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400대 이성, 논리, 과학적 인과관계를 넘어선 새로운 의학
beyond resion
개개인의 사회적 경험속에서 관찰을 되풀이하고 그 진실의 여부를 확인한 다음
각자의 문제들에 실제로 적용해서 효과가 있는지 살펴보는 것.
이것이 '임상의학의 기본'이다.
과학적 인과관계로 치유가 설명되지 않는 실용적 의학의 탐구
During the past 3000 years, many diagnostic methods have been developed to discover the causes of human pain and dysfunction. In l964, a significant step forward in the evaluation of neurological disturbances related to functional-structural impairments was made by the chiropractor Dr. George J. Goodheart Jr. and his development of applied kinesiology (AK).1–4
지난 3천년동안 인체통증과 기능부전의 원인을 발견하기 위한 수많은 진단법들이 개발되어왔음.
1964년 카이로프랙틱 의사 조지 굿하트에 의해서 AK 측정법이 새로운 진보를 드러냄.
The manual muscle testing (MMT) applications that Goodheart delineated have been taken up by practitioners in
a broad cross-section of the healing arts, including chiropractors, osteopaths, psychologists and psychiatrists, acupuncturists, nutritionists, naturopaths, bodyworkers, and kinesiologists. AK’s approach to specific health problems has been presented in the Townsend Letter; however, a broad
overview of the neurophysiology underlying this unifying
concept of health-care diagnosis has not been published
before.5–7
굿하트에 의해서 묘사된 근육검사법(MMT)은 많은 연구자들에 의해 재조명됨
AK의 새로운 건강접근법에 대한 연구가 제대로 되지 않아 이 논문에서 연구함.
Influence of AK Worldwide
Good heart’s work drew a large following of doctors and recognition. He was the first chiropractor officially appointed to the US Olympic Sports Medicine team.8 In 1976 the International College of Applied Kinesiology was founded to promote the research and teaching of AK.9 In Europe, some 3000 MDs and osteopaths now use AK as part of their diagnostic regimen.
굿하트의 연구는 많은 의사의 관심을 끌었고, 미국올림픽대표팀에서 최초의 카이로프랙터로 인정됨.
1976년 AK 연구와 보급을 위해 ICAK가 설립됨.
현재 유럽에서 3천명의 의사와 도수치료사가 AK를 진단도구로 사용중임.
The first book to describe the value of AK to other professions, AK and the Stomatognathic System, was authored by Harold Gelb, a dentist, and Goodheart in 1977.10 Gelb founded the Craniomandibular Pain Center at Tufts University College of Dental Medicine in Boston, Massachusetts. He and his team have been using MMT and the methods developed by Goodheart and the International College of Applied Kinesiology in the evaluation of patients with TMD ever since, and have published a substantial body of research on the relationship between muscle imbalances and TMD.11,12 Significant inroads into the dental profession have been made by AK.13–15
Many other “name techniques” have evolved from AK that also incorporate many of the same MMTs and neurological reflexes and procedures as part of their diagnostic systems, including Neuro Emotional Technique (NET), Neural Organization Technique (NOT), clinical kinesiology, Contact Reflex Analysis (CRA), Total Body Modification (TBM), Thought Field Therapy (TFT), behavioral kinesiology (BK), and Ulan Nutritional Systems, in addition to nearly 100 systems of “kinesiology” around the world.16–22
많은 치료테크닉 이름이 AK로부터 발달되어 근육테스트와 신경반사 그리고 검사절차가 AK진단의 일부로 통합되어 거의 100여개의 방법이 개발됨.
Neuro Emotional Technique (NET)
Neural Organization Technique (NOT),
Contact Reflex Analysis (CRA),
Total Body Modification (TBM), https://youtu.be/UAoiV1yDzbk
Thought Field Therapy (TFT),
behavioral kinesiology (BK), and
Emotional Freedom Technique, commonly known as EFT, is a popular form of “energy psychology” and has been described in the Townsend Letter. Its founder, Gary Craig (an engineer from Stanford), gives Goodheart credit for its development. Goodheart demonstrated the effect of the meridian system upon human muscle function for Craig and his teacher Dr. Roger Callahan (the founder of TFT) and, from their use of these insights, developed methods that have spread around the world.23 The ability to improve mental health problems with applied kinesiology techniques is now beginning to emerge, with much credit going to the innovative techniques of the chiropractors Goodheart and Walker, the psychiatrist John Diamond, the psychologists Roger Callahan and Fred Gallo, and many others.
감정자유 기법(emotional freedom technique).
Gary Craig 창안자.
조지 굿하트의 신뢰를 받고 응용 근신경학의 한 분야로 인정되고 정신건강 증진프로그램으로 정착함.
In 1970, Dr. John Thie (the first chairman of the International College of Applied Kinesiology USA) wanted “kinesiology” to be available for the general public, while Goodheart wanted to continue teaching AK only to professionals licensed to diagnose and treat patients. Goodheart challenged Thie to write a book for the public. Thie’s book Touch for Health is a best-seller in the self-help domain.24
1970년 John Thie(미국 ICAK 교장)은 kinesiology가 대중에게 신뢰를 받기를 원함.
반면 굿하트는 AK가 프로 라이센스가 주어져 환자가 진단 치료되기를 원함.
존 Thie는 대중을 위해 'Touch for Health'라는 베스트 셀러를 씀.
Before AK’s expansion of the applications to which the MMT could be put, the actual testing of muscles had been firmly established by Kendall and Kendall, who held that a muscle from a contracted position against increasing applied pressure could either maintain its position (rated as “facilitated” or “strong”) or break away and thus be rated as “inhibited” or “weak.”25 The testing of muscle strength itself has been widely practiced in manual medicine for almost a century, whose reliability and validity have recently been shown.26–30
AK에서 MMT를 이용하기 전 근력검사는 Kendall에 의해서 확립되어 있었음.
Since the original discovery that muscle inhibition
related to neurological disturbances and could be used to
diagnose neuromuscular problems, the AK examination
system has broadened to include evaluation of nutritional,
acupuncture, cerebrospinal fluid, lymphatic and vascular
function, and many other controlling or disturbing factors
that influence health and neurological function.1–4 The
investigation of these other causes of muscle weakness and
their correction developed into the current practice of AK
for the broad number of different professions that use it for
their own purposes. Each of these areas of human function
has been shown to affect the muscular system, and AK
and allied health systems’ research evidence in this regard
is constantly growing.9,31 Even the American Medical
Association has accepted that the standard method of MMT
used and taught in AK is a reliable tool and advocates its
use for the evaluation of disability impairments.32
근육억제는 신경질환과 연관되어 있고 신경근육 문제 진단에 사용된 이후로
AK 진단 시스템은 영양, 침, 척수액, 림프와 혈관기능 그리고 다른 건강과 신경기능에 영향을 주는 요소들로 확장됨.
근육약화와 그들간의 연관성의 원인 조사는 AK의 최신연구로 진행되어 많은 전문가들이 그 목적에 맞게사용함.
인체기능과 관련된 이러한 연구는 근육 시스템과 AK에 영향을 줌을 보여주었고 건강시스템 연구 증거는 계속됨.
미국의학협회조차도 MMT의 방법을 받아들이기 시작했고 AK는 믿을만한 진단, 치료의 도구로 가르치기시작함.
Knowing precisely what a specific malfunctioning
factor in patients’ functional ensemble does to muscle
strength can greatly enhance their understanding of their
health problem. As is well known in modern therapeutics,
the location of a primary complaint does not necessarily
correlate with the symptoms for which the patient seeks
care. Take for example the patient whose low back “slips
out” when he bends over to pick up a pencil. He thinks
that bending over caused the incident; the doctor knows
that the spine does not usually develop a problem from
such simple activity. There probably was a subclinical and
preexisting condition in the area in the form of muscular
imbalance or pathology. This may be why the MMT has
the predictive capacity to diagnose problems before they
emerge.30,33
환자의 기능(근력)에 대한 특정 비정상요인 지식의 증가는 그들의 건강문제에 대한 이해를 폭발적으로 증가시킴.
잘 알려진바와 같이 현대 치료법은 주요 불만이 증상과 필수적으로 연관되지 않는다는 것임.
예를들어 볼펜을 집다가 넘어진 경우 그는 허리굽힘이 사건의 원인이라고 생각함. 의사는 척추가 그렇게단순한 동작으로 문제가 발생하지 않는다는 것을 앎. 즉 근육 불균형이나 병리적문제가 존재한다는 것을앎. 이것은 왜 MMT가 진단적 가치가 있는지를 보여줌.
Principles and Theories
When muscle dysfunction is found, the clinician proceeds with examination to find what therapy restores proper function. Application of the therapy, if successful, immediately improves muscle function. Reexamination at a later time determines if the correction is maintained. Thus the system (1) finds disturbance, (2) determines how to fix it, (3) determines if the corrective effort is successful, and, most importantly, (4) determines if the correction is stable. If the correction is not stable, further examination is done to find the reason so it can be eliminated.
But what distinguishes AK is its emphasis upon proprioceptive responses of the muscle rather than the strength of the muscle itself. It essentially sees muscle function as a transcript of the central integrative state of the anterior horn motor neurons, summing all excitatory and inhibitory inputs from the entire organism.31 In other words, the locus of muscle dysfunction ultimately rests with the nervous system.
근육기능부전이 있을때 임상의사는 어떤 치료가 기능을 회복할지를 알기위해 검사를 진행함. 치료의 적용이 성공적이라면 근육기능은 즉시 개선됨.
AK 시스템은 문제 발견, 치료법 결정, 올바른 노력이 성공적인지를 결정, 교정이 안정적인지를 결정.
만약 교정이 지속되지 않는다면 그 이유를 찾기위해 다른 검사가 진행됨.
Diagnostic Tools: Challenge’ and Therapy Localization’
Sensorimotor “challenge” is a diagnostic procedure unique to AK that is used to determine the body’s ability to cope with external stimuli, which can be physical, chemical, or emotional. Challenge defines a mechanism to test the body’s ability to cope with external stimuli, again assessed by muscle testing.34
The use of challenge assessments gives the clinician important clues as to what removes the inhibitions of muscles associated with functional pain syndromes and health problems. The appropriate “challenge” will also remove synergist substitution employed by the patient, particularly during the MMT, because of pain.35,36
감각운동 '도전'은 AK의 독특한 진단과정인데.. 이는 인체가 외부자극(물리적, 화학적, 감정적)에 대응하는 능력을 검사하는데 이용됨. 도전은 인체가 외부자극에 대응하는 능력을 테스트하는 메커니즘으로 정의되며 이는 근육테스트로 검사함.
도전 진단법의 사용은 임상의사에게 중요한 단서를 제공하는데 ...무엇(어떤치료)이 통증과 건강문제로 인한 근육억제를 제거하는가에 대한 단서를 제공함.
적절한 도전은 특히 통증이 있는 환자를 MMT하는 동안 협력근 작용을 제거할 수 있음.
After an external stimulus is applied, muscle-testing procedures are done to determine a change in the muscle strength as a result of the stimulus. Through this approach, ineffective therapies that produced no improvements in muscle strength are rejected and only those that elicit a positive muscle response are used. This guides the treatment given to a patient.
외부자극이 적용된 후 근육테스트 과정은 자극의 결과로 근력 변화를 결정함.
이 과정을 통해 근력의 개선을 야기하지 않는 효과적이지 않은 치료법은 거절됨. 그리고 오직 근력반응에 효과적인 것만 사용됨.
Nutritional challenge as used in AK was explored and a literature review given in a recent issue of the Townsend Letter.5 Structural (or joint challenge) has been described in the AK outcomes research literature from the beginning, and all of the evidence for this approach was recently offered.2,3 Cranial challenge has been described in the literature previously.37,38
AK에서 사용되는 영양학적 도전이 연구되었고 논문연구가 진행됨.
구조(또는 관절) 도전도 연구됨.
두개골 도전은 문헌에서 이미 기술됨.
37논문
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.
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.
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.
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.
38 논문
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.
A young woman had complex optic nerve neuritis exacerbated by an ACM type I of the brain.
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.
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.
Psychological challenge has been described by Mollon
and Monti and many others.39,40 Monti et al. have shown
that if the emotional stress is strong enough, almost any
muscle in the body will show the inhibition.40 A review
of the published outcomes research in this area offered
by Walker, Callahan, and Mollon elaborates on these
ideas.16,21,39 Mollon’s history of AK’s contributions in this
area is exhaustive.39
심리학적 도전은 Mollon and Monti 와 많은 사람들에 의해 기술됨.
몬티는 다음과 같은 결과를 보여줌. 만약 감정 스트레스가 있다면 몸의 대부분의 근육은 억제됨.
Another procedure unique to AK and allied schools of therapeutics is called therapy localization (TL).41 TL seeks a change of muscle strength when the patient’s hand is placed over an area of suspected involvement. The neurophysiology of therapy localization has been updated in two recent textbooks and at the 3rd International Association of Functional Neurology and Rehabilitation Conference.2,3,42 This method is hypothesized to assist the doctor in finding areas that are involved with the muscle dysfunction found on MMT. Pollard et al. in a recent literature review presented some of the research about the AK concept of therapy localization.43 Collectively these data suggest that stimulating the skin and the cutaneomotor reflexes can produce changes in muscle function.
AK에서 또다른 치료절차가 'therapy localization (TL)'임.
TL은 환자의 손을 문제가 있다고 추정되는 곳에 대면 근력의 변화를 찾는 것임.
이 방법은 의사가 MMT동안 근육기능부전과 관련된 부위를 찾을 수 있다고 가설을 세움.
결론적으로 skin and the cutaneomotor reflexes 자극은 근육기능 변화를 야기함.
It is also characteristic of AK assessment procedures to move from the examination of the patient into the treatment almost immediately.44 As a clinician searches for information through the manual muscle test, the appropriate challenge or therapy localization to the responsible tissue or remedy will turn “finding” into “fixing.” One treatment modality accompanies another as a rather “custom made” application is created that not only varies from patient to patient but should vary from one session to the next for a particular individual as a condition improves.
환자의 진단에서 치료로 즉시 옮겨가는 것이 AK 검사절차의 특징임.
Applied Kinesiology’s Future in the Management of Stress-Related Illness
Since 1964, the AK model has aimed to integrate the physical, biochemical, and psychosocial manifestations of musculoskeletal pain. This integrative model is overdue in the conceptualization and investigation of neuromusculoskeletal pain and psychological and biochemical imbalances. This model may also provide an evidence-based rationale for the integration and appropriate timing of complementary and alternative medicine (CAM) treatments directed toward physical (biological) impairments, and biochemical and psychological factors. It is suggested that this integrated approach will be the way forward in the management of pain as well as stress-related and lifestyle illnesses, rather than the dichotomous separation of physical, biochemical, and psychological factors that so often occurs in research and practice.
There are now over 100 papers published in peer- reviewed journals on the methods and outcomes of AK.2-4,45 Few CAM therapeutic methods have been investigated or written about as extensively as AK. There have been 38 separate books published about AK methods since 1964.
Further research and reviews of applied kinesiology are listed at the National Library of Medicine, where AK research has now been given its own MESH heading. It must be cautioned, however, that several muscle testing protocols which have appeared have not adhered to AK protocols and should never be confused with the methods employed in AK.46–49
Gifford’s mature organism model demonstrates the importance of a multifactorial understanding of health, showing that physical, environmental, and emotional aspects interrelate.50 Critically, a method of assessment for these interweaving factors is vital.
The Cochrane Collaboration defined CAM as follows:
CAM is a broad domain of healing resource that encompasses all health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period. CAM includes all such practices and ideals self-defined by their users as preventing or treating illness or promoting health and well-being. Boundaries within CAM and between the CAM domain and that of the dominant system are not always sharp or fixed.51
Applied kinesiology offers an important diagnostic tool to supplement those already in place because it unifies within one diagnostic modality – the manual muscle test – the approaches commonly used throughout CAM. In considering how acupuncturists focus upon meridians, physiotherapists upon rehabilitative exercise, naturopaths upon nutrition, and chiropractors upon the joints, AK does not overrule the tenets of any of these approaches, but rather implies that human ailments may be attributed to multiple systems and that the MMT may identify these for the muscle tester educated in its use. This allows for an integrative and interprofessional model of health care to be developed.
Notes
Goodheart GJ. Applied Kinesiology Research Manuals. Detroit; 1964–1995.
Cuthbert S. Applied Kinesiology Essentials: The Missing Link in Health Care. Pueblo,
CO: Gangasas Press; 2014.
Cuthbert S. Applied Kinesiology: Clinical Techniques for Lower Body Dysfunctions.
Pueblo, CO: Gangasas Press; 2014.
Walther DS. Applied Kinesiology Synopsis. 2nd ed. Shawnee Mission, KS; 2000.
Cuthbert S, Rosner AL, Chetcuti T, Gangemi S. Correlation of manual muscle tests and
salivary hormone tests in adrenal stress disorder: a retrospective case series report.
Townsend Lett. 2015 January.
Cuthbert S. Applied kinesiology: An effective complementary treatment for children
with Down syndrome. Townsend Lett. 2007 July;288:94–107.
Rochlitz S. On the balancing of candida albicans and progenitor cryptocides: a triumph
of the science of applied kinesiology. Townsend Lett. 1986;37:113–152.
Green BN, Gin, RH. George Goodheart, Jr., D.C., and a history of applied kinesiology. J
Manipulative Physiol Ther. 1997;20(5):331–337.
9. ICAK USA research; ICAK published articles [websites]. http://www.icakusa.com/ research; http://www.icak.com/index.php/research/published-papers. Accessed January 11, 2015.
10. Gelb H. Clinical management of head, neck and TMJ pain and dysfunction. Philadelphia: W.B. Saunders; 1977.
11. Sakaguchi K, Mehta NR, Abdallah EF, et al. Examination of the relationship between mandibular position and body posture. Cranio. 2007;25(4):237–249. Research conducted at Tufts Craniofacial Pain Center.
12. Gelb H, Mehta NR, Forgione AG. The relationship between jaw posture and muscular strength in sports dentistry: a reappraisal. Cranio. 1996 Oct;14(4):320–325.
클릭클릭
13. Gelb H, Ed. The Dental Clinics of North America: Symposium on Temporomandibular Joint Dysfunction and Treatment. Chapter 13. Philadelphia: WB Saunders Company; 1983:613–630.
14. Gelb H, Ed. New Concepts in Craniomandibular and Chronic Pain Management. Chapter 15. London: Mosby-Wolfe; 1994:349–368.
15. Smith G. Cranial-Dental-Sacral Complex. Newtown, PA; 1983.
16. NET Mind Body [website]. https://www.netmindbody.com.
17. Neural Organization Technique – International Professional [website]. http://www.
neuralorganizationtechnique.net.
18. Clinical Kinesiology [website]. http://www.clinicalkinesiology.com.
19. Contact Reflex Analysis [website]. https://www.crawellnessartists.com/about.
20. Total Body Modification [website]. http://www.tbmseminars.com.
21. Thought Field Therapy [website]. http://www.rogercallahan.com/index.php.
22. Kinesiology Network [website]. http://www.kinesiology.net.
23. Emotional Freedom Techniques [website]. http://www.emofree.com.
24. Thie J, Thie M. Touch for Health. Devorss & Co.; 2012. Available at http://stores.tfhka.
com.
25. Kendall HO, Kendall FP. Posture and Pain. Baltimore; Williams & Wilkins; 1952.
26. Janda V. Muscle Function Testing. London: Butterworths; 1983.
27. Liebenson C, ed. Rehabilitation of the Spine: A Practitioner’s Manual. 2nd ed.
Philadelphia: Lippincott, Williams & Wilkins; 2007.
28. Lewit K. Manipulative Therapy in Rehabilitation of the Locomotor System. 3rd ed.
London: Butterworths; 1999.
29. Sahrmann S. Diagnosis and Treatment of Movement Impairment Syndromes. St. Louis:
Mosby Inc.; 2001.
30. CuthbertSC,GoodheartGJJr.On the reliability and validity of manual muscle testing :a
literature review. Chiropr Osteopat. 2007 Mar 6;15(1):4.
31. Schmitt WH Jr, Yanuck SF. Expanding the neurological examination using functional
neurological assessment. Part II: Neurological basis of applied kinesiology. Int J
Neurosci. 1998;97(1–2).
32. American Medical Association. Guides to the Evaluation of Permanent Impairment. 5th
ed. 2001:510.
33. JepsenJRetal. Diagnostic accuracy of the neurological upper limb examination I:inter-
rater reproducibility of selected findings and patterns. BMC Neurol. 2006 Feb 16;6:8.
34. AK Challenge Procedure: “A mechanism used as a testing procedure to determine the body’s ability to cope with external stimuli, which can be physical, chemical, or mental.”
35. Mense S, Simons DG. Muscle Pain: Understanding Its Nature, Diagnosis, and
Treatment. Lippincott Williams & Wilkins: Philadelphia; 2001.
36. LundJP,DongaR,WidmerCG,StohlerCS. The pain-adaptation model : adiscussion of
the relationship between chronic musculoskeletal pain and motor activity. Can J Physiol
Pharmacol. 1991;69(5):683–694.
37. Cuthbert SC, Barras M. Developmental delay syndromes: psychometric testing before
and after chiropractic treatment of 157 children. J Manipulative Physiol Ther. 2009
Oct;32(8):660–669
38. Cuthbert S, Blum C. Symptomatic Arnold-Chiari malformation and cranial nerve
dysfunction: a case study of applied kinesiology cranial evaluation and treatment. J
Manipulative Physiol Ther. 2005 May;28(4):e1–e6.
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Dr. Scott Cuthbert is the author of Applied Kinesiology Essentials: The Missing Link in Health Care (2014) and Applied Kinesiology: Clinical Techniques for Lower Body Dysfunctions (2013). Dr. Cuthbert is a 1997 graduate of Palmer Chiropractic College (Davenport) and practices in Pueblo, Colorado. He
has published 11 Index Medicus clinical outcome studies
and literature reviews, and over 50 peer-reviewed articles on applied kinesiology. He is on the board of directors of the International College of Applied Kinesiology USA.
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