Activator technique

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Activator V Chiropractic Adjusting Instrument Activator V adjusting instrument.jpg
Activator V Chiropractic Adjusting Instrument

The Activator Method Chiropractic Technique is a chiropractic treatment method that uses a device created by Arlan Fuhr as an alternative to manual manipulation of the spine or extremity joints. The device is categorized as a mechanical force manual assisted (MFMA) instrument which is generally regarded as a softer chiropractic treatment technique. [1] The method purports to use the device to identify and remove vertebral subluxations [2] and correct "pelvic deficiency", defined as an "'apparent' difference in leg length, not an anatomical difference". [3] These claims have been criticized. [2] [3]

Contents

Activator Adjusting Instrument

An Activator II instrument Activator II adjustment instrument.png
An Activator II instrument

The traditional Activator Adjusting Instrument (AAI), or more simply, Activator, is a small handheld spring-loaded instrument which delivers a controlled and reproducible tap to the spine or other body part. [4] The aim is to produce enough force to move the vertebrae, but not enough to cause injury. [5] The tool's design is based on a dental impactor, [6] a device that taps dental amalgam into cavities in teeth. [4]

Activator I was patented by Activator Methods International on September 26, 1978. [4] [7] [8] Activator II was released, with an added "impedance head", in 1994. [4] Activator V is a cordless electric version that gives off no more than 0.3 J of kinetic energy in a 3-millisecond pulse. [4] It is the first FDA registered and approved cordless electronic chiropractic adjustment instrument. [9]

Leg length test reliability

The method involves using the device to identify and remove vertebral subluxations and correct "pelvic deficiency", defined as an "'apparent' difference in leg length, not an anatomical difference". The chiropractor checks the patient's "functional leg length" in the prone position, then uses the device on various parts of the body, and then rechecks the leg length to see if the Activator produced a change. This is repeated until the legs are apparently of an equal length and the treatment is considered to have resolved any vertebral subluxations. [3]

Although prone "functional leg length" is a widely used chiropractic tool, it is not a recognized anthropometric technique, since legs are often naturally of unequal length, and measurements in the prone position are not entirely valid estimates of standing X-ray differences. [10] Measurements in the standing position are far more reliable. [11] Another confounding factor is that simply moving the two legs held together and leaning them imperceptibly to one side or the other produces different results. [12] [13] The Activator Methods technique uses leg length checks while prone (Position 1) and with the knees bent to 90 degrees (Position 2). Research shows good intraexaminer reliability and moderate interexaminer reliability with leg length checks in position 1, however no consensus has been met on the accuracy of leg length checks in position 1. [5]

Utilization and criticism

In 2003, the National Board of Chiropractic Examiners found that 69.9% of chiropractors used the technique, and 23.9% of patients received it. [14] The majority of US chiropractic schools and some schools in other countries teach the AMCT method, and an estimated 45,000 chiropractors worldwide use AMCT or some part of the technique. [5]

In 2001, the Chiropractors' Association of Saskatchewan considered the device "useless" and prohibited its use, a ban that was disputed in court. [15] The ban was lifted in 2003. [2] Its use has been criticized: "Activator Methods thus piles one dubious concept upon another. Its leg-length tests have not been demonstrated to be reliable or to yield significant data. Nor is there any reason to believe that 'pelvic deficiency' or its associated 'subluxations' are pathologic conditions." [3] "Activator Methods Chiropractic Technique is a nonsensical diagnostic and treatment system centered on the notion that leg-length analysis can locate subluxations and determine when to adjust the spine." [2]

Related Research Articles

<span class="mw-page-title-main">Chiropractic</span> Form of pseudoscientific alternative medicine

Chiropractic is a form of alternative medicine concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially of the spine. It has esoteric origins and is based on several pseudoscientific ideas.

A subluxation is an incomplete or partial dislocation of a joint or organ. According to the World Health Organization, a subluxation is a "significant structural displacement" and is therefore visible on static imaging studies, such as X-rays. Unlike real subluxations, the pseudoscientific concept of a chiropractic "vertebral subluxation" may or may not be visible on x-rays.

The National Council Against Health Fraud (NCAHF) was a not-for-profit, US-based organization, that described itself as a "private nonprofit, voluntary health agency that focuses upon health misinformation, fraud, and quackery as public health problems."

<span class="mw-page-title-main">Vertebral subluxation</span> Chiropractic concept

In chiropractic, a vertebral subluxation means pressure on nerves, abnormal functions creating a lesion in some portion of the body, either in its action or makeup. Chiropractors claim subluxations are not necessarily visible on X-rays.

<span class="mw-page-title-main">Spinal adjustment</span>

Spinal adjustment and chiropractic adjustment are terms used by chiropractors to describe their approaches to spinal manipulation, as well as some osteopaths, who use the term adjustment. Despite anecdotal success, there is no scientific evidence that spinal adjustment is effective against disease.

<span class="mw-page-title-main">Spinal manipulation</span> Intervention performed on spinal joints

Spinal manipulation is an intervention performed on synovial joints of the spine, including the z-joints, the atlanto-occipital, atlanto-axial, lumbosacral, sacroiliac, costotransverse and costovertebral joints. It is typically applied with therapeutic intent, most commonly for the treatment of low back pain.

The National Association for Chiropractic Medicine(NACM) was a minority chiropractic association founded in 1984 that described itself as a "consumer advocacy association of chiropractors". It openly rejected some of the more controversial aspects of chiropractic, including a basic concept of chiropractic, vertebral subluxations as the cause of all diseases. It also sought to "reform the chiropractic profession away from a philosophical scope of practice and towards an applied science scope of practice." It stated that it was "dedicated to bringing the scientific based practice of chiropractic into mainstream medicine" and that its members "confine their scope of practice to scientific parameters and seek to make legitimate the utilization of professional manipulative procedures in mainstream health care delivery." "While the NACM is focused on furthering the profession, its primary focus is on the rights and safety of the consumers." The NACM was the object of much controversy and criticism from the rest of the profession. It quietly dropped out of sight and its demise apparently occurred sometime between May 30, 2008 and March 6, 2010.

<span class="mw-page-title-main">History of chiropractic</span>

The history of chiropractic began in 1895 when Daniel David Palmer of Iowa performed the first chiropractic adjustment on a partially deaf janitor, Harvey Lillard.While Lillard was working without his shirt on in Palmer's office, Lillard bent over to empty the trash can. Palmer noticed that Lillard had a vertebra out of position. He asked Lillard what happened, and Lillard replied, "I moved the wrong way, and I heard a 'pop' in my back, and that's when I lost my hearing." Palmer, who was also involved in many other natural healing philosophies, had Lillard lie face down on the floor and proceeded with the adjustment. The next day, Lillard told Palmer, "I can hear that rackets on the streets." This experience led Palmer to open a school of chiropractic two years later. Rev. Samuel H. Weed coined the word "chiropractic" by combining the Greek words cheiro (hand) and praktikos.

Joint manipulation is a type of passive movement of a skeletal joint. It is usually aimed at one or more 'target' synovial joints with the aim of achieving a therapeutic effect.

The Toftness Radiation Detector is an instrument used by some chiropractors. It was patented by Irwing N. Toftness in 1971, and was banned from use in the United States in 1982. Toftness claimed that it detected electromagnetic radiation emanating from vertebral subluxations. The device consisted of a plastic cylinder with a series of plastic lenses inside, as well as a clear plastic "detection plate". A patient would rub their finger against the detection plate while the device was held close to an area of their body, and report the degree of perceived resistance against the movement of their fingers. An increase in perceived resistance would indicate which area of the body required chiropractic manipulation.

<span class="mw-page-title-main">Unequal leg length</span> Medical condition

Unequal leg length is often a disabling condition where the legs are either different lengths (structurally), or appear to be different lengths, because of misalignment (functionally).

Chiropractors use their version of spinal manipulation as their primary treatment method, with non-chiropractic use of spinal manipulation gaining more study and attention in mainstream medicine in the 1980s. There is no evidence that chiropractic spinal adjustments are effective for any medical condition, with the possible exception of treatment for lower back pain. The safety of manipulation, particularly on the cervical spine has been debated. Adverse results, including strokes and deaths, are rare.

Throughout its history, chiropractic has been the subject of internal and external controversy and criticism. According to magnetic healer Daniel D. Palmer, the founder of chiropractic, "vertebral subluxation" was the sole cause of all diseases and manipulation was the cure for all disease. A 2003 profession-wide survey found "most chiropractors still hold views of Innate Intelligence and of the cause and cure of disease consistent with those of the Palmers". A critical evaluation stated "Chiropractic is rooted in mystical concepts. This led to an internal conflict within the chiropractic profession, which continues today." Chiropractors, including D.D. Palmer, were jailed for practicing medicine without a license. D.D. Palmer considered establishing chiropractic as a religion to resolve this problem. For most of its existence, chiropractic has battled with mainstream medicine, sustained by antiscientific and pseudoscientific ideas such as vertebral subluxation.

<span class="mw-page-title-main">Veterinary chiropractic</span>

Veterinary chiropractic, also known as animal chiropractic, is chiropractic for animals – a type of spinal manipulation. Veterinary chiropractors typically treat horses, racing greyhounds, and pets. Veterinary chiropractic is a controversial method due to a lack of evidence as to the efficacy of chiropractic methods. Contrary to traditional medicine, chiropractic therapies are alternative medicine. There is some degree of risk associated with even skilled manipulation in animals as the potential for injury exists with any technique used. The founder of chiropractic, Daniel David Palmer, used the method on animals, partly to challenge claims that the placebo effect was responsible for favorable results in humans. Chiropractic treatment of large animals dates back to the early 1900s. As of 2019, many states in the US provide statutory or regulatory guidelines for the practice of chiropractic and related treatments on animals, generally requiring some form of veterinary involvement.

<span class="mw-page-title-main">Sherman College of Chiropractic</span>

Sherman College of Chiropractic is an American private graduate college focused on the health sciences and located in unincorporated Spartanburg County, South Carolina, with a Boiling Springs postal address; it is outside of the Boiling Springs census-designated place. It was founded in 1973 and named after chiropractor Lyle Sherman. Sherman College offers the doctor of chiropractic degree. The college is home to approximately 450 students representing 42 states and 13 countries and has more than 3,000 alumni around the world. Sherman college supports the "straight" vertebral subluxation-based focus as different from diagnosis and symptomatic treatment focus of "mixed" U.S. chiropractic schools. The name of the college was changed to Sherman College of Straight Chiropractic the late 1970s, but changed back to the original name in 2009. Sherman College also has digital x-ray services in the Health Center for use of interns and local chiropractors.

The World Chiropractic Alliance (WCA) is a not-for-profit corporation founded in Arizona in 1989 that serves as the voice of conservative "straight" chiropractors.

<span class="mw-page-title-main">William Harvey Lillard</span> American chiropractic patient

William Harvey Lillard was the first chiropractic patient.

<span class="mw-page-title-main">Daniel David Palmer</span> Founder of chiropractic (1845–1913)

Daniel David Palmer was the founder of chiropractic. Palmer was born in Pickering Township, Canada West, but emigrated to the United States in 1865. He was also an avid proponent of pseudoscientific alternative medicine such as magnetic healing. Palmer opposed anything he thought to be associated with mainstream medicine such as vaccination.

Clarence Selmer Gonstead was an American chiropractor. He created the Gonstead technique. He established a large chiropractic facility in Mount Horeb, Wisconsin.


The Webster Technique is a method within the field of chiropractic that proponents claim can assist in rotating a breech baby. The scientific studies on this technique are minimal in number and weak in conclusion, such that some chiropractic colleges and regulatory groups disallow their members from advertising the technique at all.

References

  1. ↑ Chiropractic: An Illustrated History. Mosby. 1995. ISBN   978-0-8016-7735-9.
  2. 1 2 3 4 "Chiropractic News Digest #03-04". Quackwatch. June 25, 2003. Retrieved June 19, 2024.
  3. 1 2 3 4 Homola, Samuel (March 25, 2006). "Questionable Claims Made for Activator Methods (AM)". Quackwatch. Retrieved June 19, 2024.
  4. 1 2 3 4 5 Fuhr, Arlan W.; Colloca, Christopher J.; Green, John R.; Keller, Tony S. (1997). Activator Methods Chiropractic Technique (1st ed.). St. Louis, MO: Mosby. ISBN   0-8151-3684-6.
  5. 1 2 3 Fuhr, Arlan W.; J. Michael Menke (February 2005). "Status of Activator Methods Chiropractic Technique, Theory, and Practice". Journal of Manipulative and Physiological Therapeutics . 28 (2): e1–e20. doi:10.1016/j.jmpt.2005.01.001. PMID   15800504.
  6. ↑ Vintage Dudley Research Corp Impactor Dental Instrument In Wooden Case & Parts
  7. ↑ "United States Patent - Chiropractic Adjusting Instrument". United States Patent and Trademark Office. Retrieved 3 September 2017.
  8. ↑ "Patent Images". United States Patent and Trademark Office. Retrieved 3 September 2017.
  9. ↑ "510(k) Summary of Safety and Effectiveness" (PDF). Department of Health and Human Services. Retrieved 3 September 2017.
  10. ↑ D W Rhodes, E R Mansfield, P A Bishop, J F Smith. The validity of the prone leg check as an estimate of standing leg length inequality measured by X-ray. Archived 2011-05-22 at the Wayback Machine J Manipulative Physiol Ther.; 18 (6):343-6
  11. ↑ E Hanada, R L Kirby, M Mitchell, J M Swuste. Measuring leg-length discrepancy by the "iliac crest palpation and book correction" method: reliability and validity. Archived 2011-05-22 at the Wayback Machine Arch Phys Med Rehabil. 2001 Jul; 82 (7):938-42
  12. ↑ Mitchell, Jacqueline S. (June 4, 2002). "Keeping Your Spine In Line". PBS. Archived from the original on June 28, 2002.
  13. ↑ "Adjusting the Joints". PBS. Archived from the original on June 28, 2002.
  14. ↑ Christensen MG, Kollasch MW (2005). "Professional functions and treatment procedures" (PDF). Job Analysis of Chiropractic. Greeley, CO: National Board of Chiropractic Examiners. pp. 121–38. ISBN   1-884457-05-3. Archived from the original (PDF) on 2008-09-10. Retrieved 2008-08-25.
  15. ↑ "Chiropractors argument arrives in court". CBC. January 17, 2001. Retrieved June 19, 2024.
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