EVALUATION OF TMJ IN ONE CASE STUDY WITH CONGENITALLY ABSENT RIGHT FOREARM
Janet Calhoon, D.C., D.I.B.A.K.
ABSTRACT Objective: To present the case of a young female with temporomandibular joint disorder who also had a congenitally absent right forearm, wrist, hand and fingers.
Clinical Features: A 13-year-old female presented who was unable to open her mouth more than two finger widths. This problem had been present for 1 week after she fell during physical education class and struck the left side of her head against the floor. The patient’s right upper extremity is normal in size and function from the shoulder to the elbow, but her forearm ends 2 inches below the elbow with no carpals or metacarpals and rudimentary digits, each about 1/8th inch in length.
Intervention and Outcome: AK examination revealed an upper cervical fixation, a cervicothoracic fixation, and thoracolumbar fixation. When the patient was asked to TL the right TMJ with her right hand, she was able to do so only by changing the position of her head and neck that would have added unwanted variables to the evaluation. With the doctor’s guidance, the patient was able to TL the right TMJ without moving her neck and head. Positive TL was demonstrated in this patient even with the congenitally abnormal right forearm. Examination showed a need for neuromuscular spindle technique to inhibit the right internal pterygoid muscle, and the inhibited right sternocleidomastoid muscle responded to neurolymphatic reflex treatment, Golgi tendon organ and neuromuscular spindle techniques. An intraosseous universal cranial fault was corrected on the first visit also. At the end of the first treatment, the young woman opened her mouth almost wide enough to accommodate 3 knuckles. On follow up visits, she continued to make progress with AK treatment.
Conclusion: Bilateral TL is a valuable tool in evaluation of the TMJ. In this case, a rudimentary limb was used successfully to identify malfunctioning muscles and joints.
(Collected Papers International College of Applied Kinesiology, 2000-2001;1:1-2)
Key Indexing Terms: Temporomandibular Joint Disorders; Case Reports [Publication Type]; Kinesiology, Applied; Chiropractic
APPLIED KINESIOLOGY MANAGEMENT OF ASTHMA: A CASE HISTORY
Cecilia A. Duffy, D.C., D.I.B.A.K.
ABSTRACT Objective: A case history of the management of asthma in a child is presented.
Clinical Features: A 6-½ year old female presents with symptoms of asthma. A medical pediatrician had previously diagnosed her with asthma at 10 months of age, with continuous use of prescription medications since that time (Proventil and Ventolin) for symptom control. Asthmatic episodes were intermittent.
Intervention and Outcome: AK physical examination revealed: axillary temperature 98.4 degrees; salivary pH 6.8; blood pressure seated 80/60, standing 80/58, and supine 90/50; pulse seated 100, standing 100; Lingual Ascorbic Acid Time was elevated at 15 seconds on the right and left sides of the tongue; hematocrit 38; breath holding time diminished at 10 seconds; vital capacity diminished at 650 (normal for her age is 980); right hand and foot dominance with left eye and ear dominance; Sulkawich testing for calcium levels elevated at grade 4; Koenigsberg testing for chloride (indirect sodium) elevated at 30 plus. Auscultation of the lungs revealed scattered rales and wheezing throughout both lung fields. Based on the history and physical findings (positive orthostatic hypotension, mild vitamin C deficiency, and elevated urinary chloride level), adrenal dysfunction was presumed and examined for via AK testing. The left sartorius muscle was inhibited on MMT, and strengthened with oral nutrient testing of Drenamin (Standard Process Laboratories). A category II pelvic subluxation, T9, T2 subluxations, and fixation at the right C7-1st rib junction were corrected. Dietary restrictions were given (no milk or refined grains and sugars, and she was to consume only vegetable, fruit, non-processed proteins, high quality fats, and non-processed whole grains). The patient complied with her supplementation instructions and dietary restrictions, and was seen 5 times in 3 months. Her mother discontinued both asthma medications after the first visit. During the 3 months of therapy, the patient experienced 1 episode of an asthmatic reaction that was preceded by heavy consumption of refined grain and sugar earlier in the day. At 7 and 10 months following initial presentation the patient returned after experiencing 1 asthmatic reaction and several asthmatic reactions respectively. Each time, the patient was seen twice in 2 weeks for AK treatment and prescribed adrenal and immune system supports. On each occasion, after the first visit, the asthmatic reactions stopped.
Conclusions: Successful AK management of asthma over a 32-month period in a 6-½ year-old female is presented. Further investigation into the effectiveness of AK management for asthmatics is warranted. The primary approach of medical management of asthma is medication, and correcting the underlying causes of asthma is preferable to drug-induced control of the symptoms of this condition. (Collected Papers International College of Applied Kinesiology, 2000-2001;1:3-4)
Key Indexing Terms: Asthma; Anti-Asthmatic Agents; Case Reports [Publication Type]; Therapy; Diagnosis; Adrenal Insufficiency; Chiropractic; Kinesiology, Applied
USING AK MUSCLE BALANCING TECHNIQUES TO IMPROVE SPECIFIC EXERCISE MOVEMENT PATTERNS (PILATES)
John K. Moore, D.C., C.C.N., C.C.S.P.
ABSTRACT Objective: To investigate the impact of AK treatment upon experienced Pilates class athletes.
Clinical Features: Joseph Pilates developed The Pilates Method in the 1940s. It is a method of physical training that focuses on posture, alignment, and breathing. Strengthening the abdomen, lower back and hips (core strength) are its primary focus. A questionnaire was given to 5 participants in a Pilates class (each participant had at least 1 year of experience with the technique) before and after AK evaluation and treatment of muscular imbalances. Both the individual performing the Pilates exercises and the instructor of the class (not the author) was polled as to any perceived improvements.
Intervention and Outcome: The Pilates routine was rated as improved in all cases by utilizing basic AK methods to correct muscular and spinal imbalances.
Conclusion: From this pilot study evidence is offered that athletic performance can be improved when AK treatment is employed. Improved performance may also mean that pain after exercise and the longevity of the athlete’s career may also be improved. Larger clinical trials with larger patient numbers are warranted. (Collected Papers International College of Applied Kinesiology, 2000-2001;1:13-14)
Key Indexing Terms: Task Performance and Analysis; Sports; Therapy; Chiropractic; Kinesiology, Applied
A FUNCTIONAL APPROACH TO THE TREATMENT OF URINARY INCONTINENCE
Michael D. Allen, D.C., N.M.D., Chiropractic Neurologist
ABSTRACT Objective: To describe the potential effects of AK therapy upon patients with urinary incontinence who are free from frank pathology, and to illustrate how the pelvic diaphragm muscles are involved in this condition.
Clinical Features: More than 13 million people in the U.S. have experienced urinary incontinence (UI), with one in four women ages 30 to 59 affected. Especially in the elderly, four basic types of UI occur: 1) the bladder contracts when it should not (detrusor muscle over activity, the most common cause of geriatric UI, 2) the bladder fails to contract appropriately (detrusor under activity; the least common cause of UI in the elderly, 3) bladder outlet resistance is high when it should be low (obstruction, the second most common cause of UI in older men), or 4) bladder outlet resistance is low when it should be high (outlet incompetence; which is secondary to pelvic muscle laxity, and is the second most common cause of UI in older women).The pathological causes and medical treatment of UI are reviewed. The anatomy of the pelvis is reviewed with reference to the problems that produce UI, and the bladder control systems (neurologic and digestive) are described.
Intervention and Outcome: Testing the muscles of the pelvic diaphragm, correction of subluxations and fixations affecting the nerve supply to the pelvic muscles and organs are the most common type of treatment given for UI in AK. A review of the AK methods used for the treatment of these muscles is offered. The relationship of the peroneus longus, brevis and tertius muscles and the anterior tibialis muscles to the bladder is described. The author observes that a fixation at the cervico-dorsal spine is often present when a bilateral inhibition of these muscles is found.
Conclusion: From an AK perspective, treatment of UI should be directed toward optimizing the function of the muscles of the pelvic diaphragm that helps control the unwanted release of urine found in patients with UI. Because this treatment is non-invasive and UI so widespread in the elderly, clinical trials of this method of evaluation and treatment are indicated. (Collected Papers International College of Applied Kinesiology, 2000-2001;1:27-35)
Key Indexing Terms: Urinary Incontinence; Epidemiology; Diagnosis; Treatment; Chiropractic; Kinesiology, Applied
MUSCLE TEST RELIABILITY, OR WHEN SCIENCE CONFRONTS OBSERVATION
Michel Barras, D.C.
ABSTRACT Objective: To review the factors that must be taken into consideration when doing MMT in order to increase the procedure’s reliability.
Clinical Features: The major challenge to accurate and reproducible MMT is the mastery of the technical procedures of the MMT itself. Proper angulation of the part tested, the timing of the test, the amount of force applied, and the direction of the force applied are critical. The difficulty of MMT is due to the fact that all these parameters must be respected at the same time. The ability to artfully test muscles is the most important physical talent an AK practitioner will develop. Besides this, several other factors that may modify a MMT response are reviewed.
Intervention and Outcome: The factors that may alter a MMT outcome are listed: 1) bone tapping and pressure, 2) neurological disorganization, 3) recruitment of synergistic muscles, 4) hand/finger “short-circuiting” (related to the meridian system’s effect upon muscle function), 5) head position (the neurology of this factor is reviewed), 6) position of feet/legs of the patient while testing them either prone, supine, sitting or standing, 7) tongue position (the effect of this upon the cranial mechanism is reviewed), mechanical leverage on the teeth (chewing gum, etc.), 9) sphincter synergy (the interaction between the sphincters of the body is described).
Conclusion: The MMT is complex and in order to be reliable, a number of factors must be respected. It is the mandatory price to pay in order to have constant reproducible parameters. It is the key to success in using AK as a diagnostic modality. (Collected Papers International College of Applied Kinesiology, 2000-2001;1:37-40)
Key Indexing Terms: Muscle Weakness; Diagnosis; Evaluation Studies; Models, Theoretical; Kinesiology, Applied; Chiropractic;
THE TEMPOROMANDIBULAR JOINT REVISITED
Hans W. Boehnke, D.C., D.I.B.A.K.
ABSTRACT Objective: This paper presents the AK approach for treating structurally based disorders of the temporomandibular joint through an integrated approach to patient care.
Clinical Features: Dental occlusion is suggested to be part of a larger pattern of function and interdependence that includes the spine, pelvis, cranium, extremities, and neuromuscular systems that span them. A review of the kinematics of the jaw is provided, as well as the relevant anatomy of the TMJ. The AK protocol for evaluation of these factors is presented, and specific techniques for the diagnosis and treatment of the musculature of the stomatognathic system are offered. Factors that create a recurrence of the TMJ problem are reviewed, and diagnostic approaches and treatments for these factors are offered. Specific inter-relationships between the muscles of the TMJ and the function of the feet are described. 4 case histories elucidating these findings are offered.
Intervention and Outcome: The doctor who treats problems in the TMJ faces a great number of therapeutic possibilities that can make the use of the proper technique for the problems found perplexing and difficult. The author’s review of these factors may be helpful to a physician seeking a comprehensive understanding of the problem of the TMJ.
Conclusion: With the use of MMT in the demonstration of the complex interactions going on in a patient’s body that creates problems in their TMJ, communication and understanding between the doctor and the patient is improved. (Collected Papers International College of Applied Kinesiology, 2000-2001;1:41-49)
Key Indexing Terms: Temporomandibular Joint; Stomatognathic System; Diagnosis; Treatment; Case Reports [Publication Type]; Chiropractic; Kinesiology, Applied
SWITCHING, STRESS, MUSCULAR HYPERTONICITY, FIRE ELEMENT, CENTRAL AND GOVERNING VESSELS – NEW ASPECTS FOR AN INTEGRATING OVERVIEW
Wolfgang Gerz, M.D., D.I.B.A.K.
ABSTRACT Objective: To present a literature review that suggest a direct connection exists between the meridian system, the skeletal system, the cranio-sacral system, Selye’s system of adaptation, the hormone system and the phenomenon called “switching” in AK.
Clinical Features: AK therapists have found one of the most common problems in patients is the “switching” or “neurological disorganization” phenomenon. This condition in the patient may cause erroneous information to be derived from various AK testing procedures. A review from both the European and American AK literature on the topic of switching and its diagnosis is given. A literature review of biomedical, AK, and acupuncture is also given that suggests how the meridian system in its interaction with the neuromuscular system and the adaptation system (Hans Selye) may play an important role in the switching phenomenon. The rationale for use of the conception vessel and governing vessel in therapy localization is described.
Intervention and Outcome: The meridian correlations with the endocrine glands are reviewed, and its relevance to clinical presentations and treatment strategies for patients are described. The author states that in many cases of switching, SI3 and LU7 will demonstrate a positive TL. Positive TL to SI3 is frequently found on the side of handedness and LU7 is contralateral.
Conclusion: AK allows the physical demonstration of a connection between the muscle and the meridian systems. AK hypothesizes that the muscles and organs share physiological systems connected via the nervous system. It is suggested in this paper that AK and acupuncture interact and validate one another and that both can be used in the diagnosis and treatment of patient problems. (Collected Papers International College of Applied Kinesiology, 2000-2001;1:65-74)
Key Indexing Terms: Review Literature; Meridians; Acupuncture Therapy; Medicine, Chinese Traditional; Kinesiology, Applied
THE RETICULAR FORMATION AND ITS ROLE WITH THE BEGINNING AND END POINTS OF THE GOVERNING VESSEL
Datis Kharrazian, D.C., C.C.N., C.C.S.P., C.S.C.S.
ABSTRACT Objective: To describe a treatment protocol to normalize aspects of the reticular formation.
Clinical Features: The reticular formation is the bridge for many neurological pathways between spinal segmental and suprasegmental areas. In a paper presented to the ICAK last year, the author discussed a technique for patients who had minimal facilitation with TL, gustatory motor responses, and other afferent pathway stimulations. It was argued that performing a simple procedure enhanced afferent pathways and TL. This paper discusses TL to the beginning and end points of the governing vessel meridian to assess if that technique is required. The author had found numerous discrepancies between his findings with laboratory assessment and AK indicators. The author reasoned that there was aberrant information being sent to the alpha motor neuron by the neurological pathways used in his sensory receptor challenges or TL. A review of the neurological function of the reticular formation is given, and its relevance to the discrepancies he found between AK and laboratory testing presented. For instance, when a patient TLs using light touch afferents, or when a challenge procedure to a vertebra is performed inducing mechanoreceptor afferents to cause a change in the central integrative state of the alpha motor neuron, the test is dependent upon a properly integrated thalamohypothalmoreticulospinal loop. Or when a gustatory challenge is used, the test is dependent upon properly integrated pathways from cranial nerves VII, IX, and X to the solitary nucleus and down the hypothalmoreticulospinal tract to the anterior horn. The common denominator between these pathways is the reticular formation and its medial and lateral reticulospinal tracts’ influence on the anterior horn through the final common pathway.
Intervention and Outcome: The author found that a loud noise such as clapping near the patient’s ears would stress the reticular formation and create a suprasegmental muscle inhibition pattern. The correction is made by clapping and then finding which beginning and ending acupuncture point negates the inhibition pattern. The treatment consists of performing injury recall technique after clapping and stimulating the B and E point.
Conclusion: The author has found that performing this technique resulted in dramatic improvements in TL and other afferent receptor challenges commonly used in AK. Doctors usually assume the neurological pathways from the receptor challenges to the anterior horn are modulated appropriately. This may not always be the case. In these cases the author argues that it is important to assess and correct these pathways in the initial stages of treatment. (Collected Papers International College of Applied Kinesiology, 2000-2001;1:77-79)
Key Indexing Terms: Reticular Formation; Afferent Pathways; Hypesthesia; Acupuncture Points; Kinesiology, Applied
THE ROLE OF THE TRANSVERSE LIGAMENT IN SUPRASCAPULAR NERVE ENTRAPMENTS
Datis Kharrazian, D.C., C.C.N., C.C.S.P., C.S.C.S.
ABSTRACT Objective: To discuss the role the transverse ligament plays in the suprascapular entrapment syndrome, and elaborate upon the mechanism of neuroischemia as the model for peripheral nerve entrapments.
Clinical Features: Suprascapular entrapment syndrome may produce diffuse shoulder pain, scapula-thoracic instability, even atrophy of the infraspinatus muscle. A stretching of the suprascapular nerve when the scapula is unstable is the cause of the entrapment. Activities that require scapular stability exacerbate the patient’s symptoms. This entrapment becomes evident when the infraspinatus muscle is inhibited as it is tested with the arm flexed to 90 degrees and the shoulder rotated anteriorly. The entrapment is corrected by normalizing the function to the scapular stabilizing muscles. AK techniques such as origin and insertion, strain-counter strain, fascial stretch reactions, muscle spindle techniques, reactive muscle patterns, etc. are usually successful.
Intervention and Outcome: The author presents a case where the above protocol had only limited results. A professional tennis player presented who hurt his shoulder 2 years before while attempting to hit a ball out of his reach. The patient had immediate stabbing pain in his shoulder that had diminished in 2 years to a constant boring pain. He had developed severe atrophy of the infraspinatus muscle that was obvious with inspection of the scapula. 2 years of rubber band exercises to strengthen the infraspinatus and other rotator cuff muscles were of no value. He demonstrated proper facilitation of the infraspinatus muscle on MMT, but when his arm was flexed to 90 degrees and shoulder rotated anteriorly – inhibition of the infraspinatus muscle was dramatic. The suprascapular nerve passes through a foramen created by the scapular notch on the superior border of the scapula and the transverse ligament. Challenge of the ligament to a stretch caused inhibition of all muscles. This was a rebound challenge that is commonly used in AK. After applying forceful pressure to the transverse ligament for 60 seconds there was a dramatic facilitation of the infraspinatus muscle when tested in 90-degree flexion and anterior rotation of the shoulder.
Conclusion: Restoring proper function to the scapula stabilizers and correcting the transverse ligament of the scapula has been found to correct the suprascapular entrapment syndrome among the author’s patients. Clinical trials of these methods are warranted. (Collected Papers International College of Applied Kinesiology, 2000-2001;1:81-83)
Key Indexing Terms: Shoulder Joint; Scapula; Nerve Compression Syndromes; Case Reports [Publication Type]; Diagnosis; Treatment; Chiropractic; Kinesiology, Applied
THE ROLE OF THE SCALENUS ANTICUS MUSCLE IN DYSINSULINISM AND CHRONIC NON-TRAUMATIC NECK PAIN
Thomas A. Rogowskey, D.C., D.I.B.A.K.
ABSTRACT Objective: To present a case series report on the AK treatment of dysinsulinism that also facilitated the anterior scalene muscles thereby ameliorating cervical spine related symptoms.
Clinical Features: The author presents his investigation of chronic neck stiffness in his patients and its association to anterior scalene weakness and sugar metabolism mechanisms. The physiology of dysinsulinism is presented, and its signs and symptoms are described. The author presents 4 cases (ages 15 to 65, 3 female and 1 male) that showed how the successful treatment of dysinsulinism in his patients using AK methods eliminated the need to treat this muscle’s weakness.
Intervention and Outcome: Dysinsulinism syndrome was diagnosed using two methods. Each requires a challenge to a previously facilitated long head of the biceps muscle with the arm in full extension and flexed at the shoulder 45 degrees. Pinching the pancreas visceral referred pain area (VRP), or hard rubbing of the pancreas neurolymphatic reflex produces inhibition of the long head of the biceps in this syndrome. If a facilitated muscle becomes inhibited after the patient insalivates 6X or 8X homeopathic insulin, it is interpreted as dysinsulinism also. Laboratory tests and other AK tests relating to blood sugar handling mechanisms should be used to substantiate the findings of dysinsulinism. Using the muscle that is inhibited, or any muscle that shows weakness found with insulin exposure, a receptor stimuli that overrides this test would indicate that the dysinsulinism is secondary to the receptor that was stimulated. This factor would then be treated. If no receptor stimuli are found that overrides this test, then dysinsulinism is primary. The author reviews the nutrients from the biochemical literature and other methods used in AK to treat dysinsulinism.
Conclusion: Dysinsulinism is pertinent to the practice of functional medicine because of its prevalence in the population and its importance in the physiology of patients. Its symptoms are very wide and diverse. This paper argues that applied kinesiologists have the means to help reverse this condition, and associating the anterior scalene muscle inhibition with dysinsulinism can help the practitioner investigate the root causes of this problem. (Collected Papers International College of Applied Kinesiology, 2000-2001;1:97-103)
Key Indexing Terms: Insulin Resistance; Metabolic Syndrome X; Nutrition Disorders; Diagnosis; Muscle Weakness; Treatment; Kinesiology, Applied