A "turning point" is a point in your life when you make a substantial change or a departure from the status quo or the way you "usually" do something. Sometimes the turning point is brought on by a crisis situation, and other times it is the result of new knowledge and information that changes your opinion. After more than 2 decades in practice, my turning point was based on information that convinced me to make a drastic change in my practice.

After graduation from chiropractic college, I accepted a position at one of the highest-volume chiropractic clinics in the country run by the cofounders of a well-known instrument adjusting technique. For more than 20 years, I not only saw a high volume of patients each week, I also began teaching this technique to other chiropractors. I witnessed the evolution of the instrument over the years to its present model. I thought no better instrument existed to provide low-force, high-speed spinal and extremity adjustments until I attended a training seminar in May of 2006, taught by Neuromechanical Innovations founder and CEO Christopher J. Colloca, DC, and Terry Peterson, DC.

The research presented at this seminar led me to my next turning point. Colloca and Tony Keller, PhD, chair, Department of Mechanical Engineering at the University of Vermont, had collaborated on research that led to the Impulse Adjusting Instrument. Two of these research studies led me to using the new electric Impulse instrument.

Research

Jim Gudgel, DC, PT, uses the Impulse Adjusting Instrument to adjust the wrist of one of his seminar attendees.

The first paper that impressed me compared the force-time profiles generated by the spring-loaded instrument and the Impulse instrument.¹ With the spring-loaded device, the release of the spring produced a rapidly oscillating waveform of approximately 5 milliseconds (ms) duration. The spring recoil then produced several lower-amplitude oscillations that lasted another 15 ms. These recoil oscillations had the effect of "canceling out," or interfering with, the bone movement produced by the force applied to it.

In contrast, the force-time profile of the Impulse instrument closely resembled a half sine wave with a pulse duration of 2 ms (much faster than the spring-loaded device) with nearly no rebound oscillations. This produced a much faster and "cleaner" wave form with greater bone movement. The crisp nature of the thrust and the improved results are what my patients commented on the most.

Another aspect of this paper that impressed me was the comparison of the forces generated by the spring-loaded instrument to the Impulse instrument. Peak force delivered on the Impulse's "low" setting was 123.5 Newtons (N), which was nearly the same as the peak force of the "low" setting (No. 1) of the spring-loaded device (123 N). Peak force on the Impulse's "medium" setting was just under 250 N, compared to forces of 121 N and 114 N on the two "medium" settings (Nos. 2 and 3) of the spring-loaded device. Peak force in the "high" setting on the Impulse instrument was 380 N, compared to 211 N on the "high" setting (No. 4) of the spring-loaded instrument. Thus, the Impulse instrument gave me a much wider range of forces to work with. I could deliver less force when adjusting the upper cervical spine, TMJ, or children, and now had the ability to use higher forces on the lumbar spine and pelvis where it is needed.

The second research paper that put the "icing on the cake" for me was the effect on vertebral movement when multiple thrusts were applied at the rate of six thrusts per second (something that cannot be done with the spring-loaded device).² Sometimes, a vertebra requires multiple thrusts at a certain frequency to achieve maximum movement. The research demonstrated that in most cases, maximum bone movement was achieved between three to eight thrusts delivered at a specific frequency (the frequency generated by the Impulse).

Effective and Comfortable

The Impulse was not only more effective at achieving bone movement, it generated a far greater activation of mechanoreceptors and gave the patient much quicker pain relief. Additionally, the Impulse was much more comfortable to use, and at the end of a busy day I no longer had arm and hand fatigue from pulling the handles of a spring-loaded device.

I encourage you to visit www.neuromechanical.com and read these papers yourself.

Jim Gudgel, DC, PT, is a senior instructor for Neuromechanical Innovations. Over the past 20 years, he has been running a high-volume chiropractic office in Redwood Falls, Minn. Contact him at .

References

1. Colloca CJ, Keller TS, Black P, Normand MC, Harrison DE, Harrison DD. Comparison of mechanical force of manually assisted chiropractic adjusting instruments. J Manipulative Physiol Ther. 2005; 28:414–422.
2. Keller TS, Colloca CJ, Moore RJ, Gunzburg R, Harrison DE. Increased multiaxial lumbar motion responses during multiple-impulse mechanical force manually assisted spinal manipulation. Chiropr Osteopat 2006;14:6.