The Collected Papers of the
International College of Applied Kinesiology has been published both
annually and bi-annually since the founding of the International
College of Applied Kinesiology (ICAK) in 1976. There has been a
concerted effort by the organization to present the research, outcomes
assessment, and clinical investigations of its members to the
organization as a whole and to the chiropractic profession at large.
There have been over 2,000 papers in 40 Annual Yearbooks published by
members of the organization. These yearbooks can be purchased from the
ICAK at
www.ICAKUSA.com.
It should be noted that the ICAK has not required strict conformity to
formatted research design for paper presentation in its
yearly-published Collected Papers. Many members of the ICAK are
clinicians and are not professional researchers. This is why I have
reviewed these Collected Papers and written these structured abstracts
in conformity with the style currently in use in the scientific
research literature around the world. These abstracts remain faithful
to the information contained in the original authors’ clinical reports.
Since my own immersion in sacro occipital technique (SOT) at Palmer
Chiropractic College, and then my work with Dr. David Walther and by
extension Dr. George Goodheart and the rest of the AK family, I have
discovered the seamless interlocking nature of these two highly
evolved, progressive systems of chiropractic. Drs. Goodheart and
DeJarnette will be proud to learn of that cooperation and alliance
between their two systems of chiropractic is forming as the result of
this joint effort of the ICAK-USA and SOTO-USA, making both of our
systems, chiropractic, and healthcare stronger as a result.
-- Edited by
Scott
Cuthbert, D.C.
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.
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 3rd 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)
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
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.
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
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.
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
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 6th 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 6th 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
“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.
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.
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
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.
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 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 _ of the population. (Collected Papers
International College of Applied Kinesiology, 2002-2003;1:137-156)
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.
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 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)
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.
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 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