The General Adaptation Syndrome and Muscle Testing


The General Adaptation Syndrome was first described by Hans Selye as the three distinct stages that any organism goes through when experiencing stress. Selye explained his choice of terminology as follows: “I call this syndrome general because it is produced only by agents which have a general effect upon large portions of the body. I call it adaptive because it stimulates defense…. I call it a syndrome because its individual manifestations are coordinated and even partly dependent upon each other.” He defined these as the alarm, resistance and exhaustion phases. We can see the way that this works with muscle testing by examining the way that a muscle responds to a specific stress.

Often in a Touch for Health class, we have someone think about a stressful situation while checking an indicator muscle as a way of determining whether or not the body will respond to an emotional stress. When we do this as a precheck, we expect that the previously balanced muscle will immediately go into under-facilitation, becoming weak. This coorelates with Selye’s first stage of stress – an ‘alarm’ response. In the alarm stage, we immediately go into a dip as our body grapples with the new stressor. Soon however, our body adapts and begins to compensate for the new stress and we enter the second phase which is ‘resistance’ and can also be referred to as a balanced-imbalance. The individual is managing to cope, but it is taking more energy to do so than is optimal as they have to go into a compensation pattern. In muscle testing, we often see this as a stressed, over-facilitated muscle – something that is incapable of relaxing properly. It can look like it is fine when we simply run through basic muscle-testing protocols, because it is compensating, but looking a little deeper tells a different story. When the compensation has gone on over a long period of time, eventually the body can no longer keep it up. At this point, it goes into the third stage ‘exhaustion’. Here we see the muscle go back into an under-facilitated state, but it is more dangerous this time. The body no longer has back up reserves that it can draw from and is falling apart.

The best example I have for this is what happens when a family member is in the hospital for an extended period of time. At first, everyone panics and runs to their side in a typical alarm reaction. Very quickly though, the hospital becomes the ‘new normal’. It exists in a state of balanced/imbalance as the family takes turns bringing things, dealing with doctors, exchanging news, etc. This compensation can go on for quite a long time, until eventually, the strain of the situation becomes too much, the ‘exhaustion’ phase.

“Every stress leaves an indelible scar, and the organism pays for its survival after a stressful situation by becoming a little older.”

Hans Selye (1907-1982)

The GAS is one of the reasons why, in a Touch for Health Wheel or 5-Element balance where you are charting a pattern of over and under-energies, if a muscle both unlocks and shows an indicator change when you touch the alarm points, it is counted as a stress. It means that the stress in that particular area is so great that compensation patterns are beginning to become difficult to maintain and it is slipping towards the third stage of stress.

The real problem here of course is that we do not experience stress in our lives in one area at a time. It’s not like we get to recover from one before the next stress comes along – instead, we are often in all three stages, dealing with many different stressors, from the physical to the mental and emotional. If you have several systems that have been in the resistance phase and heavily compensated for a long period of time, it doesn’t take much more to push them into the final stage. We sometimes call this, “the straw that broke the camel’s back”. You hear people say, “He was never sick a day in his life!” describing someone who has suddenly died of a heart attack, but what is more likely true is that he had many systems highly compensated and the heart was not able to take the last bit of stress.

Knowledge of the GAS allows us to take our muscle testing a little deeper. When you find stress in a specific meridian/organ/tissue, etc. you can challenge further to see what stage the stress is in. This could be as simple as offering a verbal challenge, or if you use a modality like SIPS (Stress Indicator Point System), you could use light and deep touch on the point to see which gives you an indicator change. If you are familiar with Powers of Stress from Applied Physiology, this is another way of gauging just how much stress the system is under. All of these are ways of making sure that we get to the root of the matter and help to reestablish balance in the body on the deepest level.

A Vision for the Future of Specialized Kinesiology

Guest post by Ludovico Feletto, also published on

When people ask me to explain what will look like when it is fully developed, it usually takes me a long time to explain the concept of what we are building.

Let’s compare how things are in the Kinesiology world now, to how things could be with Knowlative.

Let’s say that I am a student that already knows how to perform a Muscle Response Test, and I have completed one of the “core” specialized or applied kinesiology courses available. My goals are:

  1. To constantly upgrade my skills with the most effective procedures available;
  2. To store my client’s records in a safe and usable way and to access them easily in my work;
  3. To keep an eye on how my activity is evolving by tracking the number of sessions I give and the procedures I use most;
  4. To write a scientific paper.

Before Knowlative

  1. To upgrade my skills, I have to look for new courses available but that isn’t always a simple task. Sometimes what seems to be a very promising course is actually a waste of time and money. Sometimes a very useful procedure is impossible to learn in my country or in my geographic region or it is not advertised at all in my area so I do not even know it exists. So, I have to settle for what is available in my region; and sometimes this is not sufficient to progress in my profession.
  2. Storing my client’s records can be another time consuming and quite frustrating task. If I write down the results of what I am testing this process slows down my work. And then, if I keep confidential and sensitive data the time (and money) required to keep them safe and to adhere to Data Protection Laws can be significant. If I do not track anything to avoid these problems I will never be able to see the evolution of my practice and notice which techniques I tent to skip or ignore. Furthermore, I will never be able to write a scientific paper on the effectiveness (or not) of my balances (See point 4).
  3. What happens if I want to see how I am progressing over time: how many procedures I use in a session with my clients, how long it takes to perform a given procedure, which month do I work most (and least), what is the age group of my clients, what are the most common complaints or goals, and much more? This data, which would be very useful to improve my practice, target my advertisements, see what areas I need to strengthen, is nearly impossible to get if I do not invest a huge amount of time in tracking and calculating it.
  4. To write a scientific paper I have to expect to spend a huge amount of time (and money) planning the study carefully, collecting all the data (and for my study to be relevant I have to collect huge amounts of data), analyzing all the data and writing it. All these tasks are very specific and the majority of us do not have any idea how to achieve even the most basic skills needed to go through all the process. So, basically, I cannot do any scientific study… and as a result, Specialized Kinesiology will never be taken seriously.

In short, without Knowlative I am still traveling with a steam engine while my competitors are testing a Hyperloop trip.

With Knowlative

  1. Logging in, I have a showcase of Kinesiology Courses available from all over the world with the option to directly contact the author for more details. The basic procedure of every course is available inside my “Wikipedia-style” learning pages just a few clicks away and I can try it immediately with a test client to see if I like it or not and if I’m interested in the “real” content of the course. I can see how often the procedure is utilized in their practice by users that already took that class and the feedback they give of the lessons. If I decide to take that course I can (only for selected courses) attend online in the Knowlative platform or be redirected to a webinar of the author or, if I prefer to meet the creator of the procedure in person, I have all the dates and locations of his/her next classes.
  2. While I am working, I can browse for the appropriate technique for my client in Knowlative. The “manual” is adaptive (it shows me step-by-step what I need in real time) and I can easily record all the results of my testing. Without paper manuals, I do not waste time searching for the right page, and by recording all data in the “manual” Knowlative page directly I do not need to worry about storing data in a usable way. And if I do not remember a step of a certain procedure, with one click I can see its complete description.
  3. When I am finished working I can immediately access all the updated statistics of my practice with intuitive graphs and suggestions. I do not need to do anything for this; Knowlative does all the boring jobs for me.
  4. Experienced statistic experts analyze the collective data of Knowlative and build up observational studies. With the information gathered they design specific studies and I can decide to add an appropriate client with a few clicks. In fact, Knowlative matches my client’s parameters with the studies available in real time and, if appropriate, it asks me if I want to participate. This process will only add a few selected additional questions to my standard session and only 2 minutes of my (and my client’s) time. And my name will appear as a contributor in the scientific papers produced with my help. Without needing to spend of huge amount of money, we build strong evidence that Kinesiology is the essential tool for the medicine of the future.

And with Knowlative I have an additional bonus: if I add my findings, procedures and experience to Knowlative Database I am rewarded with a part of the project’s income in relation with how much my materials are used by other members of Knowlative and the advancement in manual response testing is much faster.

Without needing to spend of huge amount of money, we build strong evidence that Kinesiology is the essential tool for the medicine of the future.

How Knowlative will develop

To achieve the big picture, we have been working since December 2015. You can see the next phases of Knowlative in the picture. We are assembling the software and managing all the issues building a company brings up. Every one of us is working for free in evenings, weekends, vacations, …

Soon we will have to absorb more expenses to make this vision came true. The most problematic aspects are the legal issues involved in Knowlative. We have an estimation of expenses for 20000 Euros for this area alone.

We have done a lot of work so far, but now we need your help.

So, if you like what Knowlative will bring to your professional practice register to this site and visit our crowdfunding at

If you, as a client, see how Knowlative can improve the quality of your Kinesiologist, help us with the crowdfunding!

And do not forget to spread the message to your friends.


About The Author

Ludovico Feletto – Medical Doctor & Creator of Knowlative. Ludovico is a trauma and orthopedic surgeon and the creator of Knowlative. Since before his Specialization Degree in 2007, he developed a deep interest for an individualized approach to medicine, exploring many integrative methods of healing (acupuncture, Kinesiology, Neuraltherapy…). In his medical practice and in Knowlative he brings the certainty that the future of medicine is a system that assimilates the knowledge of the western medicine with the main eastern practices.

The Oxford Studies: Part II – Results and Implications

The Oxford Studies: Validating Muscle Response Testing

Part II – Results and Implications

Guest post by Dr. Anne Jensen

As mentioned in Part I of this article, I completed my DPhil (PhD) at Oxford University, where my research focused on assessing the validity of Muscle Response Testing (MRT) in a specific application: to distinguish true from false spoken statements. The rationale for the methods used was outlined previously, and in this part, I will discuss the specific methods of each study, report the results of this research and discuss its implications.

This series of studies consisted of 5 diagnostic test accuracy studies (see Table 1 below), and while the general methodologies of all studies remained consistent, specific elements were changed in an attempt to better understand how they influenced MRT accuracy.


Table 1 – An outline of this series of studies assessing the validity of MRT

Study 1 – Estimating the Accuracy of MRT

Study 2 – Replication of Study 1

Study 3 – Replacing the Practitioner with Grip Strength Dynamometry

Study 4 – Using Emotionally-arousing Stimuli

Study 5 – Estimating MRT Precision using a Round-robin Format


Summary of Testing Scenario

In all the studies, the patient viewed a computer screen on which was displayed pictures of everyday items (e.g. apple, basketball, tree, train, etc), and which instructed them (via an earpiece) what to say in relation to the picture. About half of the time, they were instructed to say true statements, and half of the time, false statements, and the order was randomly generated by the computer.

As mentioned in Part 1, the paradigm under investigation was that true statements result in a strong MRT outcomes, and false statements result in a weak MRT outcomes. Only the deltoid muscle was used for testing, however, how the participants were positioned was left up to the discretion of the practitioner, as long as they could not view each other’s computer screen. Also, practitioners could perform any pre-testing procedures, as they were encouraged to do what they would normally do in practice.

All participants gave informed consent and completed demographic questionnaires prior to beginning the actual testing. The questionnaires also asked participants about their MRT experience, their confidence in MRT, etc. During the testing, for each MRT or intuitive guess, the sequence proceeded in this manner:

Participants proceeded in this manner until they completed all MRTs / guesses, and then completed another short questionnaire, after which they were done.

Specific Study Methods

As mentioned above, while each study followed the same basic protocol, certain details were changed to investigate different factors. Now I will summarize the details of each study.

Study 1 (Main Study) – Estimating the Accuracy of MRT

In the first study, 48 pairs of participants were recruited: 48 practitioners who use MRT and 48 patients who had no previous MRT experience. During this study, the practitioner also viewed a computer screen on which was shown either the same picture as the patient or a blank black screen (see Figure 2 below). In the second case, the practitioner was blind to the statement’s truth, and it was only the blind tests that were used to calculate accuracy. Pairs performed 40 MRTs (broken up into blocks of 10), which alternated with blocks of 10 intuitive guesses.

Figure 2 – Study 1 testing scenario layout.

Study 2 – Replication of Study 1

The results of Study 1 (described below) were so impressive that my supervisors insisted I repeat it (i.e. replicate it). So, from the data collected in Study 1, another sample size calculation was performed and it was determined that only 20 pairs were needed to obtain similar results. Also, the practitioner’s computer was removed, making the practitioners blind in all repetitions. I found in the first study that the second computer added an unnecessary degree of complexity, and by removing it, made data collection flow much smoother. One other change that my supervisors asked me to implement was for me to leave the testing room while the pairs were testing. In Study 1, I was present – mainly to ensure the smooth running of things – but they thought that my presence may have had an influence on the results. So, in Study 2, I left the room. All other aspects of Study 2 were identical to Study 1.

Study 3 – Replacing the Practitioner with Grip Strength Dynamometry

One of the criticisms of MRT is that it is not objective, meaning that practitioners (and patients) could seemingly influence the outcome. With this in mind, we sought a way to standardize the assessment, and therefore, improve its objectivity. One of my supervisors suggested to run a study where muscle strength assessed by a practitioner was replaced by muscle strength assessed by a machine – with the view determine if a device could be useful in distinguishing false from true statements. So, in Study 3, MRT was replaced by grip strength testing via dynamometry, however aside from that, the same protocol was followed. Twenty patients were recruited to perform 20 grip strength tests (10 right hand, 10 left hand) following the speaking of true and false statements. In this study, the average grip strengths after true statements were compared to the average grip strength after false statements. A statistically significant difference would mean that the dynamometer could also be used to detect false statements.

Study 4 – Using Emotionally-arousing Stimuli

In Studies 1-3 & 5, the pictures that were shown to patients, were of ordinary, neutral items (e.g. an apple, a bucket, a fence, a basketball, etc). While the results obtained were very good, we thought perhaps they might even improve if the pictures were emotionally-arousing or stressful. So, in Study 4, the database of pictures presented included a combination of neutral and emotionally-arousing images, and we followed the same protocol as Study 2: 20 practitioner-patient pairs, 40 MRTs, 40 intuitive guesses, and I let the room during testing. All other elements also remained the same.

Study 5 – Estimating MRT Precision using a Round-robin Format

For a test to be considered valid, it must be both accurate and precise. So, it was also necessary to assess MRT’s precision, which would mean investigating if (under similar conditions) can MRT achieve the same results consistently. In other words, if a practitioner achieved 85% correct with one patient, did s/he achieve approximately 85% correct with other patients. One could also consider this the stability of MRT accuracy.

In order to assess this, we gathered 16 practitioners and 7 patients, in the same location. Each practitioner performed 20 MRTs and 20 intuitive guesses on each patient, following the same basic format as the previous 2 studies.


Summary of Results & their Implications

With over 400 participants evaluated in these studies, the data collected was extensive, and because of this, only some of the results can be reported here. However, the main findings are described below.

Table 2 – Summary of Accuracy Results

Result #1: MRT can accurately distinguish false from true statements.

In Table 2 (above), it can be seen that the average MRT accuracies in this series of studies ranged from 59.4% correct to 65.9% correct, and that in each study the MRT accuracy was significantly better than the average accuracies of intuitive guessing (i.e. each p-value was less than 0.05). While it is not shown in this table, it was also found that the MRT accuracies were significantly better than chance (i.e. 50-50). Therefore, it can be said that MRT is consistently more accurate than either guessing or chance at distinguishing false from true statements. This implies that MRT is not a chance occurrence, and that the success of MRT cannot be attributed to a practitioner’s ability to “read” people.

Result #2: Factors that influence degree of MRT accuracy remain unknown.

When examining the accuracy scores of all participating pairs, we found the range of MRT accuracies surprisingly wide: 25-100%. This means that some practitioners got every MRT correct, while other practitioners got a score of half as good as chance. This lead us to wonder what the 100%-practitioners were doing that the 25%-practitioners were not, and vice versa. Because previous research found that experienced practitioners were more accurate than less experienced practitioners, we wanted to know if we could replicate these results, and if there was any factors or participant characteristics that may be attributed to better or worse accuracy scores. Therefore, we tracked on those factors listed in Table 3 (below). Correlation analyses revealed that none of these tracked characteristics consistently had any influence on MRT accuracy, including practitioner experience. That is, there was no difference in MRT accuracies between novice and experienced practitioners. Moreover, the results of our correlation analyses mean we do not know why some practitioners perform better than others.

Result #3: Practitioners did not seem to influence (or bias) the MRT outcome.

Another criticism of MRT is that it may appear that practitioners can influence (or bias) the result of the MRT, so I believe that it was important to specifically address this concern. In Study 1, the practitioners were blind to the verity of the statement during approximately ½ of the repetitions (total number of repetitions was 40). It was hypothesized that when the practitioners were not blind (that is, when they were viewing the same picture as the patient), their accuracy would be close to 100%, or at least significantly more accurate than when they were blind. However, this was not the case. There was no difference in MRT accuracies when they were blind and not blind (p=0.52). This may suggest that practitioners did not consciously influence the outcome of the MRT, or in other words, they were doing honest MRT.

Table 3 – Participant characteristics tracked.

Result #4: Patients did not seem to influence (or bias) MRT accuracy.

A similar criticism to the one posed above is that it may also be possible for patients to influence (or bias) the result of MRT. During Study 1, all patients recruited had no previous experience with MRT (that is, they were MRT-naïve), and they were blind to the paradigm under investigation: they were not told that a strong MRT result indicated a true statement and a weak MRT result indicated a false statement. However, since it was not possible to blind them to the verity of the statements they were speaking, and since they may have been paying attention to each MRT outcome and deduced (i.e. guessed) the paradigm, and as a result, may have influenced the results. However, this also was not the case: those pairs whose patients reported guessing the paradigm (n=21) were no more accurate than those pairs whose patients did not report guessing the paradigm (n=27), reaching statistical significance (p=0.38)

In other studies in this series, a mixture of MRT-naïve and non-naïve patients were recruited, and it was hypothesized that those pairs with non-naïve patients may achieve higher accuracies than those with MRT-naïve patients. However, again this was consistently not the case. For example, in Study 2, when comparing the MRT accuracies of those pairs with MRT-naïve patients (n=11) and non-naïve patients (n=9), there was no significant difference in their average accuracies (0.634 and 0.544 respectively, p=0.07). It is also interesting to note that the naïve group had a higher accuracy, but the difference did not reach significance.

Result #5: MRT is not an ideomotor effect.

Psychologist/physiologist, William B. Carpenter, described the nonconscious modulation of muscular movement mediated by a heightened belief as the Ideomotor Effect, arguing that muscular movement can be nonconsciously initiated by the mind. It is common to attribute the Ideomotor Effect to any unproven, puzzling phenomena, such as dowsing, Ouija boards, automatic writing, the motion of a pendulum, Facilitated Communication and muscle testing. However, since the practitioners were blind to the verity of the spoken statement, it is unlikely that practitioners could be unwittingly responsible for an ideomotor action. Likewise, since there was no significant difference between the pairs whose patients reported guessing the paradigm, and those who did not, it is unlikely that patients caused an ideomotor response either. Furthermore, since ideomotor responses are said to be related to a heightened belief, and since no correlation was found between MRT accuracy and increase in any confidence rating, it is especially unlikely that MRT represents an Ideomotor Effect.

Result #6: Truths were easier to detect than lies.

There was one more interesting result that is directly useful to clinical practice, and that was that true statements were easier to detect than false. In other words, the average accuracy of all the true statements was consistently higher than that of all the false statements. The clinical implication of this finding is that practitioners should use more true statements than false statements when comparing spoken statements during MRT sessions.


This series of studies shows that MRT is consistently more accurate than either guessing or chance at distinguishing true from false statements. A strength of this series is that consistent results were achieved across multiple studies (see Figure 3 below). Other strengths of this series that contribute to their rigorousness include the use of a true “gold standard” as a reference standard, and a high degree of blinding. In addition, we used heterogenous samples; that is, a broad range of practitioners with varying levels of experience, and patients with different backgrounds as well. Finally, these studies used simple yet robust methodologies, which would make their replication straightforward. It is my hope that potential researchers reading this will be encouraged and carry out additional MRT research themselves.

There are also limitations of these studies, including the results are not generalizable to other applications of MRT and to other types of manual muscle testing (MMT). This means that just because MRT has been shown to accurately detect lies, it does not mean that MRT can accurately detect other conditions, such as organ dysfunction, vertebral subluxation or the need for a specific nutritional supplement. In order to make these claims, further specific research is required. Another limitation is that these studies may have been under-powered for subgroup analysis because no factors that influenced accuracy were identified.

Directions of future research

This series of studies offer encouraging first steps toward the validation of MRT, however further research is certainly required. For instance, it would be very useful to determine what factors influence MRT accuracy, and in order to achieve this, future research would require larger samples sizes. It would also be interesting to compare the results of MRT to detect lies with other lie detection tests (e.g. polygraph).

In addition, because these studies achieved MRT accuracies in the 60%-range, it is important to ascertain if this is “good enough” clinically. In order to accomplish this, MRT technique systems must be assessed for their effectiveness. This is accomplished through rigorous clinical trials (e.g. randomized

Figure 3 – Forrest Plots: (A) MRT Accuracy, and (B) Intuitive Guessing Accuracy

clinical trials, RCTs). This will not be accomplished through case studies – regardless of the number of case studies generated. In the world of evidence-based health care, case studies, while they may be interesting, they are considered poor evidence, similar to editorials and testimonials. They are largely ignored by those who make decisions about healthcare policies and funding. It is my suggestion that the effort and resources that are currently put in to generating case studies now be put toward running clinical trials. Only this will advance the evidence base.

Many practitioners who volunteered for these studies asked me how MRT worked. During my 10 years at Oxford I was only asked this question once – and that was at the very end, during my DPhil viva (PhD exam). My colleagues at Oxford were not interested in how or why an intervention or test works, but rather they were interested in learning if it works, how well it works, and if it causes harm. That’s all. Yet, after 3 hours of questioning, one of my examiners finally asked me, “So how does muscle testing work anyway?” My response to him was, “That wasn’t my research question.” He was happy with that and we moved on. The truth is: We do not know how MRT works. However, if an Oxford examiner does not care, an expert in the field of clinical research, then hopefully you readers will not care as well. We also spend a lot of time, money and other resources in an attempting to figure this out, whereas I believe that our limited resources can be better spent elsewhere. Yes, this series of studies may be a start in the validation process of MRT, but we have a long way to go.

Dr Anne Jensen, DC, PGCert, PGDip, MSc, MS, DPhil

The Oxford Studies: Validating Muscle Response Testing: Part I – Methods Used

By Anne Jensen

Feature image is from the Touch For Health muscle testing charts, available through CanASK

When I was practicing as a chiropractor in North Queensland, I avidly used a range of muscle-testing-based techniques with my patients – and we loved the results. However, I soon realized that muscle testing was one of the biggest strengths of my practice – but also one of the biggest weaknesses. It was a strength because we could clearly and quickly tune in to the body, ask it what it requires, and focus any therapy on that. It was a weakness because it lacked scientific validity. That is, insufficient (e.g. too little) robust clinical research has been carried out which supports its usefulness – as a result, it is largely thought of as unscientific, meaningless, and even dodgy.

On one hand, I did not necessarily need scientific “proof” that muscle testing “worked” – I saw proof of it in my practice every day. But on the other hand, I was curious. So, I undertook a number of small research projects in my clinic, and well, I did them poorly. I just didn’t have the knowledge I needed to make the results meaningful, and for that reason, I looked for where I could gain this knowledge. This is how I came across Oxford University’s programme in Evidence-based Health Care. It is a programme designed specifically for practitioners who want to learn how to do rigorous clinical research. It was also run alongside Oxford’s Centre for Evidence-based Medicine, giving students access to some of the top clinical researchers in the world. It seemed just what I was looking for – so I applied – and was accepted! So, off I went to England for further tertiary education.

For my research, I had originally planned to study the effectiveness of an emotional healing technique (e.g. HeartSpeak) on those with depression. However, this technique uses muscle response testing (MRT), and as can be imagined, it was met with extreme skepticism within my department (the Department of Primary Health Care Sciences). Before my supervisors would allow me to embark on a large randomized trial, they insisted I demonstrate the efficacy of MRT. This venture then took a life of its own, and the randomized trial on depression was deferred to another time.

The first step that needed to be taken to investigate the validity of MRT was to figure out how to begin. This was not as straight forward as one would think. So, I started by defining what I meant by MRT, and that was: testing one muscle repeatedly as the target condition changed. Having studied Applied Kinesiology (AK) myself, I knew that MRT was jokingly (or not) called “The Arm Push Down Test” – and was often regarded as unsound. However, I also understood that it was used within many different muscle testing technique systems – such as HeartSpeak, Psych-K, Total Body Modification, Contact Reflex Analysis, and dozens of others. So, aside from myself, I knew MRT was used widely around the world. I recognised that MRT was different from the type of muscle testing done in AK, and as such, needed to be considered as distinct.

Reiterating the distinction, in MRT, one muscle is tested repeatedly (usually the deltoid) as the target condition changes. That means, one MRT is performed for each target condition (and usually the result of one MRT influences the choice of target condition of the next MRT). A target condition is what one performs the test to detect, and examples in common use include: stress, lies, chiropractic subluxation, meridian imbalance, the need for a particular nutritional supplement, etc. Another important aspect of MRT is that it is a binary test – that is, it has only two possible outcomes, commonly referred to as “strong” and “weak.”

Then, I clearly delineated MRT as being distinct from other forms of manual muscle testing (MMT). For instance, MRT differs from orthopaedic/neurological MMT (ON-MMT) done by many physiotherapists, chiropractors, and osteopaths, in that the target condition for ON-MMT is limited to muscular strength, and the result is not binary, but usually rated on a 0-to-5 scale. As introduced above, MRT differs from Applied Kinesiology style of MMT (AK-MMT) – also a binary test – in that with AK-MMT, any muscle can be tested, and the outcome of the test will have different meanings, dependent upon which muscle was being assessed.

The next step was to determine just how widely used MRT actually is – also called the prevalence of use of MRT. As my advisors argued, if only a handful of people use MRT, then assessing its validity would be impractical. So, I set about this task – which, again, was not simple because those in many different lines of work use MRT – and also those in no particular employment (i.e mothers). For instance, many chiropractors use MRT, but not all, and kinesiologists use MRT but a kinesiologist does different things in different parts of the world. So, interviewing those in particular profession seemed inefficient. Therefore, it was decided that if the various organisations that teach MRT were polled and asked how many they have trained over the years, and if the totals were adjusted for things like attrition, inaccurate accounting, and incompleteness, then a reasonable estimation would be achieved. The results of this polling were interesting for a number of reasons. Firstly, in a painstaking search, only 86 techniques that used MRT were identified; however, undoubtedly the actual number of named techniques probably far exceeds this number. Nevertheless, all teaching organisations were contacted by either telephone or email, with unexpected mixed responses, ranging from extremely helpful to unresponsive to outright hostile. Nevertheless, from the data collected, it could be estimated that over 1 million people use MRT worldwide (for the full paper, click here). This widespread prevalence of use of MRT certainly warranted investigation of its validity.

Next, a thorough literature search had to be carried out, to determine if previous research has already demonstrated MRT to be valid, because PhD research must uncover some new information or insights. I was pleased to learn just how much research on MMT has been done, but did discover that most of it was not associated with MRT specifically. So, yes, my PhD would result in unique research.

The next question that had to be answered is how to assess the validity of MRT. There are numerous terms that are used to describe tests and measures, such as valid, accurate, precise, reliable, repeatable and so on. Because in colloquial English, the meanings of these words differ from their use in research settings, it became important for me to understand specifically what each term meant. and also, because earlier research studies used these terms. After months of reading, I determined that the place to start was to assess the accuracy of muscle testing, and to use the standard protocol for diagnostic test accuracy studies, called the STARD Statement.

At first, I was resistant to using the diagnostic test study protocol – since, after all, MRT is not used to diagnose, per se. Then I read that a diagnostic test: (1) gains information about a patient, and (2) is used to guide treatment. Since MRT is used for both of these tasks, then this was indeed an appropriate approach.

Since a diagnostic test is used to detect a target condition (e.g. manual blood pressure testing is used to detect hypertension, and a series of blood tests are used to detect diabetes), I had to consider carefully which condition to target in my studies. Since MRT is used to detect a large range of conditions, the pool was extensive – and I knew that this choice would be extremely important.

Furthermore, to assess a diagnostic test, the results of the test in question (called the index test, MRT in this case), must be compared to the results of a reference standard (a test already in use to detect the target condition and already found to be valid). Since the validity of MRT was questionable, I also knew how important it was to select an exceptionally sound reference test. It would be much more convincing if MRT was compared to an established standard rather than to another speculative test.

After much consideration, it was decided that we would use MRT to detect deceit (a lie), or put another way, to distinguish false from true spoken statements. Deceit was chosen for a number of specific reasons – primarily because the reference standard would then be the actual verity of the statement, which would be definitively known and could be controlled. Because of this, the reference standard would be a gold standard, which would add rigorousness to this series of studies. The paradigm we chose to implement is one very commonly used: the muscle stays strong when a statement is true, and goes weak when a statement is false. While this line of research did not involve explaining why or how this occurs, in the field, it is often explained that lying is a stress, and stress causes the muscle (the body?) to weaken – so it makes sense. Aside it being in common use, this explanation has good face validity and a sound theoretical framework.

Then, we defined accuracy of MRT, to be the percent correct, and it would be quite straightforward to make this calculation (i.e. the number of MRTs gotten “right” divided by the total number of MRTs performed). Using statistical methods, this number could then be compared to chance to determine if there was a difference. We compared MRT accuracy to chance because, theoretically, in a binary test, the two outcomes (strong and weak in the case of MRT) would be equally likely. However, in practice this may not be the case.

Therefore, we sought to implement a second index test which could be used to compare accuracies. Since it is the opinion of some MRT skeptics that it is not actually MRT making distinctions, but rather that the MRT practitioner is good at “reading” people. With this in mind, the secondary index test we implemented was intuitive guessing; that is, without using MRT, but only visual, auditory and kinesthetic clues, the practitioner was asked to guess whether a statement spoken by the patient was true or false. The accuracy, or percent correct, of intuitive guessing could be compared to MRT accuracy to see if there is any difference. If there is no difference, the skeptics’ hypothesis would be correct; however, if there was a difference, then there would be something to MRT after all. This addition of a secondary index test was an important and valuable piece of this research methodology.

The next aspect of the methods that had to be considered was the participant enrolment criteria – that is, defining who we were going to recruit to participate. I wanted to get a very well-rounded view of MRT accuracy, so I wanted a broad sampling of muscle testing practitioners, otherwise known as a heterogenous sample. We recruited practitioners from any profession, with any amount of experience and any amount of expertise. However, to be included, they had to have had some previous training in some kind of MRT. In contrast, the patients recruited for the first study (the largest one) had to have no previous experience with MRT, and also had to be unknown to the practitioner who was going to test them. For the first study, after doing a sample size calculation, we recruited 48 unique practitioner-patient pairs, meaning a pair could only participate once. For the 3 follow-up studies, 20 practitioner-patient pairs were used.

Blinding is another important aspect of clinical research. In this series of studies, MRT accuracy was calculated using the case when the practitioners were blind to the outcome of the MRT, meaning they did not know if the spoken statement was true or false. In addition, practitioners were not blind to the paradigm under investigation (i.e. true statements à strong MRT; false statements à weak MRT). Unfortunately, blinding patients was not as straight forward – as they were aware that they were saying true and false statements. To balance this, they were blind to the paradigm being tested – that is, they were not told that their muscle will weaken when they spoke false statements. So, in the end, I believe we attained a fair degree of blinding.

There were a good many factors that we had to consider when designing these studies, and this first part of this 2-part article describes the general methods used. In Part 2, particulars of each of the 5 studies (see Table 1) will be outlined, the results revealed, and their implications discussed.


Table 1 – An outline of this series of studies assessing the validity of MRT

Study 1 – Estimating the Accuracy of MRT

Study 2 – Replication of Study 1

Study 3 – Replacing the Practitioner with Grip Strength Dynamometry

Study 4 – Using Emotionally-arousing Stimuli

Study 5 – Estimating MRT Precision using a Round-robin Format