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Applied kinesiology Test protocol

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Robertisaacs, Jan 24, 2011.

  1. Members do not see these Ads. Sign Up.
    This is an offshoot from theChiropractor test thread.

    I laid down the challenge of a £50 bet that AK could not be shown to be more than ideomotor effect under test conditions. To my considerable delight, Ted Jed (is that your full name BTW?) took up this challenge.

    Game on:drinks

    By way of introduction.

    There is a lot of interesting information around the science behind AK. To me this is all moot unless the test is reproducable. If I constructed a theory that in a house with spinach in the fridge the mice will be green, you would not need to know my reasons to test my theory. You would need, initially, to show me a green mouse in such a house.

    You can tell I've been reading a lot of Dr Zeus recently can't you.

    So then. This needs to be a quick and simple test to see if AK is reproducable in the absence of the ideomotor principle.

    AK Has a mechanism which is outside of the Ideomotor effect.

    Null hypothesis
    AK has no mechanism which cannot be explained by the ideomotor effect.

    So this is not a study to investigate the efficacy, the validity or anything like this. It is simply to investigate if the effect is reproducable.

    The ideomotor effect is based on the principle that somebodies muscular activity (in this case perceived strength) can be affected by SUBconcious controll on behalf of the subject. Emphasis on the Sub, people exhibiting this are rarely aware that they are doing so.

    Well documented examples include pendulum dowsing.

    So there are two possible effects of this on AK.

    1. The tester pushes harder.
    2. The subject perceives a drop in strength.

    Therefore to blind this study we must attempt to eliminate both the tester, and the subjects knowledge of the test conditions. It is not enough to blind either the tester OR the subject. Either can produce the effect, or indeed by non verbal communication, communicate the test state.

    The simplest way to do this would be by testing heel raises. In the volumes we tend to use in orthoses raises it can be tricky to detect the level of a raise (though not impossible). The effect of the aforementioned non verbal communication could further be reduced by blinding (literally) the tester.

    Further effort at blinding could be made by using a subject who is unaware of the nature of the test. If the muscle weakness is truly a physiological mechanism this will have no impact. If its psychological, it will.

    So we could have 3 situations. Heel raise in left foot, heel raise in left and heel raise in right. This gives a total 6 mm difference between the two test conditions. Test, say, 20 times in random order with each time the subject leaving the room to have their shoes modified. If we place the raises under a thin poly strip which stays in both shoes it should reduce the patients ability to conciously detect the change (and be closer to the situation of adding raises under insoles)


    Would a 6mm differential be enough to produce a discernable AK change under normal circumstances?

    Anyone else
    Can anyone else think of any modifications / enhancements to the test protocol (without hydraulic raisable platforms etc or anything else which would make the test excessively complex )
  2. Deborah Ferguson

    Deborah Ferguson Active Member

    Hi Rob

    Sounds very interesting. When will this happen ?

  3. 14 or 17 of April is when the main main is in london. Don't know if he is around in the meantime...
  4. Deborah Ferguson

    Deborah Ferguson Active Member

    Thanks. Let me know if you're able
  5. W J Liggins

    W J Liggins Well-Known Member

    Hi Rob

    The protocol sounds largely fine. However, the subject could be blinded by removing the footwear in the test room (or elsewhere), so they are not aware of what - if any - alteration has been made. I do feel that the subject will be aware of the heel raise which could affect the result.

    I am always dubious about any test where p =1. How about lining up 20 to 30 subjects? Still not ideal but statistically more significant.

    All the best

  6. Hey bill.

    That was exactly what I had in mind with the shoes. I don't know how detectable a 3mm raise would be. Remember the subject won't know what I'm doing to their shoe.

    I'm looking at it this way. Let's say for the 3 states there are 2 conditions, weak and strong. When a pattern has been set (weak / strong) the tester has a 1/2 chance of getting one right, 1/4 chance of two right 1/8 chance of 3, etc etc.

    More subjects would be fab but I don't know how much time ted is willing to devote!

  7. How's about this one, it should be possible to have 3 kinds of insole: one that strengthens the voodoo, one that weakens the mojo, and one that does nothing at all.

    So, you have 20-30 subjects and you randomly allocate each of them to receive one of the above types of insoles, they don't know which one they get. Ya' man then tests each subject and "guesses" which subject is wearing which insole.

    Trouble is it becomes a circular argument, how do we know the insole had the prescribed weakening effect, strengthening effect etc....
  8. Paul Baalham

    Paul Baalham Member

    Hi Rob

    You say that the tester may subconciously push harder.

    What if, instead of pushing, the tester were to pull down on the arm?
    The subject could have a spring scale attached to his/her arm which the tester pulls thus measuring the the amount of force used.

  9. Excellent thinking, Paul. You can still push down, just use a compression force gauge, that way "the test" is still being tested not a variant of it. Rob, the link you sent me to that commercially available glove might be the way to go on this. Or just a hand held dynamometer (see what your physio dept have got) or ebay for a couple of quid: http://cgi.ebay.co.uk/Hand-Dynamome...th_Training&hash=item1e5c277bf0#ht_3735wt_871

    You'll need to agree on insole design, perhaps Ted can tell us how to design insoles which will weaken; strengthen; do nothing in terms of strength... The question still remains, "how do you know the insole has weakened the shoulder muscles?" "Well I push down on his arm...." You got to show the validity of the pushing down on the arm test first... You'll also need ethical approval to get this published, so I'd get on with that if you want to collect data in April.
  10. Ian Linane

    Ian Linane Well-Known Member

    In my previous limited experience of using this test method (in a different discipline) there are issues of:

    1. the differing subjects individual shoulder strength (something that can have a bearing on the subject response)
    2. the need for the subject to be advised of (even experience) what the tester is going to do to the arm in order to let them comply with the testers push
    3. in relation to the latter it may also be necessary for a subject arm to be pushed a couple of times so they are familiar with what to expect (maybe this can be done by someone else in another room)
    4. the push should be fleeting and relatively light as prolonged push may well increase the pressure applied by the tester (which comes back to item 1 as well)

    It was for these, amongst other reasons, that I ceased doing this kind of test in the other discipline. I remain open to it possibly having some physiological or neurophysiological bearing or value but the variables involved in subject response alone left me feeling it was not the best test.

    It might be worth Stanley giving some comment on this.

    1. Needs to be a test-retest anyway, so this shouldn't be a problem as it's relative to the subject

      You advise what they will experience, but not why.

      As near to standard protocol should be adopted

    You just use a force sensor that records force/time, easy. That way you get the impulse being applied.

    Look at it, say what it is... I remain open to there being intelligent life on other planets, to the existence of Dog etc. But lets put the things that we can test, to the test.
  11. You also need to ensure the lever arm is the same throughout, pretty easy to create greater displacement with the same impulse if you push more distally on the arm.
  12. Stanley

    Stanley Well-Known Member

    I agree Robert. That is why in AK courses, a lot of time is spent in making sure that the muscle test is performed correctly. They instructors say that unless you have an accurate reproducible test, then the AK is meaningless.

    There are only a few problems with this “study”.

    1. The heel lift may or may not cause a muscle to be inhibited. So testing for an inhibited muscle when there is none is fruitless.
    2. The muscle test proposed is an invalid test. A valid one tests one muscle, not a group of them, as only one muscle of the group may be inhibited.
    3. The tester should be qualified. No offense TedJed, as I know nothing about you, but are you certified in AK, and where have you taken your course work?
    4. Muscle testing is a skill that takes a long time to perfect, and the person’s nervous system determines how this muscle contracts. For instance in a professional athlete, the difference between inhibited and normal contraction is very minimal and is extremely difficult to determine. Also, the patient may have dysponesis, and until this is corrected, there will not be a normal muscular response. Each muscle has a different feel and strength to it and this is where the skill lies. For instance, I am confident in my ability to test the posterior tibial, and the peroneal muscles. I am not confident in my ability to test the hamstrings because I don’t routinely test them.
    The muscle test is not the strength of the muscle; it is the quality of contraction of the muscle. An EMG during muscle contraction would be a more accurate and less subjective test.
    Here is a reference in which EMG was used to with AK muscle testing:


  13. TedJed

    TedJed Active Member

    Thank you Rob for your extensive considerations and articulation of the proposed 'study'.

    I think we looking to test 2 different hypotheses.

    Your Hypothesis:

    I don't think Ideometer effect is useful for determining the efficacy of orthotic therapy or any other type of intervention.

    My hypothesis is:
    Changing proprioceptive afferent input from the foot causes changes in muscle response (strength, ability to respond to a changing physical challenge) in muscle groups involved in gait (lateral deltoids).

    I have no interest in testing 'subconscious' influences. This is too airy-fairy for me.:pigs:

    Clinical relevance:
    To test whether this neurological muscle testing can be a useful test for clinical assessment of orthoses, joint mobilisation or any other form of intervention.

    This is a really important distinction Stanley. Well made.

    It's most important that the contact points of the tester on the subject remain the same.

    Not quite; Subject is advised 'Your job is to just resist my force.' The tester then applies the force gently at first, then increasing the force. The tester (and audience) then observe the subject's response to the changing load. This is the 'quality of contraction' being tested. The test will take approx 1-2 secs in total. It's not testing strength or fatigue levels, just the quality of contraction.

    This is to test muscle strength, not quality of contraction.

    Proposed Testing Procedure:
    Tester (me, Ted Jedynak) is blindfolded.
    Tester & subject are positioned within close proximity.
    Subject is standing barefoot on a firm, flat surface.
    Subject is given instructions verbally by the tester.
    Tester tests to establish a 'baseline' of the quality of muscle contraction/resistance to the applied force.
    Results observed and recorded.
    Subject then has 1 of the following circumstances applied without the knowledge of the tester:
    a) nothing or
    b) pencils applied under the 1st & 5th metheads of one foot (to artificially sublux the transverse metatarsal arch = aberrant afferent proprioceptive feedback to the brain).
    Tester re-tests deltoid response.
    Results observed and recorded.
    Subject then has 1 of the following circumstances applied without the knowledge of the tester:
    a) nothing or
    b) pencils applied under the 1st & 5th metheads of one foot
    Tester re-tests the deltoid response.
    Results observed and recorded.

    Repeat whole process with further subjects.

    In this set up, the tester is blinded to all the variations once a baseline has been established.

    I don't think a 6mm heel raise will always be a sufficient intervention to consistently cause aberrant proprioceptive feedback (especially for someone with a LLD). A 7-8mm displacement of the metatarsal arch will directly affect the mechanoreceptors.

    My thesis is that I should be able to 'tell' whether an intervention has been applied that causes aberrant proprioceptive feedback resulting in a significant weakness in the deltoids' strength through neurological muscle testing. This is a physiological response, not a subconscious voodoo ideometer response. My understanding of neurophysiology and neuroanatomy is what I am putting my $$$$ on.

    Stanley, I have no training or certification in AK. I simply use rational scientific understanding of neurophysiology and muscles' responses to gauge the effectiveness of interventions.

  14. This is great stuff.

    I don't have time to do this justice this minute but Know I am mulling hard. Will get to it as soon as I can!
  15. Thanks for pitching in stanley.

    Good! Because I don't really want to have to plough through the "science". Like casting, if its not repeatable, then SOME of the time at least we're getting it wrong.

    Not sure if this qualifies as a "study"! Just a friendly bet.

    Ahaha. No. Because if changes in muscle power are detected which do not correlate to the change in heel height then it shows that other things have the capacity to cause the change. All we are looking for is consistancy. If the muscles are consistantly strong or consistantly weak then it may be that this patient did not respond to a heel raise. Which would also be consistant.

    In other words, if the muscle is weak one minute and strong the next, with the raise in the same side, then one (or both) of those readings does not pertain to the raise and is thus "bad".

    Its the one being used out in the world! If you like we'll say that its a test of this particular type of AK. Obviously it will not prove that another type of AK, or even another clinician, is not accurate. One cannot prove a negative, only a positive.

    I'll leave you two to argue that one! At night all cats are grey.

    But also not that relevant. I just want to know if the subjective clinical test, carried out on Deborahs patient, and carried out in practice, the one Ted uses, is repeatable. I'm not trying to investigate the science behind it, just whether it works consistantly.

    Unless you are useing an EMG in everyday clinical practice, it is not needed for this test. An xray can measure SLLD. Demonstrating that would not prove that a clinical LLD measurement is accurate / useful / usable.

    Ta. I'll have a read.
  16. My sad, geeky, pleasure.

    I agree. But you misunderstand me. The ideomotor effect is indeed not useful for anything outside of psychology. But I believe that what you ascribe to the AK effect is actually just that, the ideomotor effect.

    Now this one

    Is untestable. All one can test is whether the result happens. The reason for the effect would not be confirmed by that. If I said my hypothesis was that if I chuck a ball in the air the magnetic pull of the earth will pull it down, the ball dropping will not prove my hypothesis. The effect does not prove the cause, if the effect could have multiple causes.

    Now we CAN test the ideomotor hypothesis, because blinding the study will remove that effect, but not the proprioceptive afferent input from the foot. So if blinding the participants stops the test from working, we can safely say that its the ideomotor effect at work. If blinding the test has no effect, then we can say that its definitly NOT the ideomotor, and I am wrong.

    Standard research methods. When they test a drug, they do it by using a placebo. The placebo is not the subject of the test, but it tells the tester how much of the observed effect is caused by it. Effect - placebo = actual effect of the drugs.

    In the same way, we agree that the ideomotor effect can cause the AK phenomina. So to find out how much validity there is to this test we need to remove that element. Whatever is left is the "true" AK effect.


    What its testing is not all that relevant. We're looking at the "gross" here, not trying to break it down into its componants. In the real world Ted does not use a scale, not a fixed point, nor anything of the sore. I want to test him "as is". If the test works, it works. If not, I'm not that fussed about why not.

    We'll leave the transverse metatarsal arch to one side for a minute.:hammer:;)

    I have a problem with this. The tester will be blinded but the subject will not! There are two possibilities for a psychological effect rather than a physiological one. First, the tester pushes harder, second the subject releases easier. A subject will know if they have a pencil under their 1st met head!!

    Another source of error here. When you push down on someones arms, you pull their centre of gravity forwards on their feet. Onto their forefoot. Where two pencils are. I just tried this on my receptionist. First i pushed down with nothing under the foot and she went on tiptoes. Next I did it with the pencils and she said "ow". How do you know the muscles are not releasing because it hurts to keep the arms straight?

    The tester, yes. But critically not the subject!

    Bugger. I thought inducing an LLD of up to 6mm would be enough to cause abberant proprioceptive feedback. Don't you guys use this test for LLD? Thought I'd read that somewhere.

    There is that metatarsal arch again. :pigs:

    Thats not ALL it will do. It will also make the person aware that this is the "test condition". Which means by proxy they will know that the other is the "baseline" (especially as it was just established and we told them it was the baseline. Thus we no longer have a blinded test. Half blinded is not enough.

    To find out, we have to remove the subconcious ideomotor response. Which, BTW is a well researched and repeatable phenomina. Psychology isn't voodoo. Placebos are not voodoo. Both have to be removed to find the physiological.

    I know little about AK and a fair bit about psychology and suggestability. I could reproduce an AK test and make it go whichever way I wanted, simply by suggestion. I've done so before just for fun.

    What could we change that would be hard for the subject to conciously detect, but which would still cause a discernable AK effect?

    Like I say, I'll let you two fight that one out ;).
  17. Stanley

    Stanley Well-Known Member

    I agree that the patient may or may not respond to a heel lift.
    There are two basic means of treating a patient with a tight muscle. The more common way is to stretch the muscle. The less common way is to “strengthen” the weak antagonist. AK strengthens the weak antagonist. So an inhibited muscle is found by history, postural examination, and some additional tests, and then different things are tested to see what tonifies the inhibited muscle.
    A “subluxed” joint in the foot may or may not cause the posterior tibial muscle to become inhibited. If the “subluxed” joint is loaded by weight bearing the inhibition will then be noticed. We duplicate this by forcing a bone to go into a more subluxed position (challenge) and then testing the muscle. If the muscle weakens, we correct the joint (I correct the soft tissues to accomplish this), and when corrected, the challenge does not weaken the muscle. Challenging a normal joint will not cause muscle inhibition.
    That is not to say that a heel lift won’t cause inhibition. For instance if there is a problem with a spinal vertebra and raising the heels increases the lordosis and thereby challenges the spinal vertebra, then a muscle can become inhibited.

    So what we are testing is Ted’s muscle testing ability. As far as AK, there is only one type of AK, and that is what Dr. Goodheart developed. This is similar to a Foot Solutions store claiming to make a Root orthoses. They both appear to be similar, but someone trained in the art knows the difference. That is not to imply that TedJed does not do AK, as I have never seen him do muscle testing, or therapy related to it, but it is extremely difficult to learn. For instance, one of the things we have to learn is the acupuncture meridian system. If Ted can learn that on his own, he is a much smarter than I am. On the other hand, he does seem to know a lot.


  18. Strikes me if we tested your version then Ted could say "ah but that was just Stanley. Mine is REAL AK!"

    would the real kinesiology please stand up... ;)
  19. TedJed

    TedJed Active Member

    I will make no such claims. I only claim 'Mine is REAL TJ'

    Will reply to Stanley in due course...

  20. http://www.youtube.com/watch?v=eJO5HU_7_1w
    maybe the orange beaning will come in handing !!
  21. TedJed

    TedJed Active Member

    Am I to assume then, that you are not interested in testing the neurological effect of proprioceptive feedback affecting muscle strength?

    Yes, consistency; so I hypothesise that when proprioceptive feedback is consistently disrupting the neurological feedback cycle, the muscles will be consistently 'weak'.

    Yes they will know this, but they will not know why (to quote Spooner).

    The tester pushing harder is not the correct way to apply this form of muscle testing. The test is about 'quality of contraction', not pure strength.

    Oh dear, this indicates a very poor testing technique. Firstly, CoG will not move forward because the pressure is applied in the frontal plane, not in the sagittal plane. A firm base of stance remains throughout the test. Secondly, the pencils 'displace' the 1st & 5th rays only. If it is painful, the test will not be testing the 'artificial subluxation' and muscles will release to pain. (This might be another reason you were asked to leave the allergy class!?!:eek:)

    No we won't, it's a key, specific site of proprioceptive nerve endings. Very practical if we are to test the effect proprioceptive disruption has on muscle strength.

    This is a key point. This why a heel lift will not consistently disrupt proprioceptive feedback but dorsiflexing the 1st & 5th mtheads by 8mm will.

    When I read that line, my mind went '...oh man! What a BFO!' Why didn't I think of that??:eek: (BFO = Blinding Flash of the Obvious!) Well identified Stanley.

    Please let me repeat; I make no claim whatsoever to be an AK practitioner, I have no formal training in AK, nor do I follow the premises of AK meridian system. Rather, I have observed the phenomena that occurs to muscles when proprioceptive feedback is disrupted. The science behind this phenomena is well documented. I then apply this understanding of neurophysiology in a practical, clinical manner.

    I like to think I have a reasonable skill and experience level in manual therapies and I see neurological muscle testing being one manual method (amongst many) that helps me make clinical decisions for my patients.

  22. Just to interrupt this discussion re the metatarsal arch it´s a myth, but need to be specific re distal or proximal . So Ted if your talking about a metatarsal arch at the heads ie distal transverse metatarsal arch it does not exist.

    So maybe you should say something like ...

    the heads of the metatarsal are specific site of proprioceptive nerve endings, by changing the GRF acting on the 1st and 5th MTPJ we will test the effect proprioceptive disruption has on muscle strength.

    or not but Ted Metatarsal arch at the met heads or distal transverse metatarsal arch, no.

    sorry to interrupt but thought it might help discussions so you 2 can move forward and not get stuck on this point. Hope it helps with that.


    Attached Files:

  23. TedJed

    TedJed Active Member

    Thanks for the distinction Mike. I would just alter your suggestion by saying: '...changing the GRF acting on all the MtPJs...'

    The specifics of which MtPJs are affecting the proprioceptive nerve endings is probably a moot point. I'm proposing the altered proprioceptive feedback from any of the receptors located by the MtHds would have an effect on muscle strength.

  24. Fair point about all MTP joints.
  25. Stanley

    Stanley Well-Known Member

    In AK, dysfunctional sensors are treated. Normal sensors are not. It would make sense that putting pencils under the first and fifth mets would "sublux" the joint over time. The question is whether the deltoid will become inhibited as a result of this "subluxation". The deltoid test is not done with a straight arm, as you may accidentally test a dysfunctional elbow.

    Aren't you really testing the cuboid metatarsal and/or cuneiform first metatarsal joints? Proprioceptive sensors are found in the ligaments. As an aside, I don't manipulate joints, I work the soft tissue (ligaments and fascia).

    Thank you

    You sound reasonable and bright. I look forward to the test results.

  26. By no means!! Quite the opposite. I can reproduce an AK test with the ideomotor test any time I want, no mystery there. I want to see the physiological mechanism. But to test the physiological (proprioceptive?) mechanism, one must first remove the know error, the ideomotor element. So thats what I'm trying to build into the design. Remove the ideomotor and what is left is the proprioceptive.

    I THINK that when we remove the ideomotor we will be left with nothing. But I'm willing to be proved wrong. I'm a skeptic, not a cynic.
    Thats what we want to find out

    Yeah, I don't buy this. They will know its a test, they will know the baseline (no pencils). It would not be a huge leap for someones subconcious to recognise a difference.

    If you say so. You're the AK expert!

    Ah, right you are.

    Nah, that would be asking to repeat the test with unlabeled samples. Apparently not entering into the spirit of the thing :rolleyes:.

    Mike has sort of come into this one. Best we just talk about changing signals.

    Depends if we are talking propriceptive of exteroceptive I guess.

    Ok then, back to a protocol, how would you feel about replacing the pencils with 4 mm by 1cm strips of evalon and making the test conditions baseline (nothing) 1 st and 5th met, pushed together under the centre of the 3rd met and, just for fun, under the medial side of the heel. If subluxing the "transverse arch" weakens the arm then building it up should have a different effect no?

    If AK, single blinded, can consistantly discern whether the strips are making the trans arch convex, concave or nowhere near It, I would conceed that there may be more here than psychology.

    In other words, if you can report "strong" or "weak" for 20 tests, in random order, and the strength correlates to condition (so each condition is either always strong or always weak), you win.

    That work for you?
  27. Ain't never used pencils under a patients foot yet, never, not once, ever. No condition I have ever come across requires the prescription of pencils beneath the first and fifth metatarsal heads. Can I suggest you come up with an active insole design and a "sham" insole design and then employ these. Since standing on pencils versus not standing on pencils might be a little too obvious to all involved. On the other hand, if you place some paper between the pencils and the floor, you might come up with the next Turner prize winner.:rolleyes:
  28. TedJed

    TedJed Active Member

    Biomechanical therapy is based on the understanding that 'structure affects function'. This also means 'changing structure changes function'. This is a key premise of orthotic therapy. After all, the word 'orthotic' comes from the greek meaning 'to make straight', i.e. change structure to change function.

    Stanley, your comment that the joints would 'sublux over time' would be most likely, however, the changes in the structure (plantarflexed 2-3-4 relative to the dorsiflexed 1st & 5th) immediately changes the neurological function. The physical change in the structure cannot not change its function.

    If a subluxed joint is responsible for the stressed soft tissues you are working on, then your treatment is temporary at best because the underlying 'cause' has not been corrected. Mobilisation and/or manipulation can be an effective therapy to reduce subluxations.

    Yes, this works for me. That's what I was hoping we could show by the tester (me) being blinded to an intervention (pencils) or no intervention (nothing). Could a third intervention (brightly coloured piece of paper=sham) be used? It may have the psychological effect but no mechanical effect on the proprioceptors. Does this help or does this complicate the purity we are all seeking?

    No, better leave that title for Stanley.

    Even if one of the tests after the baseline is 'nothing'?

    What about a forefoot valgus condition with an anatomically short 1st metatarsal? Would you consider prescribing a lateral FFT posting (5th mthd elevation) and a Morton's extension (1st mthd elevation) into your orthotic device?

    I saw this done for a patient who came to me for a 2nd opinion. The neurological muscle testing showed a 'weakness' when standing on her orthoses. Removal of the Morton's extension resulted in a 'strong' muscle test (immediately). The change in the structure caused a change in function which, in this case, was more tolerable and comfortable (over time, ~3 wks).

    I think we are getting closer...

  29. I wouldn't use pencils stuck to the foot to achieve any therapeutic goal, ever. Do you have to do a lot a scribbling with them first to get them to the required length to fit into the patients footwear? Does hardness play a role? Is a 2H better than a 2B, or is it safest just to stick with a HB? What about coloured pencils, is a lime green more efficacious than an industrial brown?


    And as for the prescription variables you describe above, I can honestly say I can't recall ever using a forefoot valgus post which elevated the 5th metatarsal head in association with a Morton's extension. But if that's the design of insole you want to test then I'm sure Robert is more than capable of constructing these and then constructing some "sham" versions.
  30. Didn't one of the early versions of the spikeothotic use a pencil?

    Thats not what I suggested. What I suggested was,
    Although coloured paper is a good idea. How about some smelly ointment?

    Might need a few subjects...
  31. Further to this. I've seen this test done a number of ways with a number of methods. Some of the "interventions" we would agree are physiologically irrelevant (saying something untrue, having marmite held near them etc.) They all consistantly show strong with intervention and weak with no intervention. Thats why the sunject must be blinded to which is the "base state" and which the "intervention state". Having a state which is different to what you are are testing but still obviously a test state (like the wedges under the centre of the trans arch building it up rather than at the sides) would acheive this.
  32. Agreed. But randomly allocate and don't let the subjects see which design is in their shoes! What about a prefab shell with full length topcover study version has Mortons extension and 5th met extension, another has 2/3/4 "extension". Control is flat in the forefoot All the same colour. Use a cheap prefab and stick some eva underneath, simples...
  33. TedJed

    TedJed Active Member

    You guys are the 'design divas' (sorry for being sexist, but couldn't come up with an alliterated title to follow 'design'), I'll work with whatever you deem as suitable. As long as
    are sufficient to change the proprioceptive integrity of the joints around the metatarsal heads, I'll be happy with that.

  34. Design Demons? Better than diva's!

    If the evalon is the same height as the pencil then should be the same.
  35. TedJed

    TedJed Active Member

    'Demons,' I like it.

    BTW, would you say Ideometer? AK meridiens? Physiological? Voodoo?


  36. Timm

    Timm Active Member

    On the last video posted, watch the hands closely. When "closing" the joint he uses thr subjects thumb = "weak". Then he "opens" the joint but does this on the index finger which = "strong". Why should this work when he has compressed the thumb IPJ and then opened index finger IPJ? I would suggest this is ideomotor effect at it's best. Can't wait to hear what happens in April
  37. TedJed

    TedJed Active Member

    Well spotted Timm, except we don't get to see the muscle test result after the 'finger' test. It was edited out at that point. Could that have been because the 'result' didn't fit the desired outcome?!? (Sir Cynicism at work!)

  38. efuller

    efuller MVP

    You can't apply a force in a single plane. You can analyze that force in a single plane, but the body is three dimensional and a force applied may have an effect in all planes and you have to look to see if it does.

    If you stand with your hands at your side, your center of mass is in one position. If you now stick your arms out in front of you with your center of mass will be shifted a little bit forward. If you hold a weight in your out stretched hands, the center of mass of the combined "system" of you and the weights will be shifted even further forward. A subject with weights in their hands may choose to lean backwards a bit to keep their center of mass over their center of pressure. Another option, and in my opinion a more likely option, is that the subject will activate their ankle plantar flexors to shift their center of pressure forward when you push down on their arms.

    It is possible that the cause of the "release" is that the patient will feel that they will fall forward with the downward force on the outstretched arms. Any test with a force downward on the outstretched arms has to control for sagittal plane position of the center of mass relative to the foot.


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