CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2020; 55(03): 293-297
DOI: 10.1055/s-0039-1700832
Artigo Original
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Accuracy of the Applied Kinesiology Muscle Strength Test for Sacroiliac Dysfunction[*]

Article in several languages: português | English
1   Faculdade de Educação Física e Fisioterapia, Universidade Federal do Amazonas (UFAM), Manaus, Brasil
Lauro Sinval Bueno
2   Bacharel em Fisioterapia, Manaus (AM), Brasil
Luana Rocha de Oliveira Lombardi
2   Bacharel em Fisioterapia, Manaus (AM), Brasil
Jansen Atier Estrázulas
3   Universidade do Estado do Amazonas (UEA), Manaus, Brasil
Tiótrefis Gomes Fernandes
1   Faculdade de Educação Física e Fisioterapia, Universidade Federal do Amazonas (UFAM), Manaus, Brasil
Juliana Albuquerque Baltar
1   Faculdade de Educação Física e Fisioterapia, Universidade Federal do Amazonas (UFAM), Manaus, Brasil
4   Programa de Pós-graduação em Medicina, Universidade Federal de São Paulo, SP, Brasil
› Author Affiliations
Further Information

Publication History

25 September 2018

22 January 2019

Publication Date:
27 February 2020 (online)


Objective To investigate the accuracy of the applied kinesiology muscle strength test for sacroiliac dysfunction and compared it with four validated orthopedic tests.

Methods This is a cross-sectional accuracy survey developed at a private practice in the city of Manaus, Brazil, during February 2017. The sample consisted of 20 individuals, with a median age of 33.5 years. Four tests were applied: distraction, thigh thrust, compression and sacral thrust, and the diagnosis was confirmed when three of these tests were positive. Soon after, the applied kinesiology test was applied to the piriformis muscle.

Results The prevalence of sacroiliac joint dysfunction was of 45%; the thigh thrust test had the highest specificity, and the sacral thrust test had the highest sensitivity. The applied kinesiology test presented good results (sensitivity: 0.89; specificity: 0.82; positive predictive value: 0.80; negative predictive value: 0.82; accuracy: 0.85; and area under the receiver operating characteristic [ROC] curve: 0.85).

Conclusion The applied kinesiology muscle strength test, which has great clinical feasibility, showed good accuracy in diagnosing sacroiliac joint dysfunction and greater discriminatory power for the existing dysfunction in comparison to other tests.

* Work developed at Universidade Federal do Amazonas, Manaus, AM, Brazil.

  • Referências

  • 1 Hoy D, Bain C, Williams G. , et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum 2012; 64 (06) 2028-2037
  • 2 van Tulder M, Becker A, Bekkering T. , et al; COST B13 Working Group on Guidelines for the Management of Acute Low Back Pain in Primary Care. Chapter 3. European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J 2006; 15 (Suppl. 02) S169-S191
  • 3 Strine TW, Hootman JM. US national prevalence and correlates of low back and neck pain among adults. Arthritis Rheum 2007; 57 (04) 656-665
  • 4 Ramirez CR, Lemus DM. Disfunção da articulação sacro-ilíaca em jovens com dor lombar. Fisioter Mov 2010; 23 (03) 419-428
  • 5 Rupert MP, Lee M, Manchikanti L, Datta S, Cohen SP. Evaluation of sacroiliac joint interventions: a systematic appraisal of the literature. Pain Physician 2009; 12 (02) 399-418
  • 6 Hansen HC, McKenzie-Brown AM, Cohen SP, Swicegood JR, Colson JD, Manchikanti L. Sacroiliac joint interventions: a systematic review. Pain Physician 2007; 10 (01) 165-184
  • 7 Kennedy DJ, Engel A, Kreiner DS, Nampiaparampil D, Duszynski B, MacVicar J. Fluoroscopically Guided Diagnostic and Therapeutic Intra-Articular Sacroiliac Joint Injections: A Systematic Review. Pain Med 2015; 16 (08) 1500-1518
  • 8 Laslett M, Aprill CN, McDonald B, Young SB. Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests. Man Ther 2005; 10 (03) 207-218
  • 9 Robinson HS, Brox JI, Robinson R, Bjelland E, Solem S, Telje T. The reliability of selected motion- and pain provocation tests for the sacroiliac joint. Man Ther 2007; 12 (01) 72-79
  • 10 Stuber KJ. Specificity, sensitivity, and predictive values of clinical tests of the sacroiliac joint: a systematic review of the literature. J Can Chiropr Assoc 2007; 51 (01) 30-41
  • 11 van der Wurff P, Buijs EJ, Groen GJ. A multitest regimen of pain provocation tests as an aid to reduce unnecessary minimally invasive sacroiliac joint procedures. Arch Phys Med Rehabil 2006; 87 (01) 10-14
  • 12 Simopoulos TT, Manchikanti L, Singh V. , et al. A systematic evaluation of prevalence and diagnostic accuracy of sacroiliac joint interventions. Pain Physician 2012; 15 (03) E305-E344
  • 13 Hall S, Lewith G, Brien S, Little P. A review of the literature in applied and specialised kinesiology. Forsch Komplement Med 2008; 15 (01) 40-46
  • 14 Gin RH, Green BN. George Goodheart, Jr., D.C., and a history of applied kinesiology. J Manipulative Physiol Ther 1997; 20 (05) 331-337
  • 15 Garten H. Education: Diplomate of the International College of Applied Kinesiology. Introduction and: Systemic Disorders, General Strategies. München: German Medical Society for Applied Kinesiology; 2008
  • 16 Schwartz SA, Utts J, Spottiswoode SJ. , et al. A double-blind, randomized study to assess the validity of applied kinesiology (AK) as a diagnostic tool and as a nonlocal proximity effect. Explore (NY) 2014; 10 (02) 99-108
  • 17 Schmitt Jr WH, Leisman G. Correlation of applied kinesiology muscle testing findings with serum immunoglobulin levels for food allergies. Int J Neurosci 1998; 96 (3-4): 237-244
  • 18 Peterson KB. A preliminary inquiry into manual muscle testing response in phobic and control subjects exposed to threatening stimuli. J Manipulative Physiol Ther 1996; 19 (05) 310-316
  • 19 Pollard H, Bablis P, Bonello R. Can the ileocecal valve point predict low back pain using manual muscle testing?. Chiropr J Aust 2006; 36 (02) 58-62
  • 20 Laslett M. Evidence-based diagnosis and treatment of the painful sacroiliac joint. J Manual Manip Ther 2008; 16 (03) 142-152
  • 21 Eskander JP, Ripoll JG, Calixto F. , et al. Value of Examination Under Fluoroscopy for the Assessment of Sacroiliac Joint Dysfunction. Pain Physician 2015; 18 (05) E781-E786
  • 22 Szadek KM, van der Wurff P, van Tulder MW, Zuurmond WW, Perez RS. Diagnostic validity of criteria for sacroiliac joint pain: a systematic review. J Pain 2009; 10 (04) 354-368
  • 23 Schmitt C, Hahn PT. A fisioterapia na síndrome do músculo piriforme: uma revisão da literatura. Rev UNINGÁ Rev. 2013; 16 (01) 18-21
  • 24 Lawson A, Calderon L. Interexaminer agreement for applied kinesiology manual muscle testing. Percept Mot Skills 1997; 84 (02) 539-546
  • 25 Arnbak B, Jurik AG, Jensen RK, Schiøttz-Christensen B, van der Wurff P, Jensen TS. The diagnostic value of three sacroiliac joint pain provocation tests for sacroiliitis identified by magnetic resonance imaging. Scand J Rheumatol 2017; 46 (02) 130-137
  • 26 Walter DS, Gavin DM. Applied Kinesiology. Synopsis. 2nd ed. Pueblo: Systems DC; 1988
  • 27 Oti J. The use of manual muscle testing to assess functional integration of high-threshold versus low-threshold alpha motor neurons. In: Proceedings of the International College of Applied Kinesiology; 2004
  • 28 Waxenegger I, Endler PC, Wulkersdorfer B, Spranger H. Individual prognosis regarding effectiveness of a therapeutic intervention using pre-therapeutic “kinesiology muscle test”. ScientificWorldJournal 2007; 7: 1703-1707
  • 29 Cuthbert SC, Goodheart Jr GJ. On the reliability and validity of manual muscle testing: a literature review. Chiropr Osteopat 2007; 15: 4