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

Jet energy measurement with the ATLAS detector in proton-proton collisions at sqrt(s)=7 TeV

The jet energy scale (JES) and its systematic uncertainty are determined for jets measured with the ATLAS detector at the LHC in proton-proton collision data at a centre-of-mass energy of √s = 7 TeV corresponding to an integrated luminosity of 38 pb−1. Jets are reconstructed with the anti-kt algorithm with distance parameters R = 0.4 or R = 0.6. Jet energy and angle corrections are determined from Monte Carlo simulations to calibrate jets with transverse momenta pT ≥ 20 GeV and pseudorapidities |h| < 4.5. The JES systematic uncertainty is estimated using the single isolated hadron response measured in situ and in test-beams, exploiting the transverse momentum balance between central and forward jets in events with dijet topologies and studying systematic variations in Monte Carlo simulations. The JES uncertainty is less than 2.5% in the central calorimeter region (|h| < 0.8) for jets with 60 ≤ pT < 800 GeV, and is maximally 14% for pT < 30 GeV in the most forward region 3.2 ≤ |h| < 4.5. The uncertainty for additional energy from multiple proton-proton collisions in the same bunch crossing is less than 1.5% per additional collision for jets with pT > 50 GeV after a dedicated correction for this effect. The JES is validated for jet transverse momenta up to 1 TeV to the level of a few percent using several in situ techniques by comparing a well-known reference such as the recoiling photon pT, the sum of the transverse momenta of tracks associated to the jet, or a system of low-pT jets recoiling against a high-pT jet. More sophisticated jet calibration schemes are presented based on calorimeter cell energy density weighting or hadronic properties of jets, providing an improved jet energy resolution and a reduced flavour dependence of the jet response. The JES systematic uncertainty determined from a combination of in situ techniques are consistent with the one derived from single hadron response measurements over a wide kinematic range. The nominal corrections and uncertainties are derived for isolated jets in an inclusive sample of high-pT jets. Special cases such as event topologies with close-by jets, or selections of samples with an enhanced content of jets originating from light quarks, heavy quarks or gluons are also discussed and the corresponding uncertainties are determined