Essential to our comprehensive approach to chiropractic is the remarkable Insight Subluxation Station technology, which has been awarded certification as Space-Certified technology by NASA. With it, we are able to establish a reliable and scientifically valid representation of each patient’s condition – something never before possible. The insight this provides is significant on many levels. It enables us to analyze each patient’s condition on a whole new level. This incredible technology is able to detect problems that are not measurable by the doctor alone. It is so sensitive that it can even detect problems before they are painful. It also enables us to accurately track the effectiveness of treatment and allows us to communicate your findings more effectively.
It all starts with an understanding of the technologies that comprise the Insight Subluxation Station. So we invite you now to take a look at these technologies, as well as our unique NeuroSpinal Function Index. Then continue to explore all the other elements of our unique approach. The more you know, the more confidence you will have to join us in our mission to improve your health and YOUR QUALITY OF LIFE!
Five Technologies. Unlimited Potential
The Insight Subluxation Station™ Discovery model is a 5-technology unit that provides a comprehensive picture of your patient’s neurospinal health. The tests are painless, non-invasive, scientifically sound and easy to understand. Our integrated technology includes:
The results from these sophisticated tests can be used individually, in combination with each other, or all together for a comprehensive, multi-dimensional view of a patient’s overall spinal health known as the NeuroSpinal Function Index (NSFi): a patent pending composite index that takes the five measured components of the Insight and assimilates them into a single, easy to understand number that gives us a single number that reflects the overall impression of each patient’s neurospinal health.
1 Pattern View
This graph is the Insight’s sEMG “Pattern View”. This analysis is a unique, patent pending sEMG application that only the Insight provides. Of primary importance to the chiropractor is the way muscle energy is being distributed throughout the spine. Patterns can demonstrate ‘efficiency’ or they can exhibit lack thereof. Think of it sort of as the motor systems ‘miles per gallon’ rating. A person’s somatotype or age may affect sEMG amplitude signals. But with the Insight’s breakthrough pattern view, clinical impressions will not be skewed due to these factors. Colors and the shape of the lines serve as visual cues to easily assess the results.
2 Symmetry Graph
This scan of a patient’s muscle asymmetry depicts the amount of muscle pull from one side to another. Normal is marked by white spikes or no spikes at all. The same colors are used here – green, blue and red for mild, moderate and severe levels of muscle asymmetry respectively.
3 Amplitude Graph
The patient’s sEMG scan is compared to normal. We are viewing the amplitude (amount of tension) of paraspinal muscle activity, along with hyper- or hypo-tonicity as it compares to a normal population. Green bars indicate one standard deviation over normal, or mild elevation. Blue bars indicate moderate elevation and Red bars indicate severe elevation. Yellow indicates one standard deviation below normal.
4 Dynamic Graph
The Dynamic EMG Scan can track up to four channels of muscle activity while the patient moves through various ranges of motion. The Insight ‘event marker’ feature assists interpretation by marking the position of the patient during the test. This graph is accompanied by a dynamic narrative report.
5 Quantifications Report
The Quantifications Report Graph documents each patient’s progress.
6 sEMG – an accepted technology for clinical use
According to other sEMG manufacturers who market to the medical profession, the following medical specialties have utilized surface EMG since the late 1980’s:
- Urologists for diagnosis and treatment of urinary incontinence
- Orthopedists for muscle rehab and training
- Physiologists for anxiety, tension/migraine headaches, rehab
- General practitioners for circulation problems, anxiety, desensitization, distonia [muscle tonus], incontinence, spasms, relaxation, psychosomatic symptoms
- Family practitioners for circulation problems, anxiety, desensitization, distonia [muscle tonus], incontinence, spasms, relaxation, psychosomatic symptoms
- Neurologists for anxiety, muscle training and rehab, spasms
- Speech pathologists for anxiety, relaxation
- Sports Medicine for muscle training and rehab
- Corporate Medicine for muscle training and rehab
- Psychiatrists and psychologists for anxiety, desensitization, psychosomatic symptoms, tortocollis, writer’s cramp, phobias
- Rehab centers for muscle training, relaxation, spasms, and urinary incontinence
- Occupational therapists for muscle training/rehab, relaxation, migraine headaches
- Dentists for TMJ, anxiety, tension/migraine headaches
Go to www.bio-medical.com to see how sEMG is currently being used by physical therapists, physiatrists, massage therapists, and RNs.
7 Independent Studies
Christopher Kent, DC, FCCI, JD, CLA Co-Founder and Research Director, and one of the chiropractic profession’s leading researchers, sums up the issue on reliability of sEMG: “Studies spanning decades consistently report high levels of reliability. Quite simply, no other procedure I am aware of in chiropractic, except measurements on x-rays, approach the reliability of sEMG. Studies from the Mayo Clinic to the NZ Chiropractic College have demonstrated this. NONE OF THESE STUDIES WERE PERFORMED OR FUNDED BY CLA.”
Price, Clare, Ewerhardt (1) observed that surface electrode paraspinal electromyography has been employed since 1948 to measure muscular activity.
Cobb et al (2) concluded that “…muscle spasm (even when mild) is accompanied by muscular hyperactivity which can be evaluated by suitable electromyographic techniques. Our data suggest that surface electrodes allow better sampling than Teflon coated needles…” and that “…integration procedures (surface EMG) allow better quantification than does the visual evaluation of a (needle) EMG…”
Surface electrode electromyography with attached electrodes exhibits very good to excellent test-retest reliability. Reliability is a measure of the ability to reproduce a measurement, which is expressed as a coefficient ranging from 0.00 to 1.00. Perfect reliability results in a coefficient of 1.00, while chance agreement would be 0.0. As presented below, research data indicates that the reliability of sEMG is clearly superior to palpation for muscle tension.
Spector (3) reported a surface EMG study performed at New York Chiropractic College which yielded correlation coefficients ranging from 0.73 and 0.97.
Komi and Buskirk (4) compared the test-retest reliability of surface electrodes vs. needle electrodes in the deltoid muscle. The test-retest reliability for surface electrodes was 0.88 compared to 0.62 for inserted electrodes.
Giroux and Lamontagne (5) compared the reliability of surface vs. intramuscular wire EMG of the trapezius and deltoid muscles during isometric and dynamic contractions. The statistical analysis on the integrated EMG was a factorial analysis model with repeated measures. They found that surface EMG was more reliable than inserted wire EMG on day-to-day investigations.
Andersson et al (6) compared the electrical activity in lumbar erector spinae muscles using inserted electrodes and surface electrodes. They found that the standard deviations and coefficients of variation for wire electrodes was greater than those for surface electrodes. They concluded, “Wire electrodes are more sensitive to electrode location and give estimates with less precision than surface electrodes.”
Thompson et al (7) found that the scanning electrode technique correlated well with the “gold standard” of attached electrode technique (The Insight sEMG has both static and attached electrode techniques).
Cram et al (8) evaluated the reliability of surface EMG scanning in 102 subjects in the sitting and standing positions. sEMG scans were performed on three occasions approximately one hour apart on the same day. The median correlation between hand-held and patch electrodes was high, with a correlation coefficient of 0.64. The authors concluded, “With adequate attention given to skin preparation, EMG sensors held in place by hand with a light pressure provide reliable results.”
The Thermal Scan is used to assess the part of your nervous system that helps to control your organs, gloands, and blood vessels, the autonomic system. The instrument does this by precisely measuring differences in temperature along the spine. Since proper function of your organs, glands, and blood vessels is essential to healing and living well, this test gives your doctor a “snapshot” of how this portion of your nervous system is working and how it is responding to care.
The patented Insight™ Thermal Scanner utilizes data published in the Journal of Neurosurgery for normative comparison and reporting.
Better Scan (but not perfect)
Thermal technology has been in clinical use for over a century. The first thermal patent for healthcare use was applied for in 1924, by Dossa Evins. Later that year, B.J. Palmer started utilizing thermal technology to measure patients’ response to care.
Thermography has long been acknowledged in the scientific community as being an accurate and reproducible technology. In fact, there are over 5000 references to thermography onMedline.
The normative study used by the Insight is based on published scientific research done at JohnsHopkins University in 1988, in which a group of neurosurgeons used thermal scanning technology to determine temperature asymmetry protocols and their relationship to sympathetic dysfunction. In the abstract from the article, it states “Thermal values can be used as a standard in assessment of sympathetic nerve function, and the degree of asymmetry is a quantifiable indicator of dysfunction.”
The Insight™ Inclinometer is used to perform accurate spinal range-of-motion (ROM) measurements. There are three market-leading features to the Insight Inclinometer:
 It is three dimensional – meaning you can do rotation with the patient in the upright position!
 It is hands-free which leads to a much faster and more accurate exam.
 It is wireless using Blue Tooth™ technology and has passed all wireless coexistence regulatory requirements. (Other wireless instruments on the market don’t have this level of independent lab testing and federal regulatory compliance.)
ROM measurements are widely employed in chiropractic practice for clinical assessment of spinal dysfunction and impairment rating.
If desired, the Insight™ Inclinometer can use a dual point measurement technique. Readings and reports use the three-trial protocol and reference norms defined in the AMA Guides (1). This enables doctors performing impairment evaluations to obtain fast, accurate, compliant reports. CLA’s Inclinometer adheres to AMA Permanent Impairment’s Range of Motion Protocol for the full spine. Although useful for impairment rating, the AMA norms have been criticized because they do not account for differences in age and gender (2). Another key distinction of the Insight™ is that the software gives you both the AMA norms for impairment rating, as well as other published norms from the medical journal, “Spine,” which are adjusted to age and gender to assist you in clinical decision making (3,4).
1. Guides to the Evaluation of Permanent Impairment. American Medical Association. Chicago, IL.
2. Miller KJ: Range-of-Motion Testing: A Fresh Look . Journalof the American Chiropractic Association. Oct. 2003.
3. Dvorak J, Antinnes JA, Panjabi M, Loustalot D: Age and Gender Related Normal Motion of the Cervical Spine. Spine 17:10S 393-398, 1992.
4. McGregor AH, McCarthy ID, Hughes, SP: Motion Characteristics of the Lumbar Spine in the Normal Population. Spine 20:22 2421-2428, 1995
The Pulse Wave Profiler helps the doctor to determine your overall ability to adapt to stress. It does this by looking at the timing of your pulse, and determining the balance and tone of your nervous system. This exam is known as heart rate variability. Proper balance and tone are associated with better adaptability and a healthy lifestyle. Low heart rate variability is associated with aging and poor heart health. Published research has shown that chiropractic adjustments have a beneficial effect on heart rate variability.
The Insight PWP allows you to monitor the autonomic nervous system in new ways by collecting Heart Rate Variability (HRV) data. This is a unique, extremely exciting, and powerful tool for the chiropractor. Heart Rate Variability is the beat-to-beat variation in heart rate. This natural rise and fall of heart rate is caused by several physiologic phenomena, including breathing and autonomic nervous system activity. Healthcare professionals utilize HRV for a wide variety of clinical applications. Chiropractors use HRV to get a window into how the autonomic nervous system (ANS) modulates heart rate in the baseline or resting state. Published research has demonstrated that chiropractic adjustments have favorable effects on HRV parameters. For the first time, instead of measuring parameters on or around the spine, we are able to directly measure the effect of chiropractic care on the function of a vital organ. This significant “proof point” catalyzes a patient’s understanding of the whole body health benefits of chiropractic care.
What information is Gathered During the PWP Scan?
Frequency Domain Analysis – This view is very useful for client education and for interpreting the results of the HRV analysis. It shows parasympathetic vs. sympathetic response in the autonomic nervous system. In a balanced system both branches of the ANS are in the normal range, as shown by the location of the green square in the center box. The section in which the square appears indicates whether the system is balanced or whether one response is dominant for a particular client.
The Instantaneous Heart Rate (IHR) – This view shows the actual heart rate over the entire data collection period. As you can see from this graph, the average heart rate over this period is around 67, but the actual values range from less than 55 to over 85 – this variability is exactly what we are measuring with this protocol. The blue line at the bottom indicates the SCR (Skin Conductance Response) values. In this scan, the SCR remains under the black line (threshold), indicating that there was no unexpected “spike” in nervous system arousal.
If there was tenderness felt along your spine or if you were suffering from pain when you consulted the doctor, and Algometry (pain mapping) exam will be performed to produce a comprehensive map of the pattern of pain along your spine. This test measures the sensitivity of various locations to pressure.
The Algometer enables doctors to obtain accurate information concerning the sensory portion of the nervous system by mapping pressure/pain sensitivity along the spine. The doctor applies pressure to tender areas; the Pressure Pain Threshold (PPT) is determined by the amount of force required for the patient to first perceive discomfort. Previously subjective perceptions can now be accurately measured, mapped and graphically displayed to assess progress throughout a course of care.