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Please describe the diagnostic or testing products or services you offer:
Neuromechanical Innovations is a UL Listed® and ISO 13485 Certified manufacturer of the Impulse iQ Adjusting Instrument®, a device that provides chiropractic adjustment/spinal manipulation while simultaneously evaluating dynamic spinal stiffness.
How does your product/service help chiropractors and their patients?
Scientific research has demonstrated that forces imparted to the spine at the resonant or natural frequency can create up to three times greater spinal motion than forces delivered at the wrong frequency (Keller, Colloca, In vivo transient vibration assessment of the normal human thoracolumbar spine. J Manipulative Physiol Ther 2000; 23(8): 521-30). Thus, technology aimed at determining the resonant frequency of the spine during the treatment creates more efficient adjustments that require less force to accomplish the goal of improved clinical findings. The patented Auto-Sense® technology of the Impulse iQ® detects the frequency at which the spine is moving during the initial thrusts which automatically sets the pulse frequency for subsequent thrusts delivered during the chiropractic adjustment. As the mobility of the area improves from better joint motion and the relaxation of hyperactive muscles, the instrument will dynamically change its thrust frequency in tune with the response of the spine and when motion is maximized, the instrument ceases firing.
Chiropractors using the Impulse iQ Adjusting Instrument® receive objective biomechanical feedback about the success of their treatment which allows them to alter the vector or line of drive in their adjustment delivery. Chiropractors can more easily communicate the results of the care that they provide by educating their patients about how the instrument works. Inasmuch, the Impulse iQ helps chiropractors deliver more efficient chiropractic adjustments and patients receiving such care are able to be treated in the prone neutral position without the need for twisting and turning that is aggravating to many.
What do you think are the major barriers facing the chiropractic profession?
I believe that the major barrier facing the chiropractic profession is a lack of identity of what a chiropractor actually does. Esoteric techniques and products that lack a research base and validation serve to place the entire chiropractic profession in a negative light. When a chiropractor is thought of as the professional offering everything from Tongue analyses to foot baths and all the wild and whacky interventions in between, they are perceived as Witch Doctors. This is only worsened by practitioners who perform challenges, pressure tests, leg checks and isolation test type procedures that are nothing short of embarrassing. Validated and researched products and techniques using established gateways such as FDA Registrations, and research based chiropractic analyses, serve only to advance the acceptance and understanding of the chiropractic profession among the other health care disciplines.
How does your product/service help chiropractors address these?
Prior to releasing the Impulse iQ®, research and development was conducted for a decade to validate the technology. Spinal motions were quantified in human subjects and in a validated animal model by placing stainless steel pins into the vertebrae and attaching accelerometers accurate to a fraction of a millimeter using gold-standard biomechanical techniques. The spinal motions being quantified in this manner invasively were compared to the technology of the Impulse iQ® non-invasively. These data were subsequently published in the renowned orthopaedic journal, Spine in 2009. Thirty-four published research studies crediting to the development of the Impulse iQ are listed below:
1. Colloca CJ, Keller TS, Moore RJ, Harrison DE, Gunzburg R. Validation of a Non-Invasive Dynamic Spinal Stiffness Assessment Methodology in an Animal Model of Intervertebral Disc Degeneration. Spine 2009; 34(18):1900-5.
2. Colloca CJ, Keller TS, Moore RJ, Gunzburg R, Harrison DE. Effects of disc degeneration on neurophysiological responses during dorsoventral mechanical excitation of the ovine lumbar spine. Journal of Electromyography and Kinesiology 2008;18(5):829-37.
3. Colloca CJ, Keller TS, Moore RJ, Gunzburg R, Harrison DE. Intervertebral disc degeneration reduces vertebral motion responses. Spine 2007; 32(19):E544-50.
4. Keller TS, Colloca CJ, Harrison DE, Moore RJ, Gunzburg R. Muscular contributions to dynamic dorsoventral lumbar spine stiffness. European Spine Journal 2007; 16(2):245-54.
5. Colloca CJ, Keller TS. Spinal manipulation reduces pain and hyperalgesia after lumbar intervertebral foramen inflammation in the rat [Letter]. Journal of Manipulative and Physiological Therapeutics 2007; 30(1):76-7.
6. Keller TS, Colloca CJ. Dynamic dorsoventral stiffness assessment of the ovine lumbar spine. Journal of Biomechanics 2007; 40(1):191-7.
7. Keller TS, Colloca CJ, Moore RJ, Gunzburg R, Harrison DE. Increased multiaxial lumbar motion responses during multiple-impulse mechanical force manually assisted spinal manipulation. Chiropratic & Osteopathy 2006; 14(1):6-14.
8. Keller TS, Colloca CJ, Moore RJ, Gunzburg R, Harrison DE, Harrison DD. Three-dimensional intersegmental motion validation of mechanical force spinal manipulation. Journal of Manipulative and Physiological Therapeutics 2006; 29(6):425-36.
9. Colloca CJ, Keller TS, Harrison DE, Moore RJ, Gunzburg R, Harrison DD. Spinal manipulation force and duration affect vertebral movement and neuromuscular responses. Clinical Biomechanics 2006: 21(3):254-62.
10. Shearar KA, Colloca CJ, White HL. A randomized clinical trial of manual versus mechanical force manipulation in the management of sacroiliac joint syndrome. Journal of Manipulative and Physiological Therapeutics 2005; 28(7):493-501.
11. Colloca CJ, Keller TS, Black P, Normand MC, Harrison DE, Harrison DD. Biomechanical comparison of mechanical force manually assisted chiropractic adjusting instruments. Journal of Manipulative and Physiological Therapeutics 2005; 28(6):414-22.
12. Taylor SH, Arnold ND, Biggs L, Colloca CJ, Mierau DR, Symons BP, Triano JJ. A review of the literature pertaining to the efficacy, safety, educational requirements, uses and usage of mechanical adjusting devices. Part 2 of 2. Journal of the Canadian Chiropractic Association 2004; 48(2):152-61.
13. Taylor SH, Arnold ND, Biggs L, Colloca CJ, Mierau DR, Symons BP, Triano JJ. A review of the literature pertaining to the efficacy, safety, educational requirements, uses and usage of mechanical adjusting devices. Part 1 of 2. Journal of the Canadian Chiropractic Association 2004; 48(1):74-88.
14. Colloca CJ, Keller TS. Active trunk extensor contributions to dynamic posteroanterior lumbar spinal stiffness. Journal of Manipulative and Physiological Therapeutics 2004; 27(4): 229-37.
15. Colloca CJ, Keller TS, Gunzburg R. First Prize – Biomechanical and neurophysiological responses to spinal manipulation in patients with lumbar radiculopathy. Journal of Manipulative and Physiological Therapeutics 2004; 27(1):1-15.
16. Colloca CJ, Keller TS, Gunzburg R. Neuromechanical characterization of in vivo lumbar spinal manipulation. Part II: Neurophysiological Response. Journal of Manipulative and Physiological Therapeutics 2003; 26(9):579-91.
17. Keller TS, Colloca CJ, Gunzburg R. Neuromechanical characterization of in vivo lumbar spinal manipulation. Part I: Vertebral motion. Journal of Manipulative and Physiological Therapeutics 2003; 26(9):567-78.
18. Colloca CJ, Polkinghorn BS. Chiropractic management of Ehlers-Danlos Syndrome – A report of 2 cases. Journal of Manipulative and Physiological Therapeutics 2003; 26(7):448-59.
19. Colloca CJ, Keller TS, Peterson TK, Seltzer DE. Comparison of dynamic posteroanterior spinal stiffness to plain film radiographic images of lumbar disc height. Journal of Manipulative and Physiological Therapeutics 2003; 26(4):233-41.
20. Polkinghorn BS, Colloca CJ. Chiropractic management of chest pain utilizing mechanical force, manually-assisted short lever adjusting procedures. Journal of Manipulative and Physiological Therapeutics 2003; 26(2):108-15.
21. Keller TS, Colloca CJ. A rigid body model of the dynamic posteroanterior motion response of the human lumbar spine. Journal of Manipulative and Physiological Therapeutics 2002; 25(8):485-96.
22. Keller TS, Colloca CJ, Beliveau JG. Force-deformation response of the lumbar spine: a sagittal plane model of manipulation and mobilization. Clinical Biomechanics 2002: 17(3):185-96.
23. Polkinghorn BS, Colloca CJ. Chiropractic treatment of postsurgical neck syndrome utilizing mechanical force, manually-assisted short lever spinal adjustments. Journal of Manipulative and Physiological Therapeutics 2001: 24(9):589-95.
24. Colloca CJ, Keller TS. Stiffness and neuromuscular reflex response of the human spine to dynamic posteroanterior manipulative thrusts in patients with low back pain. Journal of Manipulative and Physiological Therapeutics Ther 2001; 24(8):489-500.
25. Colloca CJ, Keller TS. Electromyographic reflex responses to mechanical force, manually assessed spinal manipulative therapy. Spine 2001; 26(10):1117-24.
26. Wood TG, Colloca CJ, Matthews R. A pilot randomized clinical trial on the relative effect of instrumental versus manual thrust manipulation in the treatment of cervical spine dysfunction. Journal of Manipulative and Physiological Therapeutics 2001; 24(4):260-71.
27. Keller TS, Colloca CJ. Mechanical force spinal manipulation increases trunk muscle strength assessed by electromyography: a comparative clinical trial. Journal of Manipulative and Physiological Therapeutics 2000: 23(9):585-95.
28. Keller TS, Colloca CJ, Fuhr AW. In Vivo Transient Vibration Analysis of the Normal Human Thoracolumbar Spine. Journal of Manipulative and Physiological Therapeutics 2000: 23(8):521-30.
29. Colloca CJ, Keller TS, Gunzburg R, Van de Putte K, Fuhr AW. Neurophysiological response to intraoperative lumbosacral spinal manipulation. Journal of Manipulative and Physiological Therapeutics 2000: 23(7):447-57.
30. Keller TS, Colloca CJ, Fuhr AW. Validation of the force and frequency characteristics of the Activator® Adjusting Instrument: effectiveness as a mechanical impedance measurement tool. Journal of Manipulative and Physiological Therapeutics 1999: 22(2):75-86.
31. Harrison DD, Colloca CJ, Troyanovich SJ, Harrison DE. Torque misuse revisited. Journal of Manipulative and Physiological Therapeutics 1998; 21(9):649-55.
32. Colloca CJ, Fuhr AW. Movements of vertebrae during manipulative thrusts to unembalmed human cadavers [Letter]. Journal of Manipulative and Physiological Therapeutics 1998; 21(2):128-9.
33. Colloca CJ, Fuhr AW. Safety in Chiropractic Practice. Part II: Treatment to the upper neck and the rate of cerebrovascular incidents [Letter]. Journal of Manipulative and Physiological Therapeutics 1997; 20(8):567-8.
34. Harrison DD, Colloca CJ, Troyanovich SJ, Harrison DE. Torque: An Appraisal of Misuse of Terminology in Chiropractic Literature and Technique. Journal of Manipulative and Physiological Therapeutics 1996; 19(7):454-62.
The chiropractic analysis taught in the Impulse Adjusting System™ uses the most reliable and valid measures of qualitative analysis required by the Centers for Medicare and Medicaid Services (CMS). Biomechanical responses from the diagnostic qualities of the Impulse iQ® are paired with accepted clinical findings from pain to palpation, asymmetries, range of motion restrictions, and texture and tone changes in the muscles. Such logical and accepted clinical analyses allow chiropractors to practice research-based techniques in their clinical practices that they can be proud of.
To educate chiropractors on this information, Neuromechanical Innovations provides post-graduate educational seminars co-sponsored by New York Chiropractic College in most major cities in America. To educate other health care providers about the benefits of chiropractic care, I participate in 3-4 scientific conferences each year around the globe where my research is presented.
What new features or products are you offering that you would like the profession to know about?
A new LED light bar has been added to the Impulse iQ® to provide the doctor with feedback about the thrust frequency that the spine is moving during the treatment. The lightbar moves from lower frequency red LEDs to yellow or green LEDs as mobility improves from the adjustment in real-time during the treatment. This provides visual feedback to the doctor about the success of the treatment, and conversely, in instances where the light bar does not move, the doctor is informed that no improvement in mobility has been achieved, prompting them to change their vector or line of drive among other alternatives.
Also, this season for the first time we are offering 15 Continuing Education (CE) credits for all of our seminars. The expanded hours provide more hands-on clinical training for our attendees and more credits to fulfill their license renewal obligations.
What type of results are your customers seeing as they utilize your product/service?
Doctors implementing the Impulse iQ® into their practice are reporting better clinical results with their patients, especially in the most difficult cases. Other benefits reported by Impulse iQ doctors include the ability to provide adjustments that are easier on the doctor, that do not hurt the doctor’s hands as well as easier on the patients. Impulse iQ® allows chiropractors to expand the range of patients that they see – from pediatric to geriatric patients and all in between, and to expand the conditions that they can successfully manage – enabling them to care for extremity conditions together with expansion on the spinal problems they manage. Better patient understanding, compliance, and referrals are also a common positive comments received from offices incorporating Impulse iQ®. Unquestionably, this technology allows chiropractors to carve a niche in their community by adding the research-based benefits of Impulse iQ®.
What do you think the future holds for Diagnostic & Testing products/services in chiropractic?
My hope for the future of Diagnostic and Testing products in the chiropractic industry can be summed up in one word: credibility. Medical devices that can be prospectively developed out of research and can pass the vigors of ISO 13485 medical device certification will secure the credibility for the products used by chiropractors. False claims and invalid products and techniques will only serve to continue to undermine the advances made in the industry.
How long have you been offering Diagnostic & Testing Products and Services to chiropractors?
Ten years.
How can your company help chiropractors achieve higher levels of success?
See above.