Hard to find the appropriate board for this, but I'm after an answer from a neuro-perspective.

A Naprapath once tested the tone of different muscles concluding that I was, quoting, (globally) "hypertonic". My question(s) specifically regards this test/assessment of tonicity that roughly went as follows:


  1. Asking the patient to resist the practitioners force with some muscle, e.g. trying to force the patient's arm downwards while the patient is pushing it upwards.

  2. Stimulating another muscle or part of the body (nociceptors/free nerve endings in the skin above/around some muscle or other part of the body) by gentle touch such as scratching; palming; flicking; and even snapping ones fingers above the skin (to "create sonic waves affecting nociceptors over a larger area");

  3. Repeating step 1.

Example 1: Asking the patient to force the head forward (backward) into the practitioners hand, which pushes back to even out the force. Then gently flicking the patients nose upwards (downwards) and repeating the same task again. Possibly, the second time, the muscles would have a significantly (noticeable by this test) higher tone.

Example 2: Asking the patient to lie on her back, resist the practitioners force which pushes the right or left leg inwards (by pushing outwards); Then asking the patient to hold one hand (gently) on her chin, and then repeating the resisting of the same force. (If there had been some trauma to the chin, this had apparently shown in the muscle tone in a significant way.

The purpose is to see if the muscles can be made less tonic or relaxed (weaker) this way, by stimulation of nociceptors.

Loose explanation from the practitioner: "Stiffness of muscles are almost always caused by some trauma or damage to the body; I am trying to find the surface of your body where this damage is located (by gently touching it while asking you to resist my force to see if the tone of the muscle changes)". By 'tone' here, they seem to loosely mean that a high tone would imply that I can quickly "lock" my muscles and thus resist quickly, and my resisting is perceived as strong, while low would be the opposite. And in this part of the assessment it doesn't seem to matter what muscle they're testing the tone of, it would supposedly affect most muscles if I touched the right place.


Are there any neurological basis for a procedure like the one described above? i.e. How could such gentle touch of the skin affect muscle tone somewhere else in the body? (Perhaps if there's prior, healed, damage to the place of touch.) Would you refer to some explanations, and/or studies?

EDIT: No massaging or pressure point therapy is involved, the stimulations are mild (e.g. gently scraping a toothpick over the skin, or resting ones hand on the skin).

EDIT2 (Additional information): The methods of which this assessment/test is part of is apparently called P-DTR, and was founded by Jose Palomar Lever from Mexico. Not much seems to be publicly known about them however, and I cannot find anything published about these methods. I will post a separate question about this on a different forum and post links here. So, I want to stress, the main question here regards the neurological basis for such an assessment of muscle tone.

  • Christopher, I believe it is a great question, but please can you simply limit it to this: "Are there any neurological basis for a procedure like this (and mention the procedures)", otherwise it will be likely deleted to be too personal.
    – Jan
    Nov 28, 2018 at 13:40
  • Thank you! I have now edited the question to be more general. I have, however, decided to leave some of it (a sentence), since I think it is at least somewhat relevant that this was experienced by the questioner, what type of profession carried out the procedure, and in some sense why this was tested and what conclusions were made. In no way is this to be seen as a critique of anything in any way, and I sincerely hope that it cannot (now) be considered too personal either. I am merely curious as a student of neuroscience my self. Nov 28, 2018 at 14:20
  • What is the (official) type of headache in question: tension headache, migraine headache, a part of myofascial pain syndrome or undetermined so far? Also, did the practitioner used any formal names for the mentioned actions (scratching, palming, flicking, snapping) or for a procedure as a whole? Something like trigger point release or such?
    – Jan
    Nov 28, 2018 at 14:36
  • Well, I guess this is no longer an official part of the question, but: The headaches were (unofficially) tension headaches (imo, from experience by massaging the sternocleidomastoid muscle and even producing similar sensations as the headache), but undetermined so far; And no, no formal names for neither the actions nor for the procedure as a whole were mentioned. The tests seemed to be specifically to test to how quick and strongly my muscles responded to force, and if they could be made to respond less strongly (stiffly, or with less tone) by these neuro stimulations (scratching etc.). Nov 28, 2018 at 14:52
  • I guess the only concrete formal terms used was that: what was supposedly being stimulated (through touch, scratching, etc.) was nociceptors (the actual terms used was 'free nerve' endings and 'pain receptors'). Nov 28, 2018 at 15:01

1 Answer 1


I believe the procedure described is called either muscle energy technique (MET) or proprioceptive neuromuscular facilitation (PNT). More details are on Advantageceus.com (p. 229). Skin stimuli, like scratching or flicking, may be part of the mentioned techniques.

This article on International Journal of Osteopathic Medicine says that "MET application may reduce pro-inflammatory cytokines and desensitize peripheral nociceptors."

According to one PhD dissertation published by Durban University of Technology "Both superficial and deep somatic mechanoreceptos, proprioceptors and nociceptors are stimulated by [chiropractic] manipulation, which sends strong afferent segmental impulses to the spinal cord resulting in central pain transmission inhibition."



Christopher L (the OP) believes the procedure is called Proprioceptive Deep Tendon Reflex (P-DTR).

The inventor of the technique explains it in detail here. Two other doctors describe it in this document found on the inventor's home page.

The descriptions alone, even if they make sense, are not already an evidence. Scientific evidence about the effectiveness of treatment methods in neurology/orthopedy can come from placebo-controlled randomized clinical trials, but I haven't found even one. The search ""proprioceptive deep tendon reflex," using operators .gov or .edu, and the search in Google Scholar give no results.

  • First of all, note: I removed my comments above, since they had followed along with your old answer and did not relate to this one. Now, this seems more promising, however, they seem to be more stretching related techniques, i.e. working with the muscle itself in different ways to treat different things. What was in my question was an assessment of muscle tone using a very gentle stimulus. There's a lot to go through there, so I have not read everything in detail, but I couldn't really find what I was looking for. Perhaps there's evidence related to my question somewhere in there however. But, Dec 9, 2018 at 11:16
  • I have now got a confirmed (by the practitioner) answer to what the methods used by the practitioner is called: P-DTR (Proprioceptive Deep Tendon Reflex), and is a method developed by one person, Jose Palomar. One can read more at: pdtr-global.com . I found absolutely nothing published (outside of their webpage, or at least scientific) about this, the so called report from a conference on this seemed to be more a promotion and was highly unscientific imo. He charge quite a lot for video-lectures, courses and certifications on his method. The method supposedly contains more than just Dec 9, 2018 at 11:26
  • this type of assessment. I will edit this post to fit the new circumstances, but also make it specific. I will also probably post a separate question about the method in general on the skeptics stack, as it will be more suitable for my question. I will perhaps post a link to it in the comment section, when I have. Dec 9, 2018 at 11:33
  • As added in my answer, I have searched for "Proprioceptive Deep Tendon Reflex" and found no studies about it.
    – Jan
    Dec 10, 2018 at 10:11

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