The Food
& Drug Administration (FDA) has granted a 510K medical device
designation to an instrument whose sole purpose is designed to correct
the vertebral subluxation. FDA 510K clearance allows for the legal sale
of an instrument and its particular indication of use. The Integrator is
chiropractic's first adjusting instrument to receive an FDA 510K that
has gone through a funded, independent randomized, clinical trial.
Designed
by Dr. Jay M. Holder, the Integrator is manufactured by Moyco/Union Broach, one of the oldest and largest surgical instrument
manufacturers in North America.
According to Lonnie Graybill, vice president of Moyco: "Unlike some
of the other adjusting instruments found on the market, we have followed
federal regulations; protecting ourselves and the chiropractors that use
the Integrator, we're in compliance."
Not only
is the Integrator's FDA clearance exceptional, but more so is its
history.
Originally created from scratch, borrowing nothing from any current
adjusting instrument, the Integrator was designed to reproduce what the
hands of a chiropractor were intended to deliver: recoil, torque and
dynamic thrust. No other instrument in chiropractic has ever had that in
mind.
The
Integrator would never have been invented at all, but for the demands
required to conduct a human population research study designed by Robert
Duncan, Ph.D., of the University of Miami School of Medicine and funded
in part by the Florida Chiropractic Society. A totally new chiropractic
adjusting instrument (the Integrator) and a technique (Torque Release
Technique) were born out of this study by accident and without
intention.
The
purpose of the study - a 1-1/2 year-long randomized clinical trial
with 98 human subjects, blinded and with placebo control - was conducted
to determine the outcomes that subluxation-based chiropractic had in
affecting state of well being (quality of life) in the human population.
The
project, conceived by Dr. Holder, was performed at Exodus, a
residential addiction treatment facility in Miami. According to Holder,
medical director/founder of Exodus, the addicted population best serves
as a proving ground for chiropractic for several reasons:
Chemicals are one of the major causes of subluxations. Twenty- percent
of the American population suffer from addiction. Up to 83% of all crime
is drug-related. The nation's leading cause of death is drug-related.
And the addicted population is identified as suffering from RDS (Reward
Deficiency Syndrome), an inability to express a normal state of well
being or maintain a quality of life equal to the rest of the general
population.
Says
Holder, "The last thing chiropractic needs is another neck or low
back study. Today chiropractic needs studies on human potential, state
of well being and quality of life."
However,
in designing this study, a major hurdle had to be overcome: consistency
and reproducibility in the application of delivering the chiropractic
adjustment and some way to measure its outcome.
To
accomplish this, it was necessary to adjust by instrument. Yet, all
chiropractic adjusting instruments tested were not reproducible when
applied to the patient. A major flaw in the studies and claims attesting
to the reproducibility of adjusting instruments is that they test their
instruments while clamped in devices that fire the instrument against a
measurement device (piezo-electric transducers). Any instrument tested
in this fashion is claimed reproducible.
Unfortunately, instruments held by hand against the skin of the patient
and fired by hand, are not reproducible, concludes Holder. If the
pressure against the tip of any adjusting instrument varies as much as
1/8 of an ounce, the dynamic forces, frequency (Hz), and kinetic energy
characteristics will vary as much as three-hundred percent!
To
guarantee reproducibility, the development of an automatic trip sensor
mechanism had to be made. This would assure that the instrument would
fire when an exact predetermined pressure was reached when placed
against the skin of the patient and at specific line of drive desired.
Further,
this guarantees that a correct and specific frequency (Hertz) is
delivered and now allows for a more stable line of drive, often
sabotaged in instruments that must be squeezed to fire. Since the
purpose of the study was to determine the outcome of traditional
chiropractic, an instrument had to be developed that delivered what the
hands were intended to.
Up to
now, all adjusting instruments provided only axial force. However, the
hands provide, at the option of the chiropractor, two more dimensions:
recoil and torque (right or left), as in the most traditional
application of the chiropractic adjustment, toggle recoil. Torque allows
for a line of drive that remains more stable with deeper penetration and
recoil allows for greater thrust outcome with less force.
"Less is more," according to Holder. B.J. Palmer demonstrated
a nail being hammered into a wood beam. The nail was driven into the
wood after the hammer left the head of the nail, not when it was struck
(recoil). Speed is also a factor, in that force = mass X acceleration.
The Integrator fires at 1/10,000th of a second, making it the fastest
hand held adjusting instrument.
Unlike
other instruments, that use metal caps and weights to mediate or
compensate for their inability to allow the doctor to adjust force, the
Integrator has true force adjustment capability.
In a
rare interview for Drs. Patrick Gentempo and Christopher Kent's "On
Purpose" subscription tape service, Holder discussed the objective
outcome measurements of this study that clearly validated the
effectiveness of both the Integrator and Torque Release Technique.
These
results assessed by Dr. Duncan revealed a retention rate of 100%, a
significant reduction in nursing station visits, an improvement in
depression that four weeks of chiropractic surpassed what normally takes
one year to achieve with standard medical model treatment, and an
improvement in anxiety that four weeks of chiropractic surpassed what
normally takes six months to achieve with the standard medical model.
TRT
is a non-linear vitalistic model and is the first technique in
chiropractic to be born out of randomized clinical trial research first,
instead of the other way around. TRT training takes one weekend (15 hrs.) and doesn't require the use of an instrument.
Dr.
Frank Sovinsky, founder of Chiropractic Mentoring Experience states,
"The Integrator is a remarkable innovation in a hand held
instrument. TRT has opened up a whole new window in which to view the
tonal model of the vertebral subluxation complex." Whether or not
we wish to accept Torque Release Technique and the Integrator, the
research is in.
For more information or to
receive a complimentary copy of the "On
Purpose" audio tape, contact the Holder Research Institute at:
800-490-7714 or 305-535-8803.