Deliver an adjustment

In Adjust, PulStar delivers a series of impulses through the impulse head at the force and mode you choose, and shows how the stiffness changes as you treat. (If your practice uses the term “Mobilize”, the screen shows that instead.)

Important: Use the lowest force that gets the result you want. Start low on every patient and increase gradually. Take extra care in the cervical spine, and avoid high forces on children and older patients.

Choose vertebrae to treat

After the analysis, PulStar suggests vertebrae to treat, starting with the most significant red bars. The number suggested is set by Auto Select Vertebra, and their order by Adjustment Order, in Session preferences. The choice is always yours.

To add a vertebra, click its bar on the chart. Vertebrae are listed as the joint being treated, such as C3-C4.
To work on a vertebra, click it in the Selections list.

Set the force and mode

Check the force before every adjustment. The force goes from 5 to 35 in steps of 5. Each spinal region starts at its default force, or at the patient's own force if they have one. A common starting point is 20, just above the analysis force of 15, increasing only if the result you want isn't achieved.

Mode	How it works
Osseous	The default. PulStar sets the rate automatically from the tissue's stiffness, slowing as stiffness drops, and can stop the impulses on its own once the stiffness stops changing.
Specific	Holds a rate you choose, from 2 to 35 impulses per second (Hz), with the Rate control. Consider it for larger patients, or when you have a particular rate in mind.
Myofascial	The rate (30–50 Hz) follows how firmly you press the impulse head. Consider it for larger muscle groups and extremities. Force up to 20.
Point	Sweeps through the rates from 4 to 90 Hz and back. Consider it for trigger points, and for patients who are not obese. Force up to 20.

On the impulse head, double-click the button to switch between Osseous, Point and Myofascial, and press and hold it to step up the force. PulStar announces force and mode changes aloud. The force, mode and rate can't be changed while impulses are being delivered.

Deliver the adjustment

Place the dual prong attachment straddling the spinous process of the joint, using the same line of drive as in the analysis.
Press the impulse head smoothly against the patient until it starts delivering impulses.
Keep the preload steady, in the green range of the gauge, while you watch the stiffness change in the adjustment graph.
Stop when you judge that the adjustment is complete: lift the impulse head off the patient at any time to stop the impulses.

The impulses also stop on their own when:

the vertebra reaches Max Number Of Impulses (100, 150, 200 or 999), or
in Osseous mode, the stiffness stabilizes. Turn on Adjustment Effective Beep to hear when this happens.

Myofascial mode doesn't use Max Number Of Impulses: it continues until you lift the impulse head, up to 999 impulses.

The screen shows the impulses delivered to the current vertebra and the total for the session.

Move to the next vertebra

PulStar doesn't move on by itself; you decide when each vertebra is done. You can treat a vertebra as many times as you need. When you're ready:

Click the button on the impulse head to go to the next vertebra in the list. Clicking also skips a vertebra you decide not to treat.
Or click the next vertebra in the Selections list on the screen.

After the last vertebra, the next click of the button moves to the post-analysis.

Avoid overheating the impulse head

The impulse head is designed for 2,000 impulses within 5 minutes, followed by 2 minutes resting in its holder, where a fan cools it. PulStar changes the color of the impulse count for about 2 minutes after every 2,000 impulses as a reminder. If the back of the impulse head is too hot to hold comfortably, put it in the holder until it cools; overheating can damage the force sensor.

Treat soft tissue and extremities

Click Soft Tissue in the Selections list and choose a location, such as Trapezius or Knee.
Choose the side: L (left), R (right) or B (bilateral).

Soft tissue uses its own default force. Edit the list of locations in Advanced preferences. Don't use PulStar on the soft tissues listed in Safety and contraindications.