Papers by Dr. Scott Cuthbert
© 2007 Cuthbert and Goodheart; licensee BioMed Central Ltd. This is an Open Access article distri... more © 2007 Cuthbert and Goodheart; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License
Introduction A body of basic science and clinical research has been generated on the manual muscl... more Introduction A body of basic science and clinical research has been generated on the manual muscle test (MMT) since its first peer-reviewed publication in 1915. The aim of this report is to provide an historical overview, literature review, description, synthesis and critique of the reliability and validity of MMT in the evaluation of the musculoskeletal and nervous systems. Methods Online resources were searched including Pubmed and CINAHL (each from inception to June 2006). The search terms manual muscle testing or manual muscle test were used. Relevant peerreviewed studies, commentaries, and reviews were selected. The two reviewers assessed data quality independently, with selection standards based on predefined methodologic criteria. Studies of MMT were categorized by research content type: inter-and intra-examiner reliability studies, and construct, content, concurrent and predictive validity studies. Each study was reviewed in terms of its quality and contribution to knowledge...
Alternative therapies in health and medicine, 2018
Background This study examine whether there is an interrelationship between cranio-sacral dysfunc... more Background This study examine whether there is an interrelationship between cranio-sacral dysfunctions and the muscle inhibitions found in the muscles attaching to the skull in patients with headaches. Primary Study Objective To present a retrospective case series report assessing the prevalence of positive manual muscle tests (MMTs) in the assessment and management of adults with headache and cervico-cranial dysfunctions and to present patient outcomes pre- and posttreatment. Methods/Design Fifty-two patient files with headache (HA) (48 females, 4 males) were retrospectively examined. These patients had either primary (tension-type, migraine, or cervicogenic) or secondary HAs (that result from other medical conditions), according to the International Classification of Headache Disorders. A standardized MMT assessment of the major cervical muscles attaching to the skull was performed on every patient pre- and posttreatment, and a pre- and posttreatment numeric pain scale of neck and...
Spinal manipulative therapy (SMT) is common in the management of low back pain (LBP) and has been... more Spinal manipulative therapy (SMT) is common in the management of low back pain (LBP) and has been associated with changes in muscle activity, but evidence is conflicting. This study investigated the effect of SMT on trunk muscle activity in postural tasks in people with and without LBP. In 20 subjects (10 with LBP and 10 controls), EMG recordings were made with fine-wire electrodes inserted into transversus (TrA), obliquus internus (OI), and externus (OE) abdominis. Rectus abdominis (RA) and anterior deltoid EMG was recorded with surface electrodes. Standing subjects rapidly flexed an arm in response to a light, before and after a small amplitude end range rotational lumbar mobilization at L4-5. In controls, there was no change in trunk muscle EMG during the postural perturbation after SMT. In LBP subjects there was an increase in the postural response of OI and an overall increase in OE EMG. There was no change in TrA or RA EMG. These results indicate that SMT changes the functiona...
Chiropractic Journal of Australia, 2008
Objective: To describe the clinical management of 10 cases of childhood asthma using a conservati... more Objective: To describe the clinical management of 10 cases of childhood asthma using a conservative, multi-modal treatment approach based on applied kinesiology (AK) chiropractic methods. Clinical Features: Ten patients are presented (7 male, 3 female) between the ages of 3 and 22. Each patient had been medically diagnosed and treated for asthma, and all patients were taking one or more asthma medications. Intervention and Outcome: After physical, orthopaedic and AK manual muscle testing examination, the patients were admitted to a multi-modal treatment protocol including chiropractic manipulative therapy, cranial manipulative therapy, muscle therapies aimed at strengthening the muscles of respiration, and nutritional evaluation using the methods developed in applied kinesiology chiropractic. Outcome measures for the study included subjective/objective visual analogue respiratory impairment scales (VAS), improvement in exercise-induced asthma symptoms, reduction of respiratory distr...
Chiropractic Journal of Australia, 2010
Objectives: To observe the progress of a patient with chronic headache after whiplash and other i... more Objectives: To observe the progress of a patient with chronic headache after whiplash and other injuries during and following applied kinesiology (AK)-guided chiropractic and cranial evaluation and treatment. Clinical Features: Single 56-year old patient suffering severe daily cervico-cranial headaches following 2 automobile accidents, despite 7 years of manipulative, chiropractic, physical therapy, psychotherapy, narcotic, and medical treatments. Intervention and Outcome: The patient underwent a series of AK muscle weakness tests which directed mobilisations and manipulations in the cranial, cervical, pelvic, and plantar regions over 8 visits during a 3-week period. During and following this intervention, virtually all symptomatology was resolved with the score of 0 on the neck and low back pain visual analog scales (VAS).The patient has remained free of her original symptoms for 8 years following these treatments. Conclusions: The manual muscle testing (MMT) procedures used in thi...
It should always be determined during consultation whether the patient’s symptoms become worse wi... more It should always be determined during consultation whether the patient’s symptoms become worse with standing, running and other weight-bearing activities, regardless of the chief complaint. Many low back conditions are not optimally treated because the problem is diagnosed primarily within the lumbar spine. It may be hyperlordosis leading to facet syndrome, but the question, "Why is the hyperlordosis present?" must be asked and answered.
Alternative medicine review : a journal of clinical therapeutic, 2011
INTRODUCTION This case report describes the successful treatment of an adolescent female sufferin... more INTRODUCTION This case report describes the successful treatment of an adolescent female suffering daily stress and occasional total urinary incontinence with applied kinesiology methods and chiropractic manipulative therapy. PATIENT PRESENTATION A 13-year-old female developed unpredictable urinary incontinence and right hip pain immediately following emergency open appendectomy surgery. The patient was forced to wear an incontinence pad throughout the day and night for 10 months because of unpredictable urinary incontinence. ASSESSMENT AND INTERVENTION: Chiropractic and applied kinesiology (AK) methods - a multi-modal diagnostic technique that utilizes manual muscle tests (MMT) for the detection of musculoskeletal impairments and specific AK techniques for correction of identified issues - were utilized to diagnose and treat this patient for muscle impairments in the lumbar spine and pelvis. RESULTS Patient experienced a rapid resolution of her urinary incontinence and hip pain. A ...
Chiropractic Journal of Australia, 2011
Objective: To determine if 2 practitioners of differing skill levels could reliably agree on the ... more Objective: To determine if 2 practitioners of differing skill levels could reliably agree on the presence of a weak or strong muscle tested on a predetermined set of 6 proximal leg muscles when all visual, verbal and non verbal cues were removed from view of the assessing practitioners. Study Design: A reliability study. Main Outcome Measures: Percentage correct responses from both practitioners represented as a Kappa score. Results: This project involved two groups of patients, 28 with lower back pain (LBP) and 56 with no LBP. Two examiners (named Ex1 and Ex2 in this report) tested various muscles independently on the two groups, assigning each as either weak (W) or strong (S). The Hamstring muscle group had an agreement of 69.6%; Gluteus Maximus had 75.6%; Gluteus Medius 77.5%; Psoas 83.9%; Tensor Fascia Lata (TFL) 76.8%; and Rectus Femoris had an agreement of 90.5%. Conclusions: Manual muscle testing showed fair to substantial agreement between examiners however more research is ...
Objective: Issues regarding chiropractic treatment for various types of conditions such as develo... more Objective: Issues regarding chiropractic treatment for various types of conditions such as developmental delay syndromes, while controversial to some, have some support in the literature. At this time developmental delay syndromes such as ADHD have inconclusive etiologies. While many consider developmental delay disorders solely genetic in origin, others have supported the concept that a subset of patients may have a trauma or other physical related imbalances that could be contributory to the patient s dysfunction.. Clinical Features: Presented is a case of fraternal twins where one twin s developmental and emotional growth was notably delayed compared to her other twin. Chiropractic cranial care was rendered, which appeared to assist a positive outcome for the treated child. Interventions and Outcomes: Perhaps a better way of interpreting chiropractic s ability to help patients with learning disabilities, dyslexia, dyspraxia, and ADHD, is viewing a specific subset of patients as h...
The primary respiratory mechanism (PRM) as manifested by the cranial rhythmic impulse (CRI), a fu... more The primary respiratory mechanism (PRM) as manifested by the cranial rhythmic impulse (CRI), a fundamental concept to cranial osteopathy, and the Traube- Hering-Mayer (THM) oscillation bear a striking resemblance to one another. Because of this, the authors developed a protocol to simultaneously measure both phenomena. Statistical comparisons demonstrated that the CRI is palpably concomitant with the low- frequency fluctuations of the THM oscillation as measured with the Transonic Systems BLF 21 Perfusion Monitor laser-Doppler flowmeter. This opens new potential explanations for the basic theoretical concepts of the physiologic mechanism of the PRM/CRI and cranial therapy. Comparison of the PRM/CRI with current understanding of the physiology of the THM oscillation is therefore warranted. Additionally, the recognition that these phenomena can be simultaneously monitored and recorded creates a new opportunity for further research into what is distinctive about the science and practic...
Dynamic Chiropractic, Aug 27, 2007
... Int J AK and Kinesio Med, 2005;20:6-10. 60. Caso ML.Evaluation of Chapman's neurolym... more ... Int J AK and Kinesio Med, 2005;20:6-10. 60. Caso ML.Evaluation of Chapman's neurolymphatic reflexes via applied kinesiology: a case report of low back pain and congenital intestinal abnormality. J Manipulative Physiol Ther, Jan. 2004;27(1):66. Page 8. ...
Alternative therapies in health and medicine
Alternative medicine review : a journal of clinical therapeutic, 2011
This case report describes the successful treatment of an adolescent female suffering daily stres... more This case report describes the successful treatment of an adolescent female suffering daily stress and occasional total urinary incontinence with applied kinesiology methods and chiropractic manipulative therapy. A 13-year-old female developed unpredictable urinary incontinence and right hip pain immediately following emergency open appendectomy surgery. The patient was forced to wear an incontinence pad throughout the day and night for 10 months because of unpredictable urinary incontinence. ASSESSMENT AND INTERVENTION: Chiropractic and applied kinesiology (AK) methods - a multi-modal diagnostic technique that utilizes manual muscle tests (MMT) for the detection of musculoskeletal impairments and specific AK techniques for correction of identified issues - were utilized to diagnose and treat this patient for muscle impairments in the lumbar spine and pelvis. Patient experienced a rapid resolution of her urinary incontinence and hip pain. A six-year follow-up confirmed complete reso...
Journal of Manipulative and Physiological Therapeutics, 2009
Objective: This study presents a case series of 157 children with developmental delay syndromes, ... more Objective: This study presents a case series of 157 children with developmental delay syndromes, including the conditions such as dyspraxia, dyslexia, attention-deficit hyperactivity disorder, and learning disabilities who received chiropractic care. Clinical Features: A consecutive sample of 157 children aged 6 to 13 years (86 boys and 71 girls) with difficulties in reading, learning, social interaction, and school performance who met these inclusion criteria were included. Intervention and Outcomes: Each patient received a multimodal chiropractic treatment protocol, applied kinesiology chiropractic technique. The outcome measures were a series of 8 standardized psychometric tests given to the children by a certified speech therapist pre-and posttreatment, which evaluate 20 separate areas of cognitive function, including patient-or parent-reported improvements in school performance, social interaction, and sporting activities. Individual and group data showed that at the end of treatment, the 157 children showed improvements in the 8 psychometric tests and 20 areas of cognitive function compared with their values before treatment. Their ability to concentrate, maintain focus and attention, and control impulsivity and their performance at home and school improved. Conclusions: This report suggests that a multimodal chiropractic method that assesses and treats motor dysfunction reduced symptoms and enhanced the cognitive performance in this group of children.
Journal of Manipulative and Physiological Therapeutics, 2005
Objective: To present an overview of possible effects of Arnold-Chiari malformation (ACM) and to ... more 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 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 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.
Journal of Chiropractic Medicine, 2012
Objective: The purpose of this case series is to describe the chiropractic management of 21 patie... more Objective: The purpose of this case series is to describe the chiropractic management of 21 patients with daily stress and occasional total urinary incontinence (UI). Clinical Features: Twenty-one case files of patients 13 to 90 years of age with UI from a chiropractic clinic were reviewed. The patients had a 4-month to 49-year history of UI and associated muscle dysfunction and low back and/or pelvic pain. Eighteen wore an incontinence pad throughout the day and night at the time of their appointments because of unpredictable UI. Intervention and Outcome: Patients were evaluated for muscle impairments in the lumbar spine, pelvis, and pelvic floor and low back and/or hip pain. Positive manual muscle test results of the pelvis, lumbar spine muscles, and pelvic floor muscles were the most common findings. Lumbosacral dysfunction was found in 13 of the cases with pain provocation tests (applied kinesiology sensorimotor challenge); in 8 cases, this sensorimotor challenge was absent. Chiropractic manipulative therapy and soft tissue treatment addressed the soft tissue and articular dysfunctions. Chiropractic manipulative therapy involved high-velocity, lowamplitude manipulation; Cox flexion distraction manipulation; and/or use of a percussion instrument for the treatment of myofascial trigger points. Urinary incontinence symptoms resolved in 10 patients, considerably improved in 7 cases, and slightly improved in 4 cases. Periodic follow-up examinations for the past 6 years, and no less than 2 years, indicate that for each participant in this case-series report, the improvements of UI remained stable. Conclusion: The patients reported in this retrospective case series showed improvement in UI symptoms that persisted over time.
Journal of Bodywork and Movement Therapies, 2012
Modification of the motor system in assessing and treating as well as understanding one of the ca... more Modification of the motor system in assessing and treating as well as understanding one of the causes of musculoskeletal dysfunctions is a topic of growing importance in healthcare. Applied kinesiology (AK) addresses this interest in that it is a system which attempts to evaluate numerous aspects of health (structural, chemical, and mental) by the manual testing of muscles combined with other standard methods of diagnosis. It leads to a variety of conservative, non-invasive treatments which involve joint manipulations or mobilizations, myofascial therapies, cranial techniques, meridian and acupuncture skills, clinical nutrition and dietary management, counseling skills, evaluating environmental irritants, and various reflex techniques. The effectiveness of these ancillary treatments is believed to be consistent with the expanded construct validity of the manual muscle test (MMT), as described, although this assertion has primarily been tested in outcome studies. AK and its adjunctive procedures (challenge and therapy localization) are highlighted in this review providing details of its implementation as prescribed by an International College of Applied Kinesiology's Board of Examiners, cited for its scholarly and scientific activities. Because these procedures are believed to identify specific articular, soft tissue, biochemical, or emotional issues underlying muscle function, the applicability of this diagnostic method for all clinicians treating muscle imbalance disorders is described. As of yet, MMT efficacy in therapy localization and challenge techniques has not been established in published, peer-reviewed research. A variety of challenges likewise remain for professional AK to establish itself as an emerging science, with numerous gaps in the literature and testable hypotheses enumerated. Of particular concern are a multiplicity of derivatives of AK that have been described in the literature, which should be greeted with caution in light of the fact that they lack one or more of the essential attributes of AK as described in this report. The validity of these studies which have been critical of applied kinesiology appears in many instances to be no greater than several of the randomized controlled trials, cohort studies, case control studies, and case studies found in this communication to support various aspects of applied kinesiology.
Journal of Bodywork and Movement Therapies, 2011
Objective: To determine whether there was a statistical difference for manual muscle test (MMT) f... more Objective: To determine whether there was a statistical difference for manual muscle test (MMT) findings for cervical muscles in subjects with and without mechanical neck pain (MNP), and to use confidence intervals to evaluate the sensitivity and specificity of the MMT in this group of subjects. Clinical features: Manual muscle strength tests were conducted on two groups of patients who reported to two outpatient chiropractic clinics. In group 1, 148 patients were evaluated for MMT data (50 males and 98 females, average age 37), 127 with "whiplash"-type injuries (average duration 16 weeks) and 21 with non-traumatic chronic neck pain (average duration 36 weeks). In group 2, 100 patients were evaluated for comparative MMT data (39 males and 61 females, average age 38) with no current MNP or remarkable history of MNP. Methods: Standardized MMT assessments of the strength of the sternocleidomastoid, anterior scalene, upper trapezius, and cervical extensor muscles bilaterally were performed on all subjects in groups 1 and 2. Results: In group 1, 139 of 148 patients reporting neck pain also showed positive results in at least one of four MMT tests (sternocleidomastoid, anterior scalene, upper trapezius, and cervical extensors). In group 2, 30 of the 100 patients without MNP showed positive results in one or more of the four MMT tests. Confidence intervals were calculated and showed that, in terms of MMT findings, there was a significant difference between the two groups of patients. Conclusions: A symptomatic group of patients with MNP demonstrated significantly increased MMT findings in the form of reduced strength levels compared to a control group. This evidence suggests that the MMT is potentially a sensitive and specific test for evaluating cervical spine muscular impairments in patients with MNP.
Journal of Bodywork and Movement Therapies, 2011
We appreciate Dr. Perle's interest in our recent publication, attempting to establish the validit... more We appreciate Dr. Perle's interest in our recent publication, attempting to establish the validity of manual muscle testing in instances of cervical pain. While pointing out several cautionary notes common to clinical research, we have reason to believe that in this instance they are all misplaced in the four arguments that he has put forth:
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Papers by Dr. Scott Cuthbert