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Activator Methods and Instrument Adjusting Procedures - #33673 Methods 7 Elective


 

 
Paul Osterbauer, D.C., M.P.H.
Robert White, D.C.
2.0
45.0
1.0
2.0

The purpose of this course is to introduce and provide the students with knowledge of the most commonly used adjusting instruments. In addition, theoretical and practical aspects of the "Special Tests" category of PARTS model of subluxation assessment will be presented. These include such tests as relative leg length inequality, and patterns painful that have been associated with patients with common NMS complaints.

The student will enter the course with the ability to evaluate the commonly encountered spinal joint problems and selected articulations of the extremities.

During the course of the trimester, the student will become proficient in applying instrument adjusting.

Lecture: background including history of the development and evolution of chiropractic adjusting devices since the early years. Also presented will be the mechanical characteristics of these forms of adjusting. The theoretical basis for the prone relative leg alignment assessment will be discussed as well as assessment of pain patterns associated with patients with spinal complaints..

Lab: Initial approaches to instrument adjusting. Each student will get an opportunity to practice the Activator assessment and adjusting procedure under supervision.
Please select from the list on the right.

The Institution-wide learning goals define the common ground that unites the programs within the university. They are purposefully broad so that the various colleges and schools can continue to develop their unique identities through varying ways in which the goals are met.

  1. Effective Communication
    Graduates will demonstrate effective verbal, non-verbal, and written communication skills in a wide variety of contexts, including collaborative activities.
  2. Self Directed and Lifelong Learning
    Graduates will be aware of the limits of one’s personal knowledge and experience and have an intellectual interest in scholarly and creative endeavors. Graduates will actively set appropriate learning goals, pursue them, and apply the knowledge gained.
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    Graduates will demonstrate a willingness to recognize the values of others while maintaining one’s own integrity, and act ethically and professionally in all endeavors.
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    Graduates will demonstrate awareness and sensitivity to the cultural and health practices of individuals and communities. Graduates will be able to identify appropriate health related resources.
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    Graduates will understand and value the benefits of service to the community.
  6. Influence of Mind, Body and Spirit on Health
    Graduates will recognize the inter-relationship of the mind, body and spirit and the influence of extrinsic factors on an individual’s health.
  7. Critical Thought and Knowledge Acquisition
    Graduates will acquire, appraise and apply scientific information. Graduates will contextually organize and synthesize relevant information to address an issue or problem.
  8. Competence in one's Discipline
    Graduates will demonstrate competence of appropriate depth and scope for one's discipline.

Course Objectives
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A. Demonstrate knowledge of adjusting the spine using instruments.

B. Understand and be able to practice safety precautions for the patient and clinician.

C. Know the circumstances for the use of the described techniques including indications/contraindications for each.

D. Set up for the patient on the equipment and be able to deliver an appropriate and effective adjustment.

E. Keep adequate/accurate patient records of the evaluation and treatment.

Materials
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A. Required Text(s):
  • Activator Methods Chiropractic Technique Basic Scan Protocol Workbook Manual

B. Recommended Text(s):

Fuhr AW and Menke JM. Status of Activator Methods Chiropractic Technique, Theory and Practice. J Manipulative and Physiol Ther 2005; 28:135.e1-135.e20

Fuhr AW. Chapter 40: Low-Force and instrument technique. In: Haldeman, S, Ed., Principles and Practice of Chiropractic, 3rd ed. McGraw-Hill, New York, NY, 2005; p.787-803

Triano JJ. The mechanics of spinal manipulation. In: Herzog W, ed. Clincal biomechanics of spinal manipulation. Clinical biomechanics of spinal manipulation. New York, NY: Churchill-Livingston, 2000; p. 172

Herzog W. The mechanical, neuromuscular and physiologic effects produced by spinal manipulation. In: Herzog W, ed. Clinical biomechanics of spinal manipulation. New York, NY: Churchill-Livingston, 2000; pp. 191-207

Fuhr AW, Collocca C, Green, Keller TS. Activator Methods Chiropractic Technique. Mosby-Year Book, St. Louis, MO, 1997

Osterbauer PJ, Fuhr AW, Keller TS. Activator Methods Chiropractic Technique. Mosby-Year Book, St. Louis, MO, 1995; p. 471-520

Osterbauer PJ, Fuhr AW, Hildebrandt RW. Mechanical force, manually assisted, short lever chiropractic adjustment. J Manipulative & Physiol Ther 1992; 15(5):309-17

Osterbauer PJ. Technology assessment of the chiropractic subluxation. Topics in Clinical Chiropractic1996; 3(1):1-9

Dewitt J, Osterbauer P, Stelmach G, et al. Optoelectric measurement of changes in leg length inequality resulting from isolation test. J Manipulataive & Physiol Ther 1994; 17(8):530-538

VIDEO TAPES:

Fuhr AW. Activator Methods Research and Development. Activator Methods International, Ltd., Phoenix, AZ , 1999 (37 minutes)

Keller TS. Biomechanics of low force spinal adjusting: discover the Activator advantage. Activator Methods International, Ltd., Phoenix, AZ, 1999 (56 minutes)

Collocca CJ. Activator methods chiropractic technique: leg length inequality. Activator Methods International, Ltd., Phoenix, AZ, 1999 (56 minutes)

Ward L. Activator methods chiropractic technique: basic scan protocol. Activator Methods International, Ltd., Phoenix, AZ, 1996 (53 minutes)

Collocca CJ. Articular neurology. Activator Methods International, Ltd., Phoenix, AZ, 1996 (42 minutes)


C. Required Materials for Lab:
  • Adjusting Instrument
Assignments
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Weekly reading assignments of the texts and in scientific literature.

Patient evaluation using special tests such as the prone relative leg alignment, "isolation tests", postural assessment using x-ray and visual observation.
Attendance
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Attendance at lectures is expected with students being prepared to participate.
Grading Criteria
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Pass/Fail
Written and Practical final examinations: Must score 70% or more, on each test

Guaranteed grades are as follows:

A = N/A
B = N/A
C = N/A
D = N/A
F = N/A
Course Competencies
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-

COGNITIVE DOMAIN


Students should be able to:
  1. Discuss the characteristics of the various chiropractic adjusting devices.
  2. Provide clinical rationale for a particular intervention.
  3. Explain the clinical utility and indications for using the prone leg check and isolation tests in patients with cervical, thoracic and lumbar complaints.
  4. Identify the strengths and weaknesses of the different components of the PARTS assessment .
  5. Be familiar with clinical pratice guidelines.
  6. Discuss the significance of an "audible" noticed during manual HVLA procedures.
  7. Be familiar with requirements of the Food and Drug Administration regarding pre-market approval of medical devices (510-k) regarding safety and effectiveness.
  8. Critique the credibility of marketing materials provided by device manufacturers.


Conditions:
Evaluation and treatment rationale for the following:

Subluxation: as characterized by facilitated segment and tonic neck reflex theory (Basic Workbook)
  • Lower extremities
  • Pelvis
  • Lumbar
  • Thoracic
  • Upper Extremities
  • Cervical

Neuromuscular components of:

  • Facet syndrome/mechanical back pain
  • Sciatica/radicular pain syndromes
  • Geriatric complaints
  • Acute conditions
  • Common pediatric complaints
  • Extremities (as time permits)


PSYCHOMOTOR DOMAIN


Students will be able to conduct an appropriate physical examination using the following procedures on a patient presenting with cervical/mid/low back pain/dysfunction; as well as discomfort/dysfunction in the extremities:

Integrate the PARTS assessment with prone leg check findings.

Students will be able to select and properly employ the appropriate treatment technique for patients with cervical, thoracic, lumbo/pelvic and extremity pain/dysfunction.

1. Logan Body Mechanics
2. Prone leg check
  a. Neutral extended position      
  b. Flexed position      
    i) Lengthening      
    ii) Shortening      
3. Isolation Tests
  a. Knees and Feet      
  b. Pelvis      
  c. Lumbar spine      
  d. Thoracic spine      
  e. Upper extremities      
  f. Cervical spine      

1. Activator contact points and lines of drive
A. Lower Extremities

1. Medial malleolus/lateral molleolus

2. Calcaneus/Talus

B. Pelvis

1. Ischeal spine

2. Sacrotuberous ligament

3. Iliac fossa

4. Anterior base of the sacrum

5. Crest of the ilium

6. Ischeal tuberosity

7. Pubic bone

C. Lumar Spine

1. L5

2. L4

3. L3

4. L2

D. Thoracic Spine

1. T12

2. T8/ribs

3. T6/ribs

4. T4/ribs

5. T1/ribs

E. Upper Extremities

1. Scapulae

2. Humerus

3. Radius/Ulna

5. Lunate/Carpals

F. Cervical Spine

1. C7

2. C5

3. C2

4. C1

5. Occ



AFFECTIVE DOMAIN


Students will demonstrate interpersonal integrity, compassion, sensitivity, respect, and professionalism at all times, both in lectures and in labs. Students will develop an appreciation for the laboratory component of patient diagnosis, and will be able to apply the diagnostic and treatment skills learned in this course to patients while domonstrating the above attributes.
Weekly Calendar of Learning Objectives
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Week Dates Topics/Learning objectives
Week 1 -- Introduction to adjusting devices: the case of the Activator adjusting instrument
a) Introduction of the course review syllabus, grading procedure
b ) Safety and efficacy: FDA process, reasonable use Lecture
d ) Assigned reading(s): Fuhr and Menke. Status of activator methods chiropractic technique, theory and practice. JMPT 2005; 28:135e1-135e.20; Osterbauer et al. Mechanical force manually assisted, short lever chiropractic adjustment. JMPT 1992; 15(5):309-17, Keating JCK. Letter to the Editor. JMPT 1993 16:55-8
Week 2 -- Historical and contemporary review of adjusting devices. Critique the claims made by equipment developers. Introduction to Logan body mechanics and isolation and pressure tests, introduction to the functional short leg
a) Lecture on above
b) Basic workbook videotape
c) Hands on Leg testing workshop
Elevation tables
Week 3 -- Lower extremity "isolation tests".
Elevation tables
Week 4 -- Pelvic "isolation tests".
Elevation tables
Week 5 -- Thoracic "isolation tests".
Elevation tables
Week 6 -- Scapulae/upper extremities "isolation tests".
Elevation tables
Week 7 -- NO CLASS - MIDTERMS WEEK
Week 8 -- Cervical spine "isolation tests".
Elevation tables
Week 9 -- Case management (common spinal complaints)
Integrating approach
Assessment and progress
Week 10 -- Case management extremity (or other), fibromyalgia
integrating approach
assessment and progress
Week 11 -- No CLASSES: T5-T6-T7 NATIONAL BOARD DAY
Week 12 -- Pediatric/geriatric assessment
Week 13 -- Review
Week 14 --
 Final Exams
Week 15 --
 Final Exams
Please Note
This schedule of lecture and lab topics and quizzes and exams may be changed during the course of the trimester as circumstances require. Whenever possible, such changes will be announced in class before the date and time in question. You are responsible for anything that transpires during lectures and labs, even when you are unable to attend. In the event that you miss a class session, make sure you check with a classmate about any announcements or schedule changes which may have been made. Makeup exams are allowed only according to the policies described in the current student handbook, which is available in the Student Affairs office.
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Last updated: 17 February, 2006
 

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