Common errors and clinical guidelines for manual muscle testing: "the arm test" and other inaccurate procedures

<p>Abstract</p> <p>Background</p> <p>The manual muscle test (MMT) has been offered as a chiropractic assessment tool that may help diagnose neuromusculoskeletal dysfunction. We contend that due to the number of manipulative practitioners using this test as part of the assessment of patients, clinical guidelines for the MMT are required to heighten the accuracy in the use of this tool.</p> <p>Objective</p> <p>To present essential operational definitions of the MMT for chiropractors and other clinicians that should improve the reliability of the MMT as a diagnostic test. Controversy about the usefulness and reliability of the MMT for chiropractic diagnosis is ongoing, and clinical guidelines about the MMT are needed to resolve confusion regarding the MMT as used in clinical practice as well as the evaluation of experimental evidence concerning its use.</p> <p>Discussion</p> <p>We expect that the resistance to accept the MMT as a reliable and valid diagnostic tool will continue within some portions of the manipulative professions if clinical guidelines for the use of MMT methods are not established and accepted. Unreliable assessments of this method of diagnosis will continue when non-standard MMT research papers are considered representative of the methods used by properly trained clinicians.</p> <p>Conclusion</p> <p>Practitioners who employ the MMT should use these clinical guidelines for improving their use of the MMT in their assessments of muscle dysfunction in patients with musculoskeletal pain.</p

Calculation of CO 2 activities using scapolite equilibria: constraints on the presence and composition of a fluid phase during high grade metamorphism

Thermodynamic and phase equilibrium data for scapolite have been used to calculate CO 2 activities ( a CO 2 ) and to evaluate the presence or absence of a fluid phase in high-grade scapolite bearing meta-anorthosite, granulites, calc-silicates, and mafix xenoliths. The assemblage scapolite-plagioclase-garnet±quartz may be used to calculate or limit a CO 2 by the reaction Meionite+Quartz = Grossular+Anorthite+CO 2 . Granulites from four high-grade terranes (Grenville Province, Canada; Sargut Belt, India; Furua Complex, Tanzania; Bergen Arcs, Norway) yield a CO 2 =0.4-1, with most >0.7. For scapolite-bearing granulites from the Furua Complex, in which a CO 2 ≥0.9, calculated H 2 O activities ( a H 2 O) based on phlogopite dehydration equilibria are uniformly low (0.1–0.2). The a CO 2 calculated for meta-anorthosite from the Grenville Province, Ontario, ranges from 0.2 to 0.8. For Grenville meta-anorthosite also containing epidote, the a H 2 O calculated from clinozoisite dehydration ranges from 0.2 to 0.6. Calc-silicates from the Grenville, Sargur, and Furua terranes mostly yield a CO 2 1). The calculated fluid activities are consistent with metamorphism (1) in the presence of a mixed CO 2 −H 2 O fluid phase in which CO 2 is the dominant fluid species but other C−O−H−S species are minor, (2) in the absence of a bulk fluid phase (“fluid-absent metamorphism”), or (3) in the presence of a fluid-bearing melt phase. The results for many granulites and Grenville meta-anorthosite are consistent with the presence of a CO 2 -rich, mixed CO 2 −H 2 O fluid phase. In contrast the relatively restricted and low values of a CO 2 for calc-silicates require an H 2 O-rich fluid or absence of a fluid phase during metamorphism. The range of values for xenoliths are most consistent with absence of a fluid phase. The primary implication of these results is that a CO 2 -rich fluid accounts for the reduced a H2 O in scapolite-bearing granulites. However, scapolite may be stable with a wide range of fluid compositions or in the absence of a fluid phase, and the presence of scapolite is not a priori evidence of a CO 2 -rich fluid phase. In addition, close association of scapolite-free mafic granulites with scapolite-bearing granulites having identical mineral compositions in the Furua Complex, and the absence of scapolite from most granulite terranes implies that a CO 2 -rich fluid phase is not pervasive on an outcrop scale or common to all granulite terranes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47295/1/410_2004_Article_BF00307340.pd

Calculation and application of clinopyroxene-garnet-plagioclase-quartz geobarometers

Recently published thermodynamic and experimental data in a variety of chemical systems have been evaluated to derive Gibbs free energies for hedenbergite and pyrope. These were used to calculate the geobarometric equilibriaPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47284/1/410_2004_Article_BF00399441.pd