19 Apr Activator Method of Chiropractic Medicine
The Activator Method Chiropractic Technique (AMCT) is a chiropractic treatment method that involves using a device created by Arlan Fuhr as an alternative to manual manipulation. This device has been described as a mechanical force manual assisted instrument and is regarded as a softer chiropractic treatment technique.
The activator is a small handheld device that delivers a small impulse to the spine (up to 0.3 J of kinetic energy in a 3-millisecond pulse), and is applied to the spine to produce enough force to move the vertebrae while not causing any injury.
Functional length procedure: This chiropractic tool is widely used but it is challenged as an anthropometric technique (because legs can be of different lengths). Leg lengths measured with the patient standing up are far more reliable. However, for this procedure, the functional leg lengths are compared while the patient lies in a prone position. If one leg seems to be shorter than the other, the chiropractor carries out a muscle tests to activate the muscles attached to specific vertebrae. If the leg lengths are not the same, that is taken as a sign that the problem is located at that vertebra, and the chiropractor treats it and moves along the spine in the direction from the feet towards the head.
Approximately, 69.9% of chiropractors use this technique. The AMCT method is widely taught in chiropractic schools. The body of knowledge and evidence helping establish AMCT as a valid technique is growing. Some studies suggest that the activator may be as effective as manual adjustment in treatment of back pain, or even inferior to the latter.
There are two theoretical advantages of an Activator instrument-assisted treatment – (1) the activator provides fast-paced pressure, which is so quick that the body’s muscles are less likely to tense up and resist the treatment as a response, which then facilitates the treatment effectiveness; (2) the force applied by the activator is localized and does not add any additional torque or bending movement to the joint. This systematic review of the clinical trials performed in this space reported benefits to patients with spinal pain and trigger points, but these results were comparable to those of HVLA manual manipulation or trigger point therapy.
Clinically meaningful improvements were, however, reported in patients with acute and chronic low back or sacroiliac joint pain, acute and subacute neck pain, TMJ disorders, etc. There is definitely a need for more studies that include a larger patient base comparing the effects of ACMT with placebo, with better randomization and blinding protocols and an overall robust study design so that statistically significant conclusions can be drawn and practitioners can apply ACMT with greater confidence. Until then, one needs to be cautious about anecdotal evidence and use this approach judiciously based on the needs and requirements of each individual case.