Review the results, often with the patient, to confirm that the desired result was achieved.
Choosing sites to treat
PulStar shows the readings along the spine as bars normalized to their average. This works like an instrumented version of manual palpation, where you automatically allow for the differences between, say, a small child and a robust adult, and focus on what stands out.
Stiffness normally changes smoothly from one vertebra to the next. A large difference may come from joint fixation, such as:
muscular fixation, where muscle spasm or hypertonicity restricts the joint;
ligamentous fixation, from shortened or thickened ligaments;
osseous fixation, from ankylosis, congenital deformity or surgical fusion.
Because the instrument's measurement error is about 5–7%, a joint whose stiffness is 15–20% more or less than its neighbor is treated as fixated. If those sites agree with your other findings, such as X-rays, palpation, tenderness and swelling, choose them for treatment.
Treating
Use the same dual prong attachment and line of drive as in the analysis. Set the force just above the analysis force (for example 20, with an analysis force of 15), and increase it only if you don't get the result you want.
The goals are to:
Change the local stiffness. Where a site is stiffer than its neighbors, lower it. Where it reads softer, often because muscle tension is absorbing the impulse, relax the muscles, which raises the reading.
Reduce the overall variation along the spine. At first visits, readings often look disorganized (the chaotic stage). Over several visits they become less chaotic (the transition stage), until only one or two sites stand out (the organized stage).
Watch the stiffness in the adjustment graph as you treat. You end the treatment of each site, by lifting the impulse head, or the impulses stop when they reach the maximum you set or when the stiffness stabilizes in Osseous mode.
Be conservative
New users often over-treat, adjusting sites found in the post-analysis as well as the original ones. If the first treatment produces the changes you wanted, it's usually better to wait until the next visit, so that the patient can adjust to the treatment. The pre-analysis at the next visit is a better guide than the immediate post-analysis. Over-treating can also overheat the impulse head.
References
Leach RA, Parker PL, Veal PS. PulStar differential compliance spinal instrument: a randomized inter-examiner and intra-examiner reliability study. J Manipulative Physiol Ther. 2003;26(8):493–501.
Evans JM, Hill CR, Leach RA, Collins DL. The minimum energy hypothesis: a unified model of fixation resolution. J Manipulative Physiol Ther. 2002;25(2):105–110.
Evans JM. Differential compliance measured by the function recording and analysis system in the assessment of vertebral subluxation. J Vertebral Subluxation Res. 1998;2(1).