIDS hypothesis. The hypotheses in this paper need thorough examination, review, and clinical evaluation. (Collected Papers International College of Applied Kinesiology, 2001-2002;1:17-28) Key Indexing Terms: HIV; Acquired Immunodeficiency Syndrome; Etiology; Drug Therapy; Zidovudine; Sexually Transmitted Diseases; Epidemic; Communicable Disease Control 74 EPISODIC PAROXYSMAL VERTIGO: A CASE HISTORY Paul T. Sprieser, D.C., D.I.B.A.K. ABSTRACT Objective: To present the case of a woman successfully treated with AK methods for episodic paroxysmal vertigo that had been present from childhood. Clinical Features: A 17-year-old female presented with episodic paroxysmal vertigo that started at approximately 13 months of age. In her first 6 years of life she had episodes of vertigo and vomiting once a month that were from 4 to 30-40 hours in duration and usually began early in the morning while asleep. Thorough pediatric medical examination resulted in her taking Inderal, Periactin, and Meclizine, though they were not very helpful. She had an intense illusion of rotation toward the left and profuse vomiting. These symptoms had forced her out of high school. The symptoms were usually time related, with the vertigo waking her between 5 to 7 a.m. and continue until 3 p.m. when they stopped abruptly. Intervention and Outcome: AK treatment of cranial and pelvic faults, a fixation at C1 and occiput, Yaw #2 left, and PRY-T were given on her first visit. The most significant factor was the lack of any meridian involvement, except for the Then and Now technique finding. TL to the alarm point for the start of the vertigo symptoms, and then the alarm point for the end of the vertigo symptoms was positive. In her case the vertigo begins at 6 a.m., which in the circulation of chi energy is the large intestine meridian, and 12:30 p.m., which is the heart meridian. Treatment was tapping H5 for 60 seconds. 4 treatments over the course of 7 months have kept this patient free from her episodic paroxysmal vertigo for 3 years. Conclusion: The inclusion of AK evaluation and treatment of the meridian system, specifically the Then and Now technique, appears to be the proper treatment for this patient with episodic paroxysmal vertigo. Since there are many causes of vertigo, the use of AK to evaluate the whole person was able to discover the precise cause of vertigo in this particular case. Larger clinical trials are indicated for this debilitating condition. (Collected Papers International College of Applied Kinesiology, 2001-2002;1:29-31) Key Indexing Terms: Vertigo; Case Reports; Treatment; Acupuncture Points; Chiropractic; Kinesiology, Applied SPINOUS PROCESS SENSITIVITY AS AN INDICATOR OF SUBLUXATION Paul T. Sprieser, D.C., D.I.B.A.K. ABSTRACT Objective: A case series of 200 patients are examined to determine the correlation between spinous process tenderness and a subluxated vertebra as found with AK methods. Clinical Features: 118 males and 82 females were evaluated, ranging from 5 to 75 years of age. Each patient was examined by manual palpation for spinous process sensitivity, and the patient gave a numerical value from 1 to 10 for the pain level. Care was used in assuring that the amount of pressure 75 used would not cause pain in normal subjects. An electronic scale was used and found that 8 to 10 pounds of force was sufficient to elicit the tenderness response. After this examination method, each section of the spine that elicited tenderness to spinous process pressure was evaluated by standard AK MMT procedures to see if these sections would also therapy localize and be positive to challenge. Intervention and Outcome: The study showed an 83.3% correlation between the presence of spinous process pain and subluxation findings using AK methods. Conclusion: There are a number of criteria that chiropractors use to determine which vertebrae to adjust. Demonstrating a correlation between these findings is desirable. This paper demonstrates a statistically significant correlation between the signs and symptoms AK physicians use to determine the presence of vertebral subluxation and spinous process tenderness. (Collected Papers International College of Applied Kinesiology, 2001-2002;1:37-39) Key Indexing Terms: Pain Measurement; Spine; Diagnosis, Differential; Chiropractic Manipulation; Kinesiology, Applied THE ASSOCIATION OF THE SPONDYLOGENIC REFLEXES TO THE TEMPOROMANDIBULAR JOINT Paul T. Sprieser, D.C., D.I.B.A.K. ABSTRACT Objective: To present a case series and discussion of the effects of tapping the T2-T4 spondylogenic reflex areas of Dvorak and Dvorak for pain reduction in the lateral pterygoid muscles of the TMJ. Clinical Features: Patients with TMJ problems are frequently found in clinical practice, and acute pain in the lateral pterygoid muscles is a frequent finding in these cases. An AK method is described for treatment that consists of contacting the involved lateral pterygoid muscle while the patient is seated and tapping firmly on the spinous and transverse processes of T2-T4. A theoretical discussion of how stimulation of peripheral mechanoreceptors can depress transmission of pain signals, and specifically how the AK treatment of the lateral pterygoid tenderness works, is offered. The relationship of stimulation to the T2-T4 levels and the lateral pterygoid pain reduction is presented. Intervention and Outcome: The author discusses the endorphin system in his presentation, and he acquired a tablet form of sublingual naloxone and tested it on the patients in this study (a drug that blocks endorphin receptor sites). Naloxone produced diminution in pain for the lateral pterygoid muscles, as did the spondylogenic reflex tapping, suggesting that this AK treatment method may affect the endorphin system in the CNS. Conclusion: The spondylogenic reflex treatment for pain in the lateral pterygoid muscle was successful in the 48 patients studied. In patients with painful TMJ syndromes, especially those with lateral pterygoid muscle dysfunction, treatment with AK methods may be beneficial. Larger clinical trials with greater controls are warranted. (Collected Papers International College of Applied Kinesiology, 2001-2002;1:41-45) 76 Key Indexing Terms: Temporomandibular Joint; Pterygoid Muscles; Clinical Trials; Models, Theoretical; Treatment; Chiropractic; Kinesiology, Applied THE TREATMENT OF URINARY TRACT DISORDERS AND INTERSTITIAL CYSTITIS Paul T. Sprieser, D.C., D.I.B.A.K. ABSTRACT Objective: To present an overview of urinary tract disorders, particularly interstitial cystitis, and a successful method of treatment using meridian therapy. Clinical Features: Interstitial cystitis is a painful inflammation of the bladder that might be related to collagen disease, autoimmune disorders, allergic conditions, or an infectious agent not yet identified. A case series of 49 female and 1 male patient is presented. Intervention and Outcome: A protocol of treatment is presented for patients with urinary tract or pelvic diaphragm problems. TL to the alarm point for the bladder was negative, but with simultaneous TL to the lung alarm point, it became positive. The author was able to neutralize this TL pattern in these patients by tapping bladder meridian"s second point, BL2 for 60 seconds on both sides. The author also treated the bladder"s associated point BL28. This method of treatment improved the bladder problem in all the patients in this study. The extent of improvement and the method of measuring this were not documented in this report. Conclusion: This method had a high success rate for patients with urinary tract problems, including interstitial cystitis. Because interstitial cystitis afflicts millions of patients with bladder urgency, frequency, and pelvic pain, this method should be investigated for its value to these patients. (Collected Papers International College of Applied Kinesiology, 2001-2002;1:49-50) Key Indexing Terms: Cystitis, Interstitial; Pelvic Inflammatory Disease; Pelvic Pain; Case Reports; Diagnosis; Treatment; Acupuncture Points; Chiropractic; Kinesiology, Applied SKELETAL RESPIRATORY PATTERNS AND THE RELATIONSHIP TO MUSCLE FACILITATION OR INHIBITION Paul T. Sprieser, D.C., D.I.B.A.K. ABSTRACT Objective: To present a case series report and review on the skeletal motion created by respiration and its effects on patterns of muscle facilitation and inhibition. 77 Clinical Features: 100 patients (50 male and 50 female) were evaluated to discover if there was a specific relationship of the respiratory motion in the sacrum and ilium to the muscles that relate to each of these structures. All of the muscles that have origin or insertion on the innominate bones were tested. If they were inhibited, treatment to strengthen them was given before the research protocol was begun. Intervention and Outcome: Each patient"s pelvis was challenged by hand bilaterally with 8 to 10 pounds of pressure at the ASIS in the opposite direction of the normal inspiratory motion (an upward and medial direction) for 4 or 5 cycles during inspiration. Each of the muscles that attach to the innominate was retested to discover if a weakening effect occurred. Profound muscle weakening was found in the gluteus maximus, gluteus medius, tensor fascia lata, rectus abdominus, internal and external obliques, and the entire 4 heads of the quadriceps. When sacral respiratory motion was challenged in reverse of its normal respiratory movement on inspiration (sacral base forward), only the hamstrings and adductors would weaken. Conclusion: This study showed a specific relationship between the respiratory motion of the sacrum and innominate bones and the function of specific muscles that attach to them. When this motion is disturbed, specific muscle weaknesses occur. The importance of this finding should be investigated in larger groups of patients with spinal problems. (Collected Papers International College of Applied Kinesiology, 2001- 2002;1:51-52) Key Indexing Terms: Respiratory Mechanics; Diagnostic Techniques, Respiratory System; Sacrum; Ilium; Kinetics; Chiropractic; Kinesiology, Applied ABOUT PECULIARITIES OF THE EFFECT OF MUSCLE FUNCTIONAL WEAKNESS Vasilyeva, L.F., Chernysheva, T.N., Korenbaum, V.I., Apukhtina, T.P. ABSTRACT Objective: To report the results of electromyography changes in muscle strength in three patients who received sensory provocations of a mechanical, chemical, and emotional nature. Clinical Features: Electromyographic measurement of the pectoralis major and the deltoid muscle was made during 3-second muscle contractions. The examiner found the muscles to be strong on MMT. Intervention and Outcome: When the patients received sensory provocations, the examiner found muscle inhibition on MMT. The EMG amplitudes during the muscle tests were plotted graphically, and confirmed the changes in muscle strength detected manually by the examiner after sensory provocation. Conclusion: The evaluation of muscle strength changes measured with an EMG instrument confirms that muscle strength changes can be detected by AK physicians using MMT methods after appropriate sensory provocation, and that this phenomena can be measured by instrumentation. AK muscle testing procedures can be objectively be evaluated through quantification of the electrical characteristics of muscles, and the course of AK treatments can be objectively plotted over time. Numerous clinical trials relating differing clinical conditions to changes in EMG measurements on MMT are called for. (Collected Papers International College of Applied Kinesiology, 2001-2002;1:63-66) 78 Key Indexing Terms: Electromyography; Evaluation Studies; Neurologic Manifestations; Muscle Weakness; Chiropractic; Kinesiology, Applied AN APPLIED KINESIOLOGY EVALUATION OF FACIAL NEURALGIA: A CASE HISTORY OF BELL"S PALSY Scott C. Cuthbert, D.C. ABSTRACT Objective: To discuss the assessment, diagnosis and successful chiropractic management of a patient with Bell"s palsy. Clinical Features: A 51-year-old female presented with left-sided facial nerve paralysis, as well as intense neck pain and tingling in her left arm that had been present a week before the onset of the facial nerve paralysis. On examination her left lip was quivering, her left tear duct was pulsing, swollen and painful. Her vision was slightly blurred, and she had hyperacusis in her left ear. Her sense of taste was also affected by the problem, with a "mediciney taste mixed with rancid oil." Sugar diluted in water was applied to the anterior 1/3 of the tongue with a cotton swab to evaluate the chorda tympani portion of the facial nerve, and a medicine like flavor was detected. A review of the neuroanatomy of cranial nerve VII is given, with possible entrapment neuropathies and disturbances to its function given. Intervention and Outcome: Cranial and spinal adjustments were made as indicated by AK findings on examination. Tenderness along the left occipitomastoid suture was eliminated with a left inspiration, right expiration assist cranial fault correction, and compression of the 4th ventricle techniques. The deep neck flexor and sternocleidomastoid muscles were strengthened by these corrections. An occipito-atlantal fixation correction strengthened the psoas muscles. A category I pelvic fault was corrected. She was similarly treated 7 times over 24 days and was completely free of facial paralysis, without the slightest cosmetic residual problem apparent. The Bell"s palsy of 2 weeks duration had not returned 5 years later. Conclusion: Further studies into AK and cranial treatments for facial nerve dysfunctions may be helpful to determine whether this single case study can be representative of a group of patients who might benefit from this care. (Collected Papers International College of Applied Kinesiology, 2001-2002;1:67-72) Key Indexing Terms: Facial Paralysis; Bell Palsy; Case Reports [Publication Type]; Diagnostic Techniques and Procedures; Treatment; Chiropractic; Kinesiology, Applied THE PECTORALIS MAJOR CLAVICULAR, HYDROCHLORIC ACID PRODUCTION, AND ZINC STATUS Terry M. Hambrick, D.C., D.I.B.A.K. 79 ABSTRACT Objective: To present a case series where the gastric acid level was measured with the Gastro-Test Kit from HDC, Inc. These values were then correlated with MMT of the pectoralis major, clavicular division muscle (PMC) as well as zinc levels measured with the zinc tally test in the patient series. Clinical Features: The Gastro-Test procedure requires that the patient swallow a weighted capsule attached to a cotton string. The patient rests on their left side for 7 minutes, then the string is withdrawn. The cotton string is then swabbed with a reagent and reacts with the gastric juices that have soaked into the distal end of the string. The resultant color is matched with a color chart that reflects the pH of the gastric juices. Zinc status is measured with a saturated zinc solution that the patient holds in their mouth for 10 seconds. The patient reports their taste sensation to the examiner after this time. The predictable outcome is that the patient tastes nothing or has a strong sense of taste, with a grade scale from 1 to 4. Intervention and Outcome: 5 students at a seminar were tested using the above parameters. The study found that an inhibited pectoralis major, clavicular division muscle was not reflective of reduced hydrochloric acid production as measured by the Gastro-Test kit. The one patient with alkaline gastric pH was also the only one to show a facilitated PMC. Zinc levels were normal in all participants but one and this subject demonstrated an inhibited PMC muscle. Conclusion: These results challenge one of the more basic AK teachings which has shown itself to be clinically effective, i.e. that the PMC will be inhibited in cases of decreased hydrochloric acid production in patients. Possible complicating factors to the study are the sample size, the lack of screening for lumbo- dorsal fixations (that may mask the PMC weakness). The author suggests that further studies should be done to quantify and validate the correlation between an inhibited PMC muscle and gastric pH levels. (Collected Papers International College of Applied Kinesiology, 2001-2002;1:111-113) Key Indexing Terms: Gastric Acidity Determination; Achlorhydria; Diagnosis, Differential; Muscle Weakness; Case Reports [Publication Type]; Kinesiology, Applied RETAINED PRIMITIVE REFLEXES: STRUCTURAL CORRECTIONS THAT ASSIST THEIR INTEGRATION Keith Keen, Dip. Ac., D.O., D.C. ABSTRACT Objective: To present concepts regarding primitive and postural reflexes that can be retained past their normal age of integration and their use as a tool for physicians to find out why a child is not performing at their age level. Craniosacral corrections that assist the integration of retained primitive reflexes are presented. Clinical Features: Neonates are routinely checked for the presence of primitive reflexes, as they are essential for their survival and normal development. The work of Capute, Blythe and Goddard are cited that show primitive reflexes may remain long after the normal age of integration. The reflexes described here are the Fear Paralysis Reflex; Moro Reflex; Asymmetrical Tonic Neck Reflex (ATNR); Tonic 80 Labyrinthine Reflex (TLR); and Spinal Galant Reflex. The function of these reflexes is described, and the learning, developmental, and sensorimotor delays that the presence of these reflexes may produce if they are retained are discussed. Intervention and Outcome: The author describes a retrospective statistical analysis study he performed in 1998 on a group of children. They were tested for retention of primitive reflexes by a neurodevelopmental assessor before and after the corrections described in this paper. The results of that study are reviewed, showing positive changes at probabilities ranging from p<.05 to p<.01 (Keen, 1999). Treatment involves placing the child into the position of the primitive reflex and then MMT of an indicator muscle for weakening. The doctor then must find what is causing the problem (what abolishes the indicator muscle change), and then correct this factor. A cranial or a sacral fault was usually found to be necessary. Conclusion: Structural, mostly craniosacral, corrections were developed that assist the integration of retained primitive reflexes. The research offered shows that this therapy helps aspects of learning difficulties, behavioral problems, and developmental delay. Controlled clinical trials of this method for the treatment of these kinds of problems in children are necessary. (Collected Papers International College of Applied Kinesiology, 2001-2002;1:121-127) Key Indexing Terms: Reflex, Abnormal; Developmental Disabilities; Diagnosis, Differential; Muscle Weakness; Chiropractic; Kinesiology, Applied THE ROLE OF DERMAL PROPRIOCEPTORS IN REACTIVE MUSCLE PATTERNS Datis Kharrazian, D.C., C.C.N., C.S.C.S., C.C.S.P. ABSTRACT Objective: To discuss the role of the proprioceptors in the skin and their role in causing reactive muscle patterns. Clinical Features: In traditional AK methodology, the reactive muscle phenomenon occurs when a muscle becomes inhibited because of inappropriate proprioceptive impulses from another previously contracted muscle. This paper proposes that reactive muscle patterns can also be caused by aberrant afferent input from dermal proprioceptors in the skin, and that this aberrant input produces similar neurologic consequences as the reactive muscle phenomenon produced by aberrant muscle spindles. Intervention and Outcome: The involvement of the skin can be diagnosed by challenging the skin manually over the hypertonic muscle in the reactive muscle pattern. The challenge is produced by gently tugging the skin in the vector that produces the reactive muscle finding. Treatment by tugging on the skin in the opposite direction that initiated the reactive muscle pattern corrects this pattern of reactive muscle inhibition. Conclusion: The author recommends that the dermis be checked for its influence on reactive muscle patterns. It is a common finding in his experience, and corrects more thoroughly the reactive muscle patterns found clinically. Clinical trials to differentiate this treatment from treatment of the muscle spindles beneath the skin are warranted to discover which element has priority in the reactive muscle 81 pattern. Outcome studies on the effects of this treatment in symptomatic patients are needed. (Collected Papers International College of Applied Kinesiology, 2001-2002;1:129-130) Key Indexing Terms: Proprioception; Dermis; Muscle, Skeletal; Muscle Spindles; Muscle Hypotonia; Physiological Processes; Diagnosis, Differential; Chiropractic; Kinesiology, Applied SEVERE EQUILIBRIUM PROBLEMS NON-RESPONSIVE TO PHARMACOLOGICAL CARE TREATED WITH CHIROPRACTIC AND APPLIED KINESIOLOGY: A CASE HISTORY David W. Leaf, D.C., D.I.B.A.K. ABSTRACT Objective: To present a case of severe equilibrium problems successfully treated with cervical traction. Clinical Features: A 48-year-old female presented with equilibrium problems of 16 months duration. She reported that the symptoms started 2 weeks after she stood up under the kitchen sink and hit her head, and the problem was made worse when she closed her eyes. 4 neurologists and another chiropractor had treated the patient with no change in symptomatology. She exhibited an abnormal gait that resembled a drunken swagger, and was able to stand with her feet separated at least 10 inches apart but lost her balance with the feet closer together. The technique of cervical traction while the patient is walking on a treadmill, first described by Fred Illi, D.C., of Geneva, Switzerland, is presented. Intervention and Outcome: The patient showed marked inhibition of all her extensor muscles, and exhibited bilateral nystagmus. The weak extensors became strong after cervical traction challenge testing. The author used cervical traction of 6 pounds while the patient walked on a treadmill for 15 minutes. After this, she was able to stand with her feet together with no body sway. She presented no signs of nystagmus and her vertical height had increased by 2 inches after treatment. Conclusion: In this case there appeared to be a pattern of muscle inhibition as a result of compression of the occipito-atlantal articulations. This showed on MMT as inhibition of the extensor muscles of the body. Use of a home cervical traction device with 6 pounds of water causing distraction while the patient moves in a walking pattern reversed the symptom pattern in this patient. Larger clinical trials of this method for the treatment of equilibrium and imbalance disorders are warranted. (Collected Papers International College of Applied Kinesiology, 2001-2002;1:133-134) Key Indexing Terms: Musculoskeletal Equilibrium; Traction; Therapeutics; Chiropractic; Kinesiology, Applied CASE HISTORY: CLUSTER HEADACHE 82 William Maykel, D.C., D.I.B.A.K. ABSTRACT Objective: To present a case of cluster headache successfully treated using AK methods with an 8 -year follow up and no recurrence. Clinical Features: Cluster headaches represent one of the most severe forms of headache, causing some of its victims to commit suicide. In 85% of patients, the attacks are regular to the same hour or hours each day until the headache ends. Discussion of the theoretical pathogenesis of this problem from a literature review is presented. A 62-year-old male, with a 17-year history of cluster headaches, presents for treatment. The pain was severe and located over the entire left side of the face, accompanied by belching, facial pallor, conjunctival injection, nasal stuffiness and rhinorrhea, bradycardia, and lacrimation. He used Florinal to relieve the pain. The headaches occurred daily and although heavily medicated he would often lie on his back on the floor during his lunch hour and pound his head on the floor to create some relief. Intervention and Outcome: Multiple cranial faults were found: bilateral sphenobasilar flexion, left laterally displaced occiput, left parietal descent, and right temporal parietal bulge cranial faults. The cruciate and sagittal sutures were compressed, and the left clavicle was displaced laterally. AK treatment was used for reducing the strain in the craniosacral system. Food related provocation of the cluster headache was suspected, and supplemental hydrochloric acid tablets, a digestive cleansing/bulking agent, and multivitamin and multimineral were given. The patient was treated 30 times over a 7-month period, and there was a progressive reduction in the intensity of the headaches. He was not seen for 6 months, and at that time the headaches were "practically gone." The patient has been free of headaches since that time for 10 years. Conclusion: A prospective, controlled clinical trial of chiropractic management in this condition is warranted, considering the absence of otherwise effective therapy. (Collected Papers International College of Applied Kinesiology, 2001-2002;1:135-138) Key Indexing Terms: Cluster Headache; Case Reports [Publication Type]; Treatment; Kinesiology, Applied CASE HISTORY: SUCCESSFUL TREATMENT OF CERVICAL RADICULOPATHY ACCOMPANIED BY HERNIATED NUCLEUS PULPOSUS WITH CHIROPRACTIC, APPLIED KINESIOLOGICAL AND PHYSICAL MEDICINE MODALITIES William Maykel, D.C., D.I.B.A.K. ABSTRACT Objective: To present the case of a herniated intervertebral cervical disc successfully treated by chiropractic methods. Clinical Features: A 37-year-old female presents with signs and symptoms of C5 and C6 disc pathology. There had been two prior cervical acceleration/deceleration (CAD) accidents producing trauma to the 83 cervical spine. The role of prior CAD in the pathogenesis of her problem is discussed, as are the altered biomechanical factors specifically assessed and treated using AK techniques combined with other physical modalities. Intervention and Outcome: The patient was treated 49 times over a 6-month period and made a complete subjective and functional recovery. A pre-treatment MRI of the cervical spine showed "nucleus pulposus herniations at C5-6 level centrally and to the right," that "appear to impinge on the thecal sac and extend into the right neural foramen." A CT scan following myelography had the same findings. A post-treatment MRI of the cervical spine showed that though the herniated disc was still present, the previous "annular bulging" had improved with a reduction in the thecal sac impingement, and there was diminished foraminal encroachment (no extension to the right neural foramen on the post-treatment MRI study. Conclusion: The effectiveness of chiropractic care for this type of condition compared to medical care is evaluated in this paper from the research literature, showing that chiropractic care for this kind of severe pathology can be successful that might otherwise require more costly and aggressive measures. The author suggests that not all patients with symptoms referable to a demonstrated herniated disc need be considered surgical candidates. More chiropractic clinical trials to evaluate this contention are underway. (Collected Papers International College of Applied Kinesiology, 2001-2002;1:139-144) Key Indexing Terms: Intervertebral Disk Displacement; Cervical Vertebrae; Case Reports [Publication Type]; Costs and Cost Analysis; Treatment; Kinesiology, Applied TREATMENT OF BELL"S PALSY BY THE CORRECTION OF FAULTS IN THE STOMATOGNATHIC SYSTEM: CASE HISTORY William Maykel, D.C., D.I.B.A.K. ABSTRACT Objective: The successful treatment of 2 patients with Bell"s palsy by manually correcting faults in the stomatognathic system is described. Clinical Features: The natural history and prognosis of Bell"s palsy in the research literature is reviewed. 35 references are cited and discussed involving the pathogenesis, symptom picture, and prognosis of the condition. The first patient, a 57-year-old male, experienced right-sided facial paralysis 3-hours after chewing a "very thick crusted pizza while eating quickly" that had been present for 1 week. Multiple cranial disrelationships were found on examination, as well as TMJ movement problems, with masseter, temporalis, and pterygoid muscle hypertonicity. A cervical disc syndrome at the C4/5 and C5/6 levels were found, as well as a lumbar disc syndrome at L5/S1. The second patient, a 39-year-old male, had left- sided facial paralysis for 9 days. A few days prior he noted suboccipital and frontal headaches, left neck stiffness and a "tired feeling" came on with the facial paralysis, but that feeling subsequently cleared. Hyperacusis in the left ear was present also. Intervention and Outcome: Treatment for both cases consisted of cranial, muscular, and spinal adjustments to normalize aberrant skeletal and cranial biomechanics. This treatment was accompanied by 84 rapid and permanent resolution of the clinical problem of Bell"s palsy. Although the two patients were treated early in the course of their illnesses, the speed of their recovery and small number of treatments (4 treatments over a 6-day period in the first case, and 3 treatments over a 14-day period in the second case) is notable. Conclusion: Alleviation of the structural problems in patients with Bell"s palsy, which are hypothesized to create the pathology, predispose to viral infection, or hinder healing, should be applied early on to shorten the course of the illness and to lessen the severity of the symptoms. The author states that he has found the same stomatognathic compartment syndrome in 12 other cases of Bell"s palsy, and all of these cases resolved adequately in a short time frame with this treatment. Well-designed clinical trials of this potentially life-altering condition are recommended. (Collected Papers International College of Applied Kinesiology, 2001-2002;1:145-151) Key Indexing Terms: Facial Paralysis; Bell Palsy; Case Reports [Publication Type]; Diagnostic Techniques and Procedures; Treatment; Chiropractic; Kinesiology, Applied PEDIATRIC CASE HISTORY: COST EFFECTIVE TREATMENT OF BLOCKED NASO- LACRIMAL CANAL UTILIZING APPLIED KINESIOLOGY TENETS William Maykel, D.C., D.I.B.A.K. ABSTRACT Objective: To present a case of a blocked tear duct in a 14-month-old child that was successfully treated using AK methods. Clinical Features: A 14-month-old presented with poor drainage from his left eye causing it to be consistently crusty. The child had several colds over the past 6-months, and the child has been referred by the mother"s pediatrician to a pediatric plastic surgeon for surgical correction of the blocked tear duct. Intervention and Outcome: Surrogate testing, utilizing the mother"s arm muscles was used to specify necessary treatment. Treatment of cranial faults, cervical, thoracic and lumbar dysarthrias, as well as bilateral sacroiliac sprain was given. A left parietal descent, right temporal-parietal bulge, bilateral sphenobasilar flexion, left internal frontal, and left external zygoma cranial faults were manually corrected by AK methodology. A category II pelvic fault on the left was corrected, a s well as a left sacral inferiority that produced left rotation of L5, L3, C3 and C1 vertebrae. The left upper trapezius was strengthened by origin-insertion technique, and spasm of the masseter, temporalis, and pterygoid muscles were balanced manually. The child was treated 5-times over a 6-week period with complete resolution of the blocked tear duct. Conclusion: Jamming of the orbital bones in this case as well as locking of the vault bones was suspected to lead to increased tension, then swelling and closure of the nasal lacrimal canal. This conservative, cost- effective approach may become the standard protocol in the future should subsequent studies validate this method of treatment. (Collected Papers International College of Applied Kinesiology, 2001-2002;1:153- 154) 85 Key Indexing Terms: Lacrimal Apparatus Diseases; Case Reports [Publication Type]; Diagnostic Techniques and Procedures; Treatment; Chiropractic; Kinesiology, Applied VISCERO-SOMATIC REFLEXES: THEIR CLINICAL MANIFESTATIONS USING MUSCLE TESTING TO EVALUATE THE HEART AND ESOPHAGUS Victor J. Portelli, D.C., D.I.B.A.K. ABSTRACT Objective: This paper examines several clinical relationships that have been discovered by the author between the motion of an organ and specific MMT outcomes compared to general MMT outcomes to an organ challenge. Clinical Features: MMT is found to be a useful tool to help in the identification of visceral fixations and their correction. The paper demonstrates methods of diagnosis and treatment using viscero-somatic reflexes using the heart and esophagus organs as examples. Pushing or pulling an organ into or out of "lesion" while the doctor performs a MMT produces a visceral challenge. The author states that a visceral lesion refers to an organ that is in an incorrect anatomical position, has movement aberrations or adhesions, or has its blood or lymph supply compromised by an anatomical neighbor. A theoretical explanation of the mechanisms of the visceral challenge and of visceral therapy in general is presented. The anatomy of the heart and the esophagus is presented, as well as signs, symptoms and tests that may help the clinician identify when these organs may require this type of treatment. Intervention and Outcome: Specific methods of challenge for the heart and the esophagus are given. Treatment protocols for positive findings on these tests are described. The relationship of the subscapularis muscle to the heart challenges, and of the supraspinatus muscle to the esophagus challenges are delineated. The numerous treatment methods for both the heart and the esophagus involve whole-body analysis and comprehensive therapy for these organs. Conclusion: The author reports that visceral challenge reveals a neurological relationship exists between muscles and organs and that this relationship is muscle and organ specific. This relationship may be useful to determine whether physiologically normal patterns or aberrant biomechanical visceral faults are present in patients. Clinical trials with measurable outcome studies need to be done to validate this method of diagnosis and treatment. (Collected Papers International College of Applied Kinesiology, 2001-2002;1:155-175) Key Indexing Terms: Visceral Afferents; Visceral Prolapse; Diagnostic Techniques and Procedures; Treatment; Chiropractic; Kinesiology, Applied TECHNIQUES BASED ON CONCEPTS OF THE ENTERIC NERVOUS SYSTEM 86 Walter H. Schmitt, D.C., D.I.B.A.K., D.A.B.C.N. ABSTRACT Objective: To present 3 new challenge techniques and therapeutic approaches for the evaluation of the enteric nervous system (ENS). Clinical Features: The work of Michael D. Gershon, M.D., is reviewed. His discovery of the functioning of the enteric nervous system and the field of neurogastroenterology is described, and its clinical relevance illustrated. Fatty acids anywhere in the intestinal lumen stimulates the ENS to decrease peristalsis of the gut at the ileocecal area, what is called in AK the closed ileocecal valve (ICV) syndrome. This reflex exists to keep undigested fat from entering the colon where it may stimulate the growth of unfriendly flora. Carbohydrate also stimulates the ENS and produces an open ileocecal valve syndrome. The gastrocolic reflex causes increased peristalsis in the large intestine following food intake that stretches the stomach. When the stomach is stimulated by the presence of food, the colon is stimulated to empty. These reflexes have produced 3 sensory challenges that evaluate whether or not they are functioning properly. Intervention and Outcome: Fatty acid function in the ENS is evaluated with the ileal brake challenge. First, normal ICV treatments are given if needed. Then, the doctor places a good fat like olive in the mouth. If this produces a positive challenge for the closed ICV, then the patient TLs to Chapman"s neurolymphatic reflexes (NL) for the pancreas, liver, gallbladder to identify which one negates the fat- induced closed ICV challenge. Nutrients may also negate the positive challenge and are tested. Treatment to the reflex and supplementation are given. Carbohydrate challenge for the open ICV syndrome involves placing sugar or other carbohydrate in the mouth. If this produces a positive open ICV challenge, then the patient TLs the NL for the small intestine. Treatment is by rubbing NL reflex with the carbohydrate that caused the weakening in the mouth. The gastrocolic reflex challenge has 3 steps. First, the doctor pinches the referred pain area for the stomach, puts pressure through the abdominal wall to stretch the stomach, and challenges for an open ICV or Houston valve. If challenge is positive, an offending dietary substance, when tasted, will cause a positive TL to the stomach Chapman"s reflex area. Rubbing this reflex with the offending substance in the mouth will negate the challenge. If there is a recurrence of this finding, the offending substance may have to be permanently avoided. Conclusion: It appears that ENS concepts may be clinically applied by monitoring MMT outcomes following various specific sensory receptor challenges. It is suggested by the author that this treatment has improved patients" complaints and decreased recurrence of a variety of digestive symptoms. Controlled clinical trials on appropriate patient cohorts are necessary. (Collected Papers International College of Applied Kinesiology, 2001-2002;1:177-180) Key Indexing Terms: Enteric Nervous System; Reflex, Abnormal; Diagnostic Techniques and Procedures; Treatment; Chiropractic; Kinesiology, Applied THE ASSOCIATION OF REPEAT MUSCLE ACTIVATION PATIENT INDUCED (R.M.A.P.I.) TO HYPOADRENIA Paul T. Sprieser, D.C., D.I.B.A.K. 87 ABSTRACT Objective: To present a clinical finding connecting R.M.A.P.I. to functional hypoadrenia. Clinical Features: 50 patients were part of this study, 29 females and 21 males. The R.M.A.P.I. is a finding in some patients whose muscles test weak after the patient repeatedly contracts the muscle. Each patient was evaluated for a number of factors including blood pressure lying, seated and standing (Ragland"s effect noted, or a drop in the systolic blood pressure). The ligament stretch reaction (associated in AK with adrenal stress disorder), and sphenobasilar cranial fault (sometimes associated with adrenal stress disorder) were tested in each patient. Intervention and Outcome: Two methods of evaluating each patient in the study was performed. If R.M.A.P.I. was discovered during examination, then the other tests for hypoadrenia were performed. If the patient"s symptoms indicated hypoadrenia, these tests were performed as well as an evaluation of the R.M.A.P.I phenomenon. All of the patients in this study showed a drop in systolic blood pressure from lying to sitting or sitting to standing, a positive Ragland"s sign. All showed the sphenobasilar fault, the ligament stretch reaction, positive TL to the temporosphenoidal line when cross TL was done, and all patients showed one or more muscles that had the R.M.A.P.I. finding. The most common muscle to show the R.M.A.P.I. was the rectus abdominus. Nutritional support was needed by all cases to correct these findings in this study that included adrenal support with choline or adrenal tissue, and a low dosage of vitamin E from wheat germ oil or octacosanol. Conclusion: This study showed that the R.M.A.P.I. phenomenon was a part of the adrenal stress syndrome. The mechanisms of this connection should be studied further, and other clinical trials to demonstrate the significance of this finding conducted. (Collected Papers International College of Applied Kinesiology, 2001-2002;1:181-182) Key Indexing Terms: Muscles; Muscle Fatigue; Physiological Processes; Adrenal Insufficiency; Treatment; Chiropractic; Kinesiology, Applied 88
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