Is it Ethical to Utilize the MyoVision for Public Screenings to Determine Potential Spinal Disorders?
By David Marcarian, MA
NIH Principal Investigator, Former NASA Researcher
First of all, what is the MyoVision? It’s a static sEMG scanner. It’s very likely that you have a negative point of view on sEMG, as it does have a rather dubious history. I can confidently say, with the support of the VA Hospital, , the MyoVision is not like other sEMG scanners, which are plagued with a history of technical issues. The MyoVision device is a very sensitive, accurate form of electronic palpation; it precisely measures the body’s natural defense mechanism to pain: muscle guarding and splinting. The levels of muscle activity are demonstrated with the length and color of the bars. They are proportional to levels of muscle tension, with arrows pointing in the direction of imbalance. Red readings are high, magenta moderate and yellow are low. Both low and high readings are important as red indicates very high levels of muscle guarding, and yellow indicates potentially chronic levels of muscle tension.
The MyoVision system is a Class II diagnostic device, which has been used in VA Hospital studies and directly called “the most advanced type of equipment” by researchers at the VA. It has been tested in control group studies and published in peer reviewed journals, and is the only device of its kind with this distinction. It’s also safer than most regulary used medical devices, like full body scans and X-Ray, where damaging radiation can negatively impact health. The MyoVision scanner is so harmless, it can be used on pregnant women, children and even on those with pacemakers. It is simply a measuring device with no radiation of any kind.
I, David Marcarian, am the designer of The MyoVision. It was designed under a National Institutes of Health Grant (NIH) after I completed my research work at NASA. As the designer of the device, I am the first to criticize those using it inappropriately. I have authored the paper, “A proposed quality assurance program for the clinical use Surface Electromyography in the chiropractic office,” published in the Journal of the Canadian Chiropractic Association and am well qualified to discuss the issues associated with public screenings and the use of sEMG technology. Healthcare practitioners who distort the MyoVision data to deceive the public into purchasing care plans not only damages my credibility, but my invention as well. I do not believe misrepresenting science to trick the public into chiropractic care has any benefit to the chiropractic profession. There is a legitimate and valuable application of Surface EMG technology in the screening setting when used properly, and when the results are presented accurately without embellishment.
I once testified against a chiropractor who claimed the Static sEMG results proved the patient would eventually develop cancer if they were not adjusted. My testimony led to the loss of their license.
I have over 30 years’ experience working with Surface EMG, and have run into 3 cases where the pattern of muscle activity was so unusual, I sent the patient for further analysis to evaluate issues with kidneys, liver and spleen – two of the three cases having undiagnosed cancer. In other words, the Static sEMG DOES have incredible value, as extremely unusual patterns of muscle firing are indicative of some underlying cause. The Static sEMG provided the clue that lead to appropriate treatment and ultimately saved their lives. But it was never presented as proof of need for any particular treatment in these 3 cases. Mechanical sources of back pain are much easier to tie to the MyoVision Static sEMG results.
Screening is so well accepted that almost every pharmacy has an automated blood pressure cuff. We’ve all seen it and likely used it. Though it has limited capability in the pharmacy setting, it does allow patients to educate themselves on the status of their blood pressure. Those results may compel them to make an appointment with their doctor who will perform a full evaluation and determine whether there is a true medical issue or not. Well being comes from awareness, and that is the purpose of using this device.
The Department of Health and Human Services (HHS) recommends screening for health issues on their website. Why? Preventative care. If we seek out solutions to ailments before they become serious, it will lower the cost of healthcare and improve everyone’s quality of life.
In the case shown in the photo below, the information provided by the Static sEMG was life changing. This patient had severe head forward position and the data from his sEMG scan led him to see a chiropractor. This chiropractor not only adjusted him, but also reminded him about the importance of proper ergonomics. He was working with a laptop, looking down with his hands lifted up on the table. She told him to get an external monitor so he could look up and a keyboard drawer with external keyboard so he could get his elbows at a 90 degree angle. Head forward position was demonstrated so clearly in the high levels of muscle tension in his upper thoracic (the upper thoracic is what compensates for the head being placed forward), that this objective data led to him fixing the problem and a long-term solution including not only chiropractic care but proper ergonomics. A win-win-win for everyone.
When the Clinic Director at Palmer College in Florida, who has 20 years experience using the MyoVision, was asked if there was anything illegal or unethical about Palmer Florida performing public screenings with the MyoVision Static sEMG, he responded, “As long as HIPAA and confidentiality is maintained, a sample screening would not lead to a diagnosis without a full history and exam, and that would be performed in office.”
To further confirm this, he checked with the State Board’s attorney who put in writing:
“There are no issues as long as PHI was protected and the DC offering it for free had a disclaimer with full price noted of the free service and did not attempt to rescreen at the office and submit a bill or charge for the service.”
When it comes right down to it, any test, no matter who performs it, can be abused, misused or misrepresented. So, is there a way to avoid this? Yes, with proper education and knowledge. This idea is being implemented throughout the country in chiropractic colleges.
Many Chiropractic Colleges now routinely screen with the MyoVision, but require that each screener complete the online certification course so they 1) perform the test properly, and 2) know what is appropriate to say when interpreting the results. This online certification course is required by Palmer College, Life Chiropractic College West, University of Western States and Life University prior to using at any screening. By properly training at the beginning, we have begun to resolve the matter of individuals lacking the knowledge of proper utilization, limitations and explanation of the results. My recommmendations with regards to quality control and screening in public: Education is critical. The chiropractic colleges have approved the Online Certification Course, and anyone performing a screening should have proof of completing.
- Everyone performing the test must complete the online certification course, which is approved by the chiropractic colleges. This will ensure proper test technique, so false positives and negatives are reduced.
- Screeners must never present the data with diagnosis. They should explain the results provide a quick screening to show their particular muscular compensation for their bio-mechanical issues, which lack the clinical accuracy of a test performed in the office.
- A disclaimer (shown to the right) can be used to make certain there is no questions with regards to the statements made during the screening. This is a patented process that embeds this text into the graphic so it cannot be altered. This may be used as a requirement at all screenings to prevent miscommunication.
With the advent of technology to improve preventative care, every specialty in medicine has a form of screening tool implemented. Medical doctors have blood pressure cuffs in pharmacies, full body scans are being offered by many clinics, and even cardiac screenings are being done for arterial plaque. These screenings are never definitive, but are used as a detective uses data: To develop a clue as to the source of underlying potential health risks, so they can be addressed preemptively, and result in long-term health. The situation is no different with chiropractic: Chiropractors are licensed practitioners, and the MyoVision has been selected as the Gold Standard by both the AMA, the VA and most of the Chiropractic Colleges meaning that it’s use by Doctors as a screening tool is completely legitimate. Just like the MD reading an MRI, it is simply important that the Chiropractor not misrepresent the results. That being the case, the number of patients helped through this tool which makes them aware of their spinal health, and potential biomechanical issues is crucial to a system based upon patient-centered care, as the MyoVision puts the patient’s spine in the center of the discussion.
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