Dynamic Chiropractic - February 10, 1997, Volume 15, Issue 04|
This text is primarily a compendium of Dr. Arlan Fuhr's teaching and research notes from the inception of Activator Methods Chiropractic Technique (AMCT). The first section in the text in devoted to the scientific and historical basis for AMCT, including discussions on articular neurology, leg-length inequality, and basic analytic techniques. Discussion of the inception of the technique is creditable, including the discovery of isolation tests by "trial and error," with follow-up clinical observation and testing. Dr. Colloca's accounting of articular neurology is an excellent recapitulation of current knowledge and research, and provides support for the effect of aberrant sensory input on spinal balance. Some material will be clearly redundant for the student (i.e., physiology of action potentials) but is helpful for the reader who may not be current on the literature, or has been away from basic physiology for some time.
In their discussion of leg-length inequality and analytic techniques, the authors are honest in their avowal that (like many other clinical methods) "the procedures of subluxation detection and correction have not been scientifically validated"; that there are "no current estimates for overall efficacy and effectiveness." They even venture to say about leg-length reactivity (responsiveness to challenge) that "validation and reliability studies are necessary to determine the clinical utility of such assessments."
The bulk of the book (over 300 pages) is dedicated to recounting scanning protocol, isolation and stress tests, pattern of subluxations and methods for correction. These notes are thorough, including (in scanning order) lower extremities, pelvis, lumbar and thoracic spine, ribs, upper extremities, and the cervical spine. Specific protocols and patterns of analysis are delineated. Common complaints in the region are detailed and methodology for correction proffered.
The final chapter is a recounting by Dr. Tony Keller of research performed with use of the activator adjusting instrument and in vivo vibrational analysis of the spine. It includes engineering studies previously presented in Advances in Chiropractic, Spine and JMPT. Although a thorough overview is provided, it may be more technical than many chiropractors can digest.
My major concern is that after acknowledging the lack of validation and reliability of analytic procedures, the authors contradict each other. Dr. Fuhr asserts that "leg length analysis enables the clinician to constantly and consistently identify subluxation and facilitation." Tests such as isolation, stress, and pressure, along with the "short-long" rule are used to isolate and identify the site and direction of spinal and extremity misalignments. Balance of leg length is the stated therapeutic goal of AMCT's analytic approach. Applicability of the analytic measures detailed within this text lies in the doctor's acceptance of that therapeutic goal as valid. If so, the 300+ pages of analysis and methodology will be extraordinarily helpful if pursuing the technique. If not, the activator instrument will most likely be applied to correct segmental dysfunctions detected by other means. In that event, the text still provides excellent clinical correlation of subluxation patterns and clinical syndromes.
Dr. Judy Silvestrone Rating: 9 out of 10