Featuring the Impulse iQ Instrument

IQ




Health Care for 1.3 Billion.
The Milken Institute Review, Karen Eggleston, 2
nd
Quarter, 2012




Health Care for 1.3 Billion.
The Milken Institute Review, Karen Eggleston, 2
nd
Quarter, 2012

Up until the 1950s, health care in China was of poor quality for
most Chinese and primarily paid by the patient with the more
affluent getting the better care. 50

!"#$% &
uring the !aoist era "1950s#19$0s%, China enacted
go&ernment health policies "the 'ural Cooperati&e !edical
(cheme ) 'C!(% intended to pro&ide
access to basic health care for e&en the poorest citi*ens.
' () $0 *, +, - ./0 +1 ,
2345678
+his ga&e rise to the famous ,barefoot doctors- of the 19.0s
and 19$0s who had minimal training.
9+1:;<=# 678 >? @AB CDE
F
/owe&er this did impro&e the general health of the
Chinese population ) the life e0pectancy went from 10
years at the end of the Communist 'e&olution to ..
years by 1920. GH +1I4JK 78L
M, 3 N O P 10 1920 .0

,3arefoot doctor-




Health Care for 1.3 Billion.
The Milken Institute Review, Karen Eggleston, 2
nd
Quarter, 2012

4ith the onset of eng 5iaoping6s mar7et based economic reforms of the
1920s, the financing and deli&ery of public health care shifted to local
go&ernments
who passed it on down to the patient.
Q RS7TU VWX , YZ @LM +E [\]+
,, ^\]+,_
+he economic reforms &astly increased the incomes of most Chinese
and many were then able to purchase pri&ate health insurance and could afford
topay for more and better quality health care.
VW \X K` ab , `c!d LMe ,
fgh45$`$ &
3ut by 8001, .59 of health care e0penses were still paid by the patients. G
8001 ,.59LM Ei





Health Care for 1.3 Billion.
The Milken Institute Review, Karen Eggleston, 2
nd
Quarter, 2012

:n 8008 the go&ernment attempted to broaden insurance co&erage
to more of the population and created the ;ational Cooperati&e !edical
(cheme ";C!(%.8008 , +,Qjkl m/0 , n e opq
+his had the effect of reducing pri&ate spending to 1.9 "still a much higher
percentage than in many other countries% due to direct subsidies
paid to go&ernment doctors, clinics, and hospitals for citi*ens who bought the
go&ernment#sponsored insurance. +1 E rs 1.9, G
tuv `wx myJ , +, z { |}=
@~
3ut health care deli&ery in the rural areas was still inadequate and<or
unaffordable, so in 800$ the go&ernment introduced the Urban
'esidents6 3asic !edical :nsurance program "U'3!%. G .\ @
Etu" % , h800$ , +, -K 78 e

ue to the ;C!( and U'3! systems, since 8009 959 of the Chinese
population has some sort of health care co&erage. +he current slogan is
,equal access by 8018 and uni&ersal co&erage by 8080.- T +1,
8009 959 cK e . +,3 H =,8018
S=b8080 sqop
>nrollment in these programs is still &oluntary but strongly encouraged by
the go&ernment. 9 -tuHGH+,




Health Care for 1.3 Billion.
The Milken Institute Review, Karen Eggleston, 2
nd
Quarter, 2012

/owe&er the large enrollment in these health care plans encouraged the
use of e0pensi&e, higher#le&el pro&iders.
GH, e 9 +
/ealth care deli&ery is primarily hospital#based managed through the
!inistry of /ealth and this is not cost#efficient.
Hh @ 7 , H
?ttempts to reform the system and reduce costs has placed emphasis
on a shift of care toward non#hospital based primary care to local primary
care pro&iders with the goal of 8 or @ general practitioners for e&ery 10,000
residents.
9 VW r + , & [C
\ ] r . HS9O8 @
+his is being met with resistance since patients ha&e a distrust of the quality
of primary care pro&iders "appro0imately 509 of health care pro&iders6
incomes comes from the sale of high#profit margin drug ) thus Chinese doctors
&astly o&er#prescribe medications%. +1 7 45
^#d," T509 ab TJ , @D`
] %




Health Care for 1.3 Billion.
The Milken Institute Review, Karen Eggleston, 2
nd
Quarter, 2012
+he current goals of the Chinese medical system are=
/0
1. to achie&e uni&ersal health care co&erage, ; Leop
8. strengthen primary care, 78
@. raise clinical quality, and 4J
1. impro&e incenti&es for health care pro&iders to reduce demand on more
e0pensi&e hospital#base care. 4J - , rh 7

Neuro
Neuromehanial
mehanial
!esearh " #e$elo%ment



&hat is it and ho' does it 'or(


&hat is it and ho' does it 'or(

)he Impulse iQ Instrument is*

+Q H

a hand held de$ie, 9 j

eletriall, %o'ered, d

a -... /#0 a%%ro$ed %erussi$e 1thrusting2

de$ie, /#0 X

a de$ie that monitors the mo$ement of the

o34et reei$ing the thrust 3, $irtue of an
aelerometer and om%uter hi% im3edded in the
instrument 1muh li(e a Wii ontroller measures
motion of the %la,er5s hand and transfers the signal
to the om%uter to 3e dis%la,ed on the sreen2.
=aXd T
&++ k :j b hA !
E
+he Wii interacti&e &ideo game=
4ii game controllers=Wii k
4ii +ennis Aame Controller
Bushing a child on a swing=
4hen do you push to achie&e ma0imum oscillationC


&hat is it and ho' does it 'or(

)he Impulse iQ Instrument is*

+Q H

used 3, health are %rofessionals to treat

the human 3od, for $arious musulos(eletal
onditions and in4uries : E
"

to alle$iate %ain and restore funtion.

! #


&hat is it and ho' does it 'or(

)he Impulse iQ Instrument is* +Q

H

a%%lied to s%inal and e6tremit, 4oints and

musles for the %ur%ose of %roduing an
osillating mo$ement of the 3ones
om%rising the su3lu6ated 1in4ured2 4oint7
T # :; $ % $ $
@

a de$ie that %rodues a thrusting fore

that reates neuro%h,siologial effets in
and around the 4oint 3eing mo$ed. EXd
A w @ @ $


&hat is it and ho' does it 'or(

)he aelerometer in the Impulse iQ

Instrument* +Q

measures the mo$ement 1osillation2 of

the 3one that it has a%%lied the fore 1thrust2
to, Xd $

sends this information to the om%uter

hi% 'hih is %rogrammed to ma(e the
instrument thrust again 'hen the 3one has
om%eted an osillation ,le. (9 $
; g:
EXd


&hat is it and ho' does it 'or(

the neuro%h,siologial effets %rodued

3, the osillation 1mo$ement2 of the 3one
allo' the 4oint to mo$e freel,, orretl,, and
normall,. @ @ : ~ $ $
~D
)he Impulse iQ is rigorousl, tested*
&hat is a su3lu6ation*

.u3lu6ation 8 4oint d,sfuntion 'ith h,%omo3ilit,7
fi6ation7 3lo(age7 loss of 4oint %la,.
9 h !- % $
0n error of mo$ement is %resent that ma, or ma, not
3e assoiated 'ith misalignment.
s/ g! fg! $ $ $
Dernon E !ro*e7, ,? re&ised definition of manipulation,- F!B+, 8005=82
&hat is a su3lu6ation*

.u3lu6ation 8 a 4oint 'ith im%aired mo3ilit, 'ith or
'ithout %ositional alteration.
0 funtional entit, in$ol$ing restrited $erte3ral
mo$ement.
+t is the restrition of mo$ement 'hih res%onds to
thrust %roedures.
% $
9 k !
H Xd9 k &
Aatterman, Foundations of Chiropractic Subluxations, 8005, >lse&ier
&hat is a su3lu6ation*


)he result of trauma or umulati$e mirotrauma that
ause su3failure in4ur, in %assi$e restraints inluding
ligaments, 4oint a%sules, and diss, resulting in
damage to the mehanoree%tors 'ithin these tissues
A ~ A k gh $
# '
BanGabi, ,? hypothesis of chronic bac7 painH ligament subfailure inGuries lead
to muscle control dysfunction,- European Spine Journal, 800.=15
&hat is a su3lu6ation*


,amage to the mechanoreceptors results in partial
deafferentation.- # g( b (
,+his leads to loss of spatial and temporal integrity of
recei&ed transducer signals from mechanoreceptors in the
damaged ligament or Goint capsule.- A# $
#a -
BanGabi, ,? hypothesis of chronic bac7 painH ligament subfailure inGuries lead to
muscle control dysfunction,- European Spine Journal, 800.=15
&hat is a su3lu6ation*


+hese changes can set up an inflammatory cascade
producing inflammation of spinal tissues abundant in
nociceptors, resulting in chronic pain, recurrences,
disturbed 7inematics, and reduced functional capacity.
V ghA # @
) -
!

+eyhen et al, ,Fluoroscopic &ideo to identify aberrant lumbar motion, Spine,
800$=@8
amaged mechanoreceptors=
isc
Iigament
Foint
capsule
$
!uscle
(7in )
3rain

(pinal cord
?ffarent ner&es b
>fferent ner&es E
# '
Cer&ical Jygapophyseal Foint Bain 'eferral Batterns*
[ $

Ho' the Impulse iQ 'as de$elo%ed*

+Q H


8000
+o determine whether !F!? spinal manipulati&e therapy affects muscle
strength=
h l * !F!? X H d
Ho' 'as it de$elo%ed* H &


2000
Isometric Trunk Extension
+
Pre- vs Post Adjustment sEMG
EMG
9:
93
92
91
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1
2
3
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0 ; 10 1; 20 2; 30
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)ime 1.eonds2
?;9! 1@re90d42
?;9! 1@ost90d42
Methods

To quantify in vivo vertebral
motions and neuro-
hysiolo!ical resonses
durin! sinal maniulation"
=#
@
Materials
Protocol #
]#
$erve %oot Electrodes

&one Mov't
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EMG (
EMG #
EMG )
EMG *
+, $erve %oot

%, $erve %oot

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milliseconds
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&el!ium (---. $eurohysiolo!ical %esonses to /MT
v (--- /MT @
To quantify in vivo sinal motions
and coulin! atterns"
/ ,

Patient 00) 00)

AAI 12 re-load control frame
3 inut force
3 acceleration resonse
AAI 12 k-
3 bd
3
MRL MRL
4ual Three-Axis Accelerometers
.
(, +)
#, +*
&iomechanical %esonses
@d /
&iomechanical %esonses
@d ]q /
/in!le /tylus

4ual /tylus
.
4ual /tylus rovides increased neuromuscular
resonses and u to )x !reater PA dislacement
45$` J . ) "
PA [
!otion ma0imi*ed
/untionalit,
+m%ulse iQ
A
0d4usting +nstrument
0udi3le +ndiators
#ou3le Bee% #ou3le Bee% No Bee% No Bee%
?cceleration
;ot Ket
!a0imi*ed
;o Change
:n ?cceleration
'esponse
?cceleration
'esponse
!a0imi*ed
.ingle Bee% .ingle Bee%
+m%ulse iQ
A
0d4usting +nstrument
0udi3le +ndiators "
Clinial #eision <a(ing
(ignificant :mpro&ement in at Ieast 8
Components of B?'+ ocumentation in
'e#?ssessment of Clinical :ndicators
?cceleration
'esponse
!a0imi*ed
.ingle Bee% .ingle Bee%
Kes ;o
'e#?ssess Clinical :ndicators
?dGustment of Ie&el or
?rea (uccessful
?dGustment of Ie&el or
?rea ;ot (uccessful
+m%ulse iQ
A
0d4usting +nstrument
0udi3le +ndiators "
Clinial #eision <a(ing
(ignificant :mpro&ement in at Ieast 8
Components of B?'+ ocumentation in
'e#?ssessment of Clinical :ndicators
@. +hrusts
?cceleration
'esponse ;ot Ket
!a0imi*ed
#ou3le Bee% #ou3le Bee%
Kes ;o
'e#?ssess Clinical :ndicators
?dGustment of Ie&el or
?rea (uccessful
?dGustment of Ie&el or
?rea ;ot (uccessful
L :nsure Contact was Correct with
Consistent Breload +hroughout ?dGustment
+m%ulse iQ
A
0d4usting +nstrument
0udi3le +ndiators "
Clinial #eision <a(ing
r # $ V% 0
@. Xd
c6 1
. .
Kes ;o
'e#?ssess Clinical :ndicators
(

L e = d * 2 *
&l
+m%ulse iQ
A
0d4usting +nstrument
0udi3le +ndiators "
Clinial #eision <a(ing
(ignificant :mpro&ement in at Ieast 8
Components of B?'+ ocumentation in
'e#?ssessment of Clinical :ndicators
;o (ignificant
:mpro&ement
in ?cceleration
'esponse
No Bee% No Bee%
Kes ;o
'e#?ssess Clinical :ndicators
?dGustment of Ie&el or
?rea (uccessful
?dGustment of Ie&el or
?rea ;ot (uccessful
L :nsure (egmental Contact Boint was Correct
L :nsure Iine of ri&e 4as Correct
L Consider that ?rea !ay ;ot Change

+ests and procedures to determine where
to apply the manipulation<oscillation=
)he .aroilia and Hi% 4oints