The Impulse adjusting instrument is a handheld tool made by Neuromechanical Innovations. I use it, along with other methods, when a precise thrust fits the examination. The office serves Ave Maria, Immokalee, and Naples.
What the instrument does
Impulse is electromechanical. The tip delivers a series of very short thrusts at one spot. There is no twisting of the body for this part of the visit. The standard instrument is set near six thrusts a second. The developers chose that rate to line up with an average natural rhythm of the spine, sometimes called a resident frequency. Impulse iQ adds sensors that change the rate during the thrust, using the response from the thrust before it.
Neuromechanical’s science page describes tests that compared the instrument’s readings with accelerometers fixed to the spinous processes. The company reports that matching the thrust rate to that rhythm increased measured bone movement by more than 25 percent in that testing, more than the investigators had expected. That figure is about movement of the bone during the test. It is not a measure of how much pain changed.
Research you can read
The notes below are drawn from the Colloca white-paper collection used in this office. Christopher J. Colloca, DC, developed the Impulse instrument with colleagues, and some of the studies were supported by the company. Open a topic, then select a title. A laboratory measurement, a reading taken during surgery, and a report about one patient do not carry the same weight. None of these notes is a promise about your own visit. The full collection is also available as a PDF .
How the thrust is delivered
2 studies
Six handheld adjusting instruments compared on a force sensor How force and thrust duration change vertebral movement
Motion measured in people
2 studies
Lumbar motion during thrusts in four people already in surgery Low-back stiffness at rest and during a muscle effort
Nerve and muscle signals
2 studies
Nerve-root signals during thrusts in people with lumbar radiculopathy Nerve and muscle signals timed against the thrust
Animal and laboratory studies
4 studies
Three instruments compared on sheep spines One Impulse thrust compared with a short series of thrusts How fast the spine is pushed changes its stiffness Disc injury and nerve signals in a sheep spine
A case report
1 study
Tailbone pain in one patient, treated with an Activator instrument
Other papers in the same collection
7 studies
A mathematical model of a push on the lumbar spine Spinal stiffness compared with disc height on X-ray Posture, spinal curves, and estimated disc load A review of the flexion-relaxation muscle pattern The force profile of a hands-on toggle technique How a forward chest posture changes estimated disc load Seated cervical traction and manipulation in a neck-pain comparison
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A bench test of six instruments
Journal of Manipulative and Physiological Therapeutics, 2005
Six handheld instruments, including spring-loaded Activator models and the electromechanical Impulse, were pressed against a force sensor in the laboratory. Nobody was treated. The electromechanical instruments produced very short thrusts, about 2 to 4 milliseconds, and a wider span of peak force from the low setting to the high setting than the spring-loaded instruments. The paper describes the force each device can deliver. It does not report a change in symptoms.
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Force, duration, and movement in sheep
Clinical Biomechanics, 2006
This was a laboratory study in sheep, not a study of patients. As the posteroanterior force increased, movement of the lumbar vertebra increased in a fairly straight line, and muscle electrical activity rose at the higher forces. Very short thrusts, about 10 milliseconds, moved the bone less than thrusts lasting 100 or 200 milliseconds, while the acceleration response was higher. The authors said those mechanical differences may be part of why clinical results can differ. The study did not measure pain.
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Movement during surgery
Journal of Manipulative and Physiological Therapeutics, 2003
Four people already undergoing lumbar decompression surgery had a sensor pinned to a lumbar spinous process. Short thrusts were applied at different force settings, over the facet joints and over the spinous process. Movement increased as the force increased, and the direction of movement depended on where the tip was placed. The recorded displacements were fractions of a millimeter. This measures motion during surgery. It does not measure whether pain improved afterward.
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Stiffness while the back muscles work
Journal of Manipulative and Physiological Therapeutics, 2004
Thirteen people with low back pain were measured with a handheld impulsive device at L3, first lying at rest and then during a back-muscle effort. The question was how much the working trunk muscles change the stiffness of a posteroanterior push. This is a measurement study. It is not a trial of a course of Impulse care.
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Nerve-root signals during surgery
Journal of Manipulative and Physiological Therapeutics, 2004
Nine people already undergoing lumbar decompression surgery received short thrusts next to a sensor on the vertebra and electrodes at the S1 nerve root. Thrusts at 88 newtons and above moved the vertebra more than a sham thrust. About three quarters of the thrusts produced a nerve-root signal, on average 12 milliseconds after the thrust began. Thrusts over the facet joints created more side-to-side motion. Thrusts over the spinous process created more motion along the spine. The authors said the meaning of those nerve signals for patient care still needed more study.
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Signals that follow the thrust
Journal of Manipulative and Physiological Therapeutics, 2003
Four people already in lumbar surgery were recorded while short thrusts were applied. Vertebral motion, muscle electrical activity, and spinal nerve-root signals lined up in time with the force of the thrust. The delay from the start of the thrust to the nerve or muscle signal ranged from a few milliseconds to a few tens of milliseconds, and the responses differed from person to person. The paper suggests that the small motion between vertebrae may be part of what triggers those signals. It does not report a change in pain.
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Three instruments on sheep spines
Journal of Manipulative and Physiological Therapeutics, 2006
This was a laboratory study in six sheep, not a study of patients. Sensors were pinned to L1 and L2, and three instruments, including the Impulse and a spring-loaded Activator IV, delivered thrusts to T12 at low, medium, and high settings. At the high setting, the Impulse produced larger acceleration and displacement than the spring-loaded instruments. The two authors who developed the Impulse instrument did this work, and it was funded in part by the company. A finding in animals is a reason for more research. It is not the same as a result in a person.
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One thrust and a short series
Chiropractic & Osteopathy, 2006
This was a laboratory study in fifteen sheep. An Impulse instrument delivered one thrust and then a series of twelve more thrusts over about 2.5 seconds, at three force settings, to T12. Vertebral acceleration followed the size of the force. The study compared the first thrust with the later thrusts in that series. It did not treat patients, and it did not measure pain.
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Stiffness depends on the rate of the push
Journal of Biomechanics, 2007
This was a laboratory study in sheep. A motor pushed on L3 at several speeds. The stiffness of the spine, force divided by movement, changed about 3.7-fold across the frequencies that were tested. The lowest stiffness in the resting trial was near 4 hertz. The finding is about how the spine resists a push at different speeds. It is one reason the developers talk about matching a thrust rate to the spine. It is not a trial of symptom change.
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A disc injury model in sheep
Journal of Electromyography and Kinesiology, 2008
This was a laboratory study in sheep. Some animals had a surgical cut made in a lumbar disc to model disc injury. Others did not. The researchers then pushed on the spine and recorded nerve and muscle signals. The question was whether a damaged disc changes those signals. It was not a study of patients.
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One patient’s tailbone pain
Journal of Manipulative and Physiological Therapeutics, 1999
This report describes one 29-year-old woman with tailbone pain for three weeks after moving heavy boxes. Sitting and standing up from a chair were painful. She was treated with the Activator II instrument, not with the Impulse. A report about one person can show what happened in that case. It cannot show that the same result will happen for someone else.
Read it in the collected PDF
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A model of lumbar motion
Journal of Manipulative and Physiological Therapeutics, 2002
This paper is a mathematical model of how the human lumbar spine moves when a posteroanterior force is applied. It is a way to calculate motion from the mechanical properties of the spine. It did not follow a group of patients through care.
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Stiffness and disc height on X-ray
Journal of Manipulative and Physiological Therapeutics, 2003
This study compared a dynamic posteroanterior stiffness measurement with the height of the lumbar discs on plain X-rays. It asks whether the feel of a push lines up with what the film shows. It is not a trial of the Impulse instrument as a treatment.
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Curves and estimated disc load
The Spine Journal, 2005
Lateral full-spine X-rays of 67 young adults without symptoms were used to build a model of disc loads in upright posture. The paper describes the range of thoracic, lumbar, and pelvic curves in that group and estimates how those curves load the discs. Nobody was adjusted for this study.
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A review of a bending muscle pattern
Journal of Manipulative and Physiological Therapeutics, 2005
This paper reviews earlier research on the flexion-relaxation phenomenon, the quieting of the lumbar erector muscles as the trunk bends forward. It is a review of a muscle pattern. It does not test the Impulse instrument.
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A hands-on toggle technique
Journal of Manipulative and Physiological Therapeutics, 2009
This paper measures the force-time profile of the McTimoney toggle-torque-recoil technique, which is a hands-on adjustment, not a thrust from the Impulse instrument. It is in the same collected PDF because the authors studied the force of that method. It does not describe Impulse care.
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A forward chest and estimated disc load
European Spine Journal, 2004
Eighteen adults without back pain had two standing X-rays: one in their usual posture and one with the chest shifted forward. A model estimated the muscle and disc loads. In the forward posture, the calculated extensor-muscle load at L5–S1 rose from about 147 newtons to about 667 newtons, and the compressive load on that disc nearly doubled. Nobody was adjusted. The paper is about posture and estimated load, not about the Impulse instrument.
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Seated traction, not an instrument trial
Journal of Manipulative and Physiological Therapeutics, 2003
This comparison followed people with loss of the forward curve in the neck. One group received seated extension-compression traction plus cervical manipulation. A separate group received no treatment. The traction group reported less neck pain and a larger cervical curve on later X-rays. The untreated group did not. This is a Chiropractic Biophysics traction study. It does not test the Impulse instrument, and the groups were not assigned at random.
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A visit
After the examination, I will tell you whether Impulse adjusting fits what you need.
If you live in Ave Maria, Immokalee, or Naples, call (239) 763-7016 to schedule an appointment.
