Instrument adjusting: A growing trend

Colleges do not teach it in the core curriculum; students and professors denigrate it; some insurance companies reject it for reimbursement; and academics as well as experienced researchers rank it near the bottom of the list of techniques.

Despite this, instrument adjusting — especially high- end computerized instrument adjusting — is growing in popularity.

Three reasons may explain this phenomenon: Laws of physics, patient preferences, and repeatability.

• Laws of physics. The first, and perhaps the most important, reason is that the laws of physics apply to chiropractic adjustments as well as any other area that involves the transfer of momentum or

The theory says that for every action there is an equal and opposite reaction. As a chiropractor, if you use a more robust and forceful impulse in the adjustment, the greater the force that is applied to your own body.

Students learn that the ideal adjustment is one in which the impulse is delivered as fast and forcefully as possible. This lesson may be contributing to the early retirement of many chiropractors through the self- infliction of repetitive stress injury.

Many, if not most, of the individuals who use computerized instruments have suffered adjustment- related injuries and wish to extend their careers by incorporating instrument adjusting into their practices.

• Patient preferences. The second reason is due to the chiropractic profession’s loss in the healthcare market share. From 1997 to 2002, the chiropractic profession lost almost 30 percent of the healthcare market share.

Instrument adjusting is more patient-friendly and able to attract patients who might otherwise never seek chiropractic care. In part, this attraction may be the lower force that is required for adjustment when compared to manual adjusting. The attraction may also be due to the visual evidence of the effects of adjustment provided by the computerized system screens and printouts.

• Finally, in addition to being gentler on the chiropractor and patient, the analysis of spinal resistance performed with the computerized assessment instruments has shown remarkably high repeatability, especially when compared to the lack of repeatability of manual palpation.

Not only are the computerized analyses more repeatable, but with many instruments, the patient can be shown the graphical results before and after the adjustment whether the adjustment is done with the instrument or manually.

In addition, recent studies of the effectiveness of computerized multiple impulse adjusting systems indicate that their use may be just as effective or even more effective for some patients as adjusting by hands alone.

It will be interesting to watch the continuing development of this rapidly evolving technology and its potential effect on long and strongly held beliefs within the profession

Joseph M. Evans, PhD, formerly headed the Biosciences and Medical Systems Department of the Westinghouse Research Laboratories. He is CEO and chairperson of Sense Technology, Inc. (www.pulstarfras.com). He can be contacted through the company’s Web site or by calling 800-628 -9416.