Dear Mel


As always well said. The issue of movement and function is incredibly
complex, but could the problem be a labelling mistake. That is to say, the
tests and findings have some functional merit in the rehabing of
individuals, but the rationale of isolation is flawed. The test may identify
a failing pattern of movement, but to blame one structure for this may be
wrong.  Your views please.

Warm Regards Kevin Reese Physio UK
-----Original Message-----
From: [log in to unmask] <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: 26 August 1999 00:07
Subject: ISOLATED MUSCLE TESTING


>The controversial subject of isolated muscle testing has arisen
periodically
>and is regarded with undeserved acclaim by some.  Unfortunately, some
>clinicians apply these tests as if the muscles and joints act independently
>of the nervous system.  It is well known that posture and balance are the
>result of structure and function, and that muscle 'weakness' may have far
>more to do with underlying nervous processes than intrinsic muscular
>insufficiency.
>
>Let us consider some basic questions regarding isolated muscle tests:
>
>1.  What do these tests reveal on a person who is under general
anaesthesia?
>
>2.  What does passive movement of a limb tell the tester under such
>conditions?
>
>3.  Do the muscles reveal the same 'imbalances' for deviations of a few
>degrees from the prescribed test positions?
>
>4.  Do these tests reveal the same 'imbalances' if we perform selective
>blocks of different levels of the spinal nerves by injecting local
>anaesthetic?
>
>5.  Do these tests reveal the same 'imbalances' if an adjacent joint is
>flexed, extended, adducted or abducted?
>
>6.  Do these tests reveal the same information if the test is carried out
>with slow, fast and ballistic muscle action?
>
>7.  Do the same 'imbalances' occur when the entire limb or body is carrying
>out a complex sporting skill?
>
>8.  Do the tests reveal the same 'imbalance' if the patient perceives any
>part of the movement to be painful?
>
>9.  Do these tests reveal the same imbalances if the stretch reflex is
>strongly elicited during any stage of the movement?
>
>10.  Do these tests take into account any learning effect which may distort
>the results?
>
>11.  Do these tests totally eliminate the possible effects of fatigue,
>especially subjects whose static strength-endurance is already compromised?
>
>12.  Do these tests reveal imbalances which may become significant only
when
>maximal force, maximal endurance or maximal range of movement occurs?
>
>13. Do these tests distinguish between muscle weakness and neurological
>dysfunction?
>
>14.  Do these tests distinguish between central and peripheral nervous
>factors which may underlie the muscle 'imbalance'?
>
>15.  Do these tests make allowance for the existence of conditioned
reflexes
>(operant and respondent conditioning of muscle actions) which influence the
>pattern of muscle movement?
>
>16.  Do biomechanical tests always agree with the apparent results of
muscle
>tests?
>
>17.  Do these tests explain why athletes with apparently clear evidence of
>'imbalance' often are able to effectively and safely produce exceptional
>performances?
>
>18.  Do these tests always display high levels of reliability,
repeatability
>and accuracy?
>
>19.  Do the identical muscles always become involved in the same way during
>every repetition of the test?
>
>20.  Do the tests take into account the fact that different muscular
>contributions may produce the same joint action, especially in complex
>multi-articular movements?
>
>21.  Do the results of isolated muscle tests correlate strongly with tests
of
>complete sporting movements?
>
>22.  Do these tests distinguish between the many different types of
>'strength' fitness, such as starting-strength, acceleration-strength,
maximal
>strength, maximal power, rate of force development (RFD), deceleration
>strength and eccentric strength?
>
>If one ponders all of these questions objectively in the light of current
>biomechanical research and clinical findings (e.g. in various issues of
>'Exercise & Sports Sciences Revs' & The J of Biomechanics) , you will note
>that the answers to the last 20 yes-no questions is NO.  This offers some
>pretty sound reasons for seriously questioning those old traditional tests.
>What do you all think?
>
>It really is time that more definitive tests were developed and that the
>shortcomings of the older tests stimulated more research into their
revision.
> The old ones may play a limited and useful role in cases where isolation
of
>a single joint clearly is involved in a clinical condition, but they do not
>necessarily extrapolate at all well to the realm of multi-dimensional
sport.
>What is the alternative?  Evaluation of the sporting actions themselves,
>performed at increasingly more demanding levels of stress is one such
method.
> Any other suggestions?
>
>Dr Mel C Siff
>Denver, USA
>[log in to unmask]
>
>



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