Jun 25 2012

Diagnosis by Applied Kinesiology

Those of us promoting the application of scientific skepticism to medical claims deal with a very broad range of claims, from just at the edge of acceptable science to abject magical thinking. It is useful, and unfortunately necessary, to deal with the full range of pseudoscience, but I admit a particular fascination with the pure magic end of the spectrum. What thought process is going on in people who casually accept the impossible as true?

Take, for example, a recent news report of a Canadian man who apparently has suffered from pain for years. The reporting in the article, not surprisingly, is horrific. There isn’t a hint of journalistic skepticism, no consultation with a medical expert, and not even a token attempt at balance. I have learned that this means the journalist, Doug Hempstead, likely approached the article as a “human interest” story, which means there is no apparent need for any journalistic integrity, accuracy, balance, or important background or story details. All that matters is that there is a human interest and some sensational element.

The core of the story is that Eric Bertrand, who has suffered muscle pain for years despite treatment from real doctors, was finally pressured by his family to consult an alternative practitioner. The article mentions naturopathy – naturopathy, essentially, is medicine without science (or even basic reason and common sense, in my opinion). Naturopaths use a hodge podge of prescientific, fanciful, unproven or even disproved modalities. There is no real theme or consistency to what they use – anything goes.

However, Bertrand consulted Ottawa practitioner, Tony Brunelle, who is a chiropractor. (Brunelle now proudly displays his mention in the Ottawa Sun – nice free advertising).  Brunelle used a technique known as applied kinesiology to diagnose Bertrand’s problem.

The background story we are given about Bertrand is that he has had leg pain for years. His doctors diagnosed him with compartment syndrome, a syndrome in which there is pressure build up within a compartment of a limb, and enclosed space lined with dense fascia or connective tissue. The fascia has a limited capacity to expand, so when the pressure builds up it can squeeze the structures within causing pain. If it becomes serious enough it can even block off the blood supply and cause serious damage. Bertrand, we are told, has had surgical procedures to release the pressure, which did help his symptoms, but he continued to have chronic pain. There are many details about this story we are not told and therefore it is not possible to formulate any medical opinion based on this story alone about Bertrand’s condition.

Apparently none of this history mattered to Brunelle, who used the following technique to diagnose Bertrand:

Bertrand was told to keep an outstretched arm held strong while answering questions about various organs in his body. He was to reply that the organ in question was healthy and if Brunelle couldn’t easily budge the arm, that would prove it. When the doctor asked about Bertrand’s liver, the arm slid down with ease.

He repeated the process, listing different liver ailments until the arm once again slid down.

Diagnosis: liver parasite.

This is reported in the Sun without the slightest hint of irony or skepticism, as if it makes perfect sense. This is a good description of applied kinesiology, which was developed by a chiropractor. The idea is that the body is all connected in some vague way by magical life energy (the kind of vitalistic force that traditional chiropractors believe in), so that when there is a problem with one part of the body (like the liver) then the muscle that corresponds to that organ through this mysterious energy connection will be weak. Not only that, just thinking about your unhealthy organ will make your muscles generally weak (the whole “mind-body” thing), or (as in this case) falsely stating that the organ in question is healthy will significantly weaken your muscles. I bet you didn’t realize that humans were such frail creatures. Just telling a lie can make us collapse like weak kittens.

This video is a good demonstration of applied kinesiology. One simple hypothesis to explain the apparent weakness resulting from negative thoughts or untrue statements is that it is simple suggestion. It does not require either person to be consciously faking. One thing to note is the give and go nature of the “weakness” on display in the video. The person’s arm goes down in ratchety, non-smooth fashion. We call this “give way” weakness, because initially there is greater strength which then gives way. This is a reliable sign of decreased effort, as opposed to genuine weakness. The decreased effort does not need to be conscious, however. It simply means that the muscles are not truly weak, but the decreased resistance is due to reduced activation coming from the brain. This is all consistent with suggestion, rather than a true physiological effect.

There is also the possibility of more or less effort on the part of the person doing the testing. So both people may be adding to the subjective nature of this test. How can we tell for sure? Well, if both the tester and subject were blinded as to what was being tested then we can eliminate the variability of effort. When proper blinding is put into place the effect completely disappears (here is a good summary). Phenomena that disappear under proper blinding conditions are not real – they are artifacts of suggestion or imagination.

So Brunelle used a diagnostic test that is fraudulent. It is not based upon any valid scientific principle. The basic elements of the technique have never been established, and in fact are unscientific (the existence of vital force or its alleged influence on muscle strength), and the technique has been shown to be ineffective when tested scientifically. It’s also plainly absurd. But even absurd-sounding claims may be accepted as true if they are backed with sufficient rigorous evidence. In this case the absurd claim was exposed as false when studied scientifically.

Brunelle concluded based upon applied kinesiology that Bertrand has a liver parasite. There is no mention of any follow up testing to confirm this diagnosis. Brunelle then gave Bertrand pink root, and herbal remedy (a fake remedy for the fake illness). According to the article, Bertrand then felt better. I have no idea how accurate this report is, but even if we accept the report what can we make of that? Since Bertrand was treated for his apparent underlying condition, he may have been on the mend in any case. Chronic pain is also tricky, and often has a huge psychological component. Chronic pain medications also have an effect, and we have no idea from the article what other variables were changed recently.

But all of those variables aside, we often see similarly profound subjective effects from pure faith healing. People with chronic conditions walk out of the faith-healer’s tent feeling much better. I have personally seen this myself. There are physiological and psychological mechanisms for this – the release of endorphins, for example. Essentially this is just a placebo effect, and tends to be short lived. In cases that I have seen the recipients of the faith healing were impressed by their reduction in symptoms (even though objectively they were no different), but paid for their short term pain reduction with later worsening.

The power of self deception is well documented, and pain is particularly subject to psychological factors. Even an improvement in mood from the offer of a treatment is enough to reduce the experience of pain.

Stories like this often prompt the question – what’s the harm? Even if this is all self-deception and faith healing, if Bertrand feels better, so what? Well, we don’t know that Bertrand is actually better, if his symptoms were improving anyway, and what his long term outcome will be. What we do know is that this story is being used to promote medical nonsense. Applied kinesiology is being used to diagnose actual medical disorders, not just for a feel-good benign treatment. Belief in nonsense and pseudoscience is very pernicious, especially in the medical field.

This irresponsible article will now drive more people to consult pseudoscientists for their medical conditions, and to believe in magic.

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12 responses so far

12 Responses to “Diagnosis by Applied Kinesiology”

  1. SARAon 25 Jun 2012 at 9:17 am

    Magic – it’s so much easier to understand than Science because it’s very existence implies you don’t need to understand. Magic belongs to the land of the intellectually lazy.

    I had a frustrating discussion yesterday about the brain’s self deception. I just changed anti-depressants and was feeling better the next day. My friend insisted the drugs were working. I explained it was not likely, since their known efficacy happens in 4-6 weeks, with a smaller subset showing slight symptom improvement in a week. 1 day was rather unlikely.

    I explained placebo, but I felt that my improvement was more likely due to the occasional and momentary “chemical upswings” that happen in my life. She became so agitated that I would not accept this improvement as belonging to my new drug. I was in the curious position of debating the lack of efficacy of my current science based treatment against the magical thinking of my friend who is also sure her chiropractor is the only doctor she can truly trust.

    If you are afraid of the possibility of things not working, of there not being a solution, you can always apply the easiest answer. Because the easy answers rarely involve discussing those things.

  2. HHCon 25 Jun 2012 at 10:45 am

    The naturopathy chiropractor in Canada did more than give the Navy man a pink pill. Most likely after the patient’s surgery, he needed a series of adjustments of his spine because of his unnatural way of walking and putting pressure on his healing joints. Skilled Canadian chiropractors can also adjust limbs. But his muscles needed strengthening and conditioning as well. So he began an exercise regimen of running. The only way you can get this advertised pink liver pill is to make an office visit. If he has a liver problem, the Navy man probably has a substance abuse problem as well. Here is an example of a placebo for wellness.

  3. DevoutCatalyston 25 Jun 2012 at 10:57 am

    My guess is that most applied kinesiologists couldn’t get hired on the carnival midway, yet can get a gig as a fake doctor. I think this is because people expect to be
    considered potential “marks” when at the carnival, and when in a
    trusting situation with alt-med types pretending to
    themselves to be doctors people instead will relax their guard. It is an
    important role to call out these mal practices and practitioners, after
    all, CAM purveyors stack the deck constantly by planting seeds of doubt
    regarding real medicine, we had better be better and more thorough at
    this than they are.

    I have had applied kinesiology, um, applied to myself. Although I wasn’t
    a skeptic at that time, it felt rather cornball. I also used to feel
    embarrassed for being so stupid as to have sought out alternative
    medicine in the first place. Then I read recently that Michael Shermer had colonics back in
    the day! Hah, imagine if you will his cherubic countenance with a pipe
    stuck up his butt, and then realize the potential of critical thinking
    to empower a turnaround in a person’s life, sometimes
    surprisingly so. Applied skepticism is the key to a better world for
    every citizen. Applied kinesiology can do no such thing.

  4. Karl Withakayon 25 Jun 2012 at 11:30 am

    SARA,

    That’s a good story to use when someone tries to claim that babies and animals aren’t subject to placebo effects/responses.

    Every observation has two components: the observed and the observer. Placebo effects/responses are not confined to the observed.

    Actually, one could argue that placebo effects/responses are ALWAYS the due to the observer; it’ just that often the observer is observing themselves.

  5. SARAon 25 Jun 2012 at 12:12 pm

    Karl Withakay

    I had not thought before about about 3rd person placebo effects for those unable to communicate. And it’s rather disturbing to think about choices being made for the helpless based on tricks being played by our brain.

  6. locutusbrgon 25 Jun 2012 at 2:04 pm

    So many of my patients “give way” when I examine them. True neurological or muscular weakness has a certain characteristic to that clearly distinguishes it from lack of effort. Most “I hope” are not trying to fool me, rather are trying to convince me of the severity of their condition. It may also be unconscious. I have seen many many cases where a patient has chronic lower back pain and has been asked so many times if the have radicular pain (commonly known as sciatica) that they begin to answer yes. This is despite the fact that after further history I realize that they so not even know what sciatica is. Neither do they describe sciatic pain. Rather they point to their lower back and say that is where I have sciatica. Given that this is anecdotal eval I would review specifically what sciatica means and what it is limited to. Then they would recant that diagnosis in their history. I began to realize that they had been asked the question so much they began to think that saying yes would lead to other treatments. They were desperate for anything. Sound familiar.

  7. jreon 25 Jun 2012 at 3:48 pm

    Western medicine is unable to find the root cause of conditions such as Mr. Bertrand’s, and confesses itself baffled. But fear not — Dr. Boli can help!

    http://drboli.wordpress.com/2011/03/05/advertisement-594/

  8. daijiyobuon 25 Jun 2012 at 3:50 pm

    Per: “the idea is that the body is all connected in some vague way by magical life energy (the kind of vitalistic force that traditional chiropractors believe in) [...which is] unscientific (the existence of vital force or its alleged influence on muscle strength), and the technique has been shown to be ineffective when tested scientifically”

    and being that AK is so science-exterior, you can find naturopaths also using this and wrongly-labeling it as within their ‘science-based’ category.

    E.g.: National University of Health SCIENCES, which has the triple threat of acupuncture, chiropractic and naturopathy degree programs, has a quite active AK club

    http://nuhs-ak-club.tripod.com/id1.html .

    The word “diagnose” is on that page three times.

    Fascinating.

    -r.c.

  9. Kawarthajonon 25 Jun 2012 at 8:28 pm

    I just want to say that, in my humble opinion as a former resident of Ottawa, the Ottawa Sun is not a credible source of information about anything. It is commonly referred to as a “rag” because it is just about as useful for news as a greasy rag. Journalistic standards mean nothing for the writers in the paper and they base their business on sensationalism and conservative anti-establishment stories. I can’t stand the paper, so I don’t recommend trusting anything you read in it.

  10. linda65on 27 Jun 2012 at 11:29 am

    I have a question about Brain Balance. I attended a conference session on sensory sensitivity and Brain Balance was mentioned. I would like to know if there is recent research on this and if the centers are legitimate sources of help for these children.
    Linda65

  11. expblaston 27 Jun 2012 at 7:40 pm

    Sara.. awesome. Marry me. Its a new age boondoggle just like all of the others. *** Off topic..Has any one else noticed that a lot of vitamins have an improper dosage on the label? I have a few friends that have their PHD in various fields, and they have told me that a majority of the nutrients that our body needs come from our food – the western diet. Yet I’m holding a bottle of vitamins that claims that I should take two a day. All of the vitamins in this pill are anywhere from 60% to 800* of the daily recommended value. Where to they get two a day? Are vitamins regulated by the FDA, or are they “not intended to diagnose, treat, or cure any disease etc?” I know they are not medicine per se.

  12. bthomas001on 30 Jun 2012 at 6:25 am

    Sara:

    While I agree that noticeable symptom improvement after a single day of antidepressant therapy is unlikely, you may be interested to know that the “conventional wisdom” regarding delayed onset of action is far from certain. At least with respect to SSRI therapy, several reviews of 100+ (previously published) double-blind, placebo controlled studies have concluded that objective measures of depressive symptoms show statistically significant improvement within the first week of therapy, followed by up to five weeks of improvement that diminishes in magnitude. The 4-6 week figure may just be an artifact of the lack of statistical power individual studies possess, such that improvements do not reach the level of statistical significance in small groups of patients until well into treatment.

    Further, a delay on the timescale of weeks, if it were present, would suggest changes in gene expression as a prime candidate for the mechanism leading to that delay. It is conceivable that even those drugs that do not produce clinically significant symptom improvement would still induce similar changes in gene expression. It seems to me that prior exposure to the same class of drug might “prime” a brain, thereby truncating any delay when an effective alternative is finally introduced. Pure speculation on my part, but perhaps some food for thought.

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