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By Tina Beychok
In an earlier series of online articles, Chiropractic Economics discussed three ways in which there are clear benefits to instrument adjusting versus manual adjusting: Benefits according to physics, benefits for chiropractors’ bottom line, and benefits for patients.1-3 While each of these areas bolster the benefit for performing chiropractic adjustments with an instrument rather than with the hands, there has also been some exciting research that adds to the body of clinical science showing an advantage for instrument adjusting over manual adjusting.
Literature review
A literature review article looks for commonalities between a series of other articles on the same topic. The strongest advantage to a literature review is that it can combine findings from a number of studies with only a small number of subjects in order to create a larger pool of subjects and hopefully be able to extract relevant findings.
A literature review published in the March 2012 issue of the Journal of the Canadian Chiropractic Association pooled together the results from eight other research articles to examine the effectiveness of instrument adjusting compared to high velocity, low amplitude (HVLA) manual adjusting.4 Patients in these studies had a variety of conditions, ranging from acute or chronic spinal pain, to temporomandibular joint (TMJ) dysfunction, to trigger points of the trapezius muscles. By comparing the results from all eight papers, the researchers found evidence for the effectiveness of instrument adjusting in treating both types of spinal pain and trapezius trigger points.
Randomized clinical trial
Randomized clinical trials (RCTs) are often considered to be the gold standard for evidence based medicine. A randomized clinical trial in medicine attempts to look at the differences between two or more groups of patients, each of whom are given a different therapy. The goal is to determine which treatment was the most useful, according to a specific set of measures.
[/fusion_text][fusion_text]An article published in the May 2001 issue of the Journal of Manipulative & Physiological Therapeutics compared instrument adjustments and HVLA manual adjustments to the cervical spine region.5 Thirty patients were divided into two groups, each receiving treatment for one month. The patients who received instrument adjustments reported a significant improvement in both left and right rotation and left and right lateral flexion at the end of the trial. Patients who received HVLA treatment only reported significant improvement in left rotation by the end of the trial.
DCs who perform instrument adjustments may find themselves having to answer questions from concerned patients. This is why continuing research on the benefits of instrument adjustments is so vital — it provides the DC extra credibility and the patient extra security in knowing that instrument adjustments are both safe and effective.
References
1Beychok T. “Instrument adjusting versus manual adjusting, part 1: physics.” Chiropractic Economics. https://www.chiroeco.com/news/chiro-article.php?id=14828. Published January 2014. Accessed September 2014.
2Beychok T. “Instrument adjusting versus manual adjusting, part 2: bottom line benefits.” Chiropractic Economics. https://www.chiroeco.com/news/chiro-article.php?id=14850. Published January 2014. Accessed September 2014.
3Beychok T. “Instrument adjusting versus manual adjusting, part 3: patient benefits.” Chiropractic Economics. https://www.chiroeco.com/news/chiro-article.php?id=14851. Published January 2014. Accessed September 2014.
4Huggins T, Luburic Boras A, Gleberzon BJ, et al. Clinical effectiveness of the activator adjusting instrument in the management of musculoskeletal disorders: A systematic review of the literature. J Can Chiropr Assoc. Mar 2012;56(1):49-57.
5Wood TG, Colloca CJ, Matthews R. A pilot randomized clinical trial on the relative effect of instrumental (MFMA) versus manual (HVLA) manipulation in the treatment of cervical spine dysfunction. J Manipulative Physiol Ther. 2001 May;24(4):260-271.[/fusion_text]
