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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