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The Activator technique is a chiropractic treatment method and 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.
Physical characteristics of the activator device
The activator is a small handheld spring-loaded instrument which delivers a small impulse to the spine. It was found to give off no more than 0.3 J of kinetic energy in a 3-millisecond pulse. The aim is to produce enough force to move the vertebrae but not enough to cause injury.
Activator method chiropractic technique
The activator method chiropractic technique (AMCT) involves having the patient lie in a prone position and comparing the functional leg lengths. Often one leg will seem to be slightly shorter than the other. The chiropractor then carries out a series of tests such as pressing on a vertebra. If the shorter leg seems to become even shorter, that is taken as a sign that the problem is located at that vertebra. The chiropractor treats problems found in this way moving progressively along the spine in the direction from the feet towards the head.
Leg length test reliability
Although prone "functional leg length" is a widely used chiropractic tool, it is not a recognized anthropometric technique, since legs are often of unequal length, and measurements in the prone position are not entirely valid estimates of standing X-ray differences. Measurements in the standing position are far more reliable. 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. Fuhr claims that properly trained doctors show good interexaminer reliability.
In 2003, the National Board of Chiropractic Examiners found that 69.9% of chiropractors used the technique, and 23.9% of patients received it. The majority of U.S. 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.
There have been a number of studies of AMCT, including case reports, clinical studies and randomized controlled trials, but there are still unanswered questions. A few studies suggest that the activator may be as effective as manual adjustment in treatment of back pain. The efficacy of manual adjustments is also questionable and is under debate.
- 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. http://linkinghub.elsevier.com/retrieve/pii/S0161475405000023. Retrieved 2008-08-18.
- 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. J Manipulative Physiol Ther. ;18 (6):343-6
- 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. Arch Phys Med Rehabil. 2001 Jul ;82 (7):938-42
- Keeping Your Spine In Line, Adjusting the Joints, and Video, Alan Alda, PBS, Scientific American Frontiers. Video discusses Activator and leg length
- 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. http://nbce.org/pdfs/job-analysis/chapter_10.pdf. Retrieved 2008-08-25.
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