Patients often present themselves for chiropractic treatment with conditions that may include contraindications for manipulative therapy. This report describes successful chiropractic treatment of acute shoulder pain involving a patient who presented with mixed metastatic carcinoma affecting the humerus, scapula, and clavicle using an Activator Adjusting Instrument.
The successful outcome of the case demonstrates the possible value of instrumental chiropractic adjustment in treating neuromusculoskeletal cases where a forceful, high-velocity adjustment or manipulation would be contraindicated because of the underlying osseous pathology involved. Further study into this possibility should be provided to help train those physicians who are called upon to treat these cases and to help further define risk management protocols for the chiropractic profession.
Chiropr Tech 1995; 7(3):98-102.
Author information: Polkinghorn BS. Private practice of chiropractic. Santa Monica, CA, USA.
To test systematically if spinal manipulative treatments (SMT) and the audible release associated with SMT cause activation of spinal muscles.
Experimental pilot study.
Human Performance Laboratory, The University of Calgary.
One male and one female asymptomatic volunteer.
Slow and fast SMTs to the left transverse process of thoracic vertebrae using a reinforced hypothenar contact. The treatment forces were directed in a posterior-to-anterior direction with the subjects in a prone position.
Main Outcome Measures:
Forces applied by the chiropractor during SMT. Measurements of the audible release using skin-mounted accelerometers. Electromyographical activity of selected spinal muscles.
Electromyographical (EMG) activity was observed consistently 50-100 msec after the onset of each of the fast SMTs, whether the treatment resulted in an audible release or not; for slow SMTs, there was never any visible electromyographical activity of the target muscles, whether the treatment resulted in an audible release or not.
The results of this study suggest that fast treatment thrusts elicit muscle activation, whereas slow force application does not. The timing of the onset of the EMG response suggests that activation may be produced by a reflex response originating in the muscle spindles. It also appears that the audible release does not (by itself) evoke muscle activation or a joint proprioceptive reflex response as has been speculated in the literature.
J Manipulative Physiol Ther. 1995 May;18(4):233-6. [PMID:7636413]
Author information: W. Herzog, PhD.; P.J. Conway, DC; Y.T. Zhang, PhD.; J. Gal, PhD; A.C.S. Guimaraes. Faculty of Physical Education, University of Calgary, Alberta, Canada.
Subject: The Activator Adjusting Instrument – Biomechanical
Reference: Tony S. Keller; J.B. Lehneman…Musculoskeletal Research Lab, February 1994: pp.1-16
Introduction: The Activator Adjusting Instrument (AAI) is a devise used for chiropractic manipulations. The device is intended to produce repeatable impacts (manipulations) at various force settings. The force is easily adjusted by turning the small knob on the lower part of the device.
Objective: The purpose of this study is to determine the effect of the force setting, and preload on the actual force delivered by the AAi to the impact surface.