The PulStar instrument represents a 21st century approach to the evaluation and care of the chiropractic patient. While many chiropractors have been introduced to instrument adjusting, the analysis of the patient in most cases still relies upon methods of identifying the subluxation that are somewhat subjective. The PulStar takes evaluation of the patient to a new and scientific level.

Using the impulse head of the PulStar, the doctor—beginning at the occiput—moves down the spine one segment at a time, delivering an impulse at each level. The instrument is introducing a thrust or impulse and reading the resistance of the segment. Essentially, the instrument measures the stiffness of each segment. Areas of high resistance are those areas of restricted segmental motion, or to use a classic chiropractic term, fixation.

The PulStar computer, using scientific algorithms, will then display on the computer screen up to five of the most restricted segments of the spine. It not only lists the five segments but displays a graph using color-coded bars to show the doctor the resistance of the segments. Each bar is also accompanied by a numerical resistance reading.

Analysis to Treatment

The chiropractor then goes from analysis mode to treatment mode. The PulStar, using multiple impulses, can deliver a thrust at variable pressures beginning at 5 pounds of force and at 5-pound increments up to 35 pounds of thrust, allowing the chiropractor to select a level of thrust most appropriate to the patient. This allows the chiropractor to select the appropriate amount of thrust for each spinal region and perhaps more importantly, for the different patients cared for in chiropractic practices.

Whether the patient is a lineman for the local high school team or an 80-year-old woman with osteoporosis, the PulStar can deliver the appropriate level of thrust. The unit allows the chiropractor to select his or her default preferences, but the preferences can still be changed at any time by the chiropractor.

The chiropractor then identifies the segment to be adjusted, and places the instrument head, a two-pronged arrangement, straddling the spinous process of the involved segment. The chiropractor then slowly increases pressure to preload the instrument until the instrument begins to make multiple thrusts.

No Overadjusting

The PulStar can deliver a thrust at variable pressures beginning at 5 pounds of force and at 5-pound increments up to 35 pounds of thrust, allowing the chiropractor to select a level of thrust most appropriate to the patient.

The chiropractor has the discretion to set the maximum number of impulses to be used, usually 150 impulses. I say maximum because while the instrument is delivering the thrusts, it is constantly measuring the resistance of the segment. If the PulStar determines that the resistance has reduced, it will automatically stop delivering impulses. In other words, the PulStar will not overadjust. After adjusting, the chiropractor will then re-analyze the entire spine. The screen will display a four-color pre- and post-bar graph allowing the chiropractor to see the corrections that have occurred. The chiropractor can then assess if sufficient correction has been made or if areas of resistance still need correction.

The display also allows the chiropractor to show the patient immediately the correction that has been accomplished. A printout can be generated that the patient can take with him. Other office information can be preprinted on this sheet, making it an excellent patient-education tool. Having the ability to demonstrate to the patient that changes have taken place is a powerful feature. The patient feels that his problem has been addressed and that it is in the process of correction.

In addition to the ability to vary the amount of thrust, the PulStar has what is called a "sweep" mode. In sweep mode, the thrusts are delivered beginning at a frequency of 2, ramping up to 60, and then back down to 2. I have found this to be useful and effective in reducing paraspinal muscle spasm, and it is well-liked by the patients. Patients report that the muscle spasm feels lessened at the conclusion of the impulses.

The PulStar system is available as a desktop model, a portable model, and a Positional Standing Unit. The standing unit allows the chiropractor to evaluate and treat the spine under weight-bearing stress. The unit is adjusted for the patient's height. The patient is instructed to bend forward, placing his head on the headrest section and placing his arms just below. This places the spine in a gentle flexed position, which is very comfortable. The standing unit also has a card reader that allows many driver's licenses to be read and either selects the correct patient or is used to generate a new patient file. The portable unit can be used in the office as well, with the patient in a prone or seated posture, but it is truly portable. Placing the PulStar unit and laptop computer in a briefcase helps you become ready to attend health fairs, conduct screenings, or make house calls.

The portable unit with a printer is an incredible tool to use for screenings. The patient can have his spine evaluated and leave with a color printout to review later or show family and friends. Simply asking a patient, "Have you ever had your spine checked by a computer?" usually ensures a willing participant in the screening process because of the uniqueness of the system. Once people discover this high-tech multiple impulse approach to chiropractic, they are more willing to schedule an appointment as a new patient.

For more on adjusting instruments, check out our February 2007 article, "Instrument of Success."

Is the PulStar perfect? Not yet. The one feature I would like to see would be to select thrust settings for a patient and then save them for future visits. This would eliminate the need to reset the amount of thrust for the different patients throughout the day and save some time in the treatment process.

One of the important features of this system is the reduced wear and tear on the chiropractor. Some of us in later years realize the toll that years of manual adjusting have taken on our spines, shoulders, and wrists, for example. Having an instrument system like the PulStar allows chiropractors to continue providing high-quality care without the physical stress on our bodies. It is something to think about now or in years to come.

Stephen M. Savoie, DC, FACO, practices in Clermont, Fla. Contact him at .