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The central feature of the Activator Method protocol is what?

Leg Length Analysis (LLA)


Leg Length Analysis (LLA) is a series of repeated systematic measure of what two things?

prone extended and flexed leg length Inequality (LLI)


The leg length analysis id's neuroarticular dysfunction ____ and ___ even when a pt suffers from atypical or no symptoms.

confidently and consistently


What info is found by measuring LLI?

isolate neuroarticular dysfunction
direction of misalignment
confirm direction of ADJ and post-ADJ assessment


What key point is determined from leg length analysis?

where to adj
when to adj
when not to adj


Research and clinical experience docs have a good to very good intra-examiner reliability when evaluating what structure?

Pelvic Deficiency PD or Leg Length Inequality LLI


A functional short leg is designated as what?

Pelvic Deficient (PD leg) AKA Reactive leg


What are anatomical changes seen on a short leg?

unleveled pelvis
shipped patella
flatten arch
excessive pronation


True or False: Proper footwear should have a back/strap good for toe gripping, tight fit, not badly warn.



Tilt table preserves and enhances what postural distortions and compensations?

width: supports arms
bolster under ankle relax knee
face slot: commodities short/tall leave ankles proper position


What is the name of the activator table?

Lloyd Activator Hylo


Describe the doctors stance.

at the foot of the table in stance that permits a clear line of sigh to plantar surfaces of pt's feet
one foot forward in-line or scissor stance
Upright posture


Look don't touch: what are you looking for?

Asymmetry, inversion or eversion, excessive toe-out or toe-in flare


What is the next step after "look don't tough"?

bring legs together


In most cases what info is noticed by visual inspection?

Pelvic Deficient (PD) or Reactive, Leg


How do you perform the "six-point landing"?

1. place hands in 6 point landing
2. remove inversion( supination)/eversion (pronation)
3. gentle dorsiflex feet
4. flare feet 10º
5. apply gentle headward pressure


Feet in 6 point landing, look at __

heels, observe/measure PD (pelvic deficient) leg


What is position one?

pt prone on the table
6 point landing


The initial short leg is considered what?

PD or reaction leg


Leg check drills

look, don't touch
bring legs together
six-point landing
hands off


What step must be completely done before putting moving to position 2?

Hands off


What are the 4 essential steps of the initial leg check?

1. pt placement
2. visual observations
3. position 1 procedure (id pd leg)
4. position 2 procedure (id starting point for analysis)


Position 2 procedure

1. stand in-line, scissor stance
2 contact dorsal feet at MTP junction w/middle fingers
3. Plantar flex feet until slack is taken up, before lifting legs
4. slow lift legs raise feet flexing knees
5. ~30º of knee flexion, index fingers into welt shoe, position thumbs on soles near ball of each foot
6. Continue to raise until see flexed to no more than 90º
7. site imaginary mid-line (2nd sacral tubercle to EOP)
8. at 90º, Abduct feet to 10º toe-out foot flare


What are you looking for in position 2?

look at shoe welt, heels and measure change in relative length of PD leg


Feet raised in position 2 allows doc to observe what?

PD leg go short or long and determine starting point for activator method (AM) assessment protocol based on change in leg length


What is the proper Activator instrument setting for
a. C1-C
b. C7-C2

a. Activator II 1st ring, IV and V setting 1
b. Activator II 2-3 ring, IV and V setting 2


a. What is the LOD for C0 (posterior occiput)
b. Isolation test for C0
c. What is the LOD for C1

a. anterior, inf nuchal line
b. pt push face into table then relax
c. straight medial: CP lateral aspect of TVP of C1


C1/C2 post-ADJ, isolation test is performed and shows a reactive PD leg in position 1, what is indicated?

both C1 and C2 are involved
Note: Pressure test is performed to confirm.


What is the short/long rule?
C1 longe
C2 short

if the PD leg relatively Lengthens in Position 2, ADJ C1 on the PD side
If the PD leg Shortens in Position 2, ADJ C2 on opposite side


Instruct the pt to slightly TUCK the CHIN toward the chest and then relax. What type of test is this and what area?

Isolation test
Upper cervical C2-C1


What is the contact point and LOD for C2?

pedicle-lamina junction
Anterior, superior and slight medial


The axis-atlas (C2-C1) testing involves a variation of the Short/Long Rule:
a. If PD leg shortens in position 2 proceed to C2 ___
b. If PD leg lengthens in position 2 proceed to C1 __

a. on the opposite PD
b. on the PD side


a. What is the LOD for C5?
b. What is the isolation test for C5?

a. Anterior Superior and slightly medial, CP pedicle-lamina junction
b. pt extend the neck slightly by raising the head from table then relax


a. What is the LOD for C7?
b. What is the isolation test for C7?

a. Anterior, Superior, and slight medial, CP pedicle-lamina junction
b. pt turn the head back to a face-down, neutral position


When testing the upper T-sp, scapulae, the head is turned to what direction?

turned to the side of PD


Adjustment procedures are essentially the same for what segments of the C-spine?

Note: contact point and LOD is all same
CP pedicle-lamina junction on side of involvement
Ant, Sup and slight medial via facet joint plane line at 45º


Testing the C-spine:
a. Verify leg lengths are Even in what position?
b. Have pt perform what test?
c. Use short/long rule in position 2 to determine what?

a. position 1 and Position 2
b. isolation test (use stress test if pt unable to properly perform isolation test)
c. side of involvement


Cervical spine adjustment follows the testing and adjustment of what structure?



What is the proper activator instrument setting for extremities?

Activator II: 3 rings, IV and V setting 2


a. A lateral scapula articular dysfunction is assocated with what test?
b. pt keeps their face in what direction then what?

a. isolation test
b. towards the side of PD then squeezes elbow on the side opposite PD against the body


The lateral scapula contact and LOD is what?

scapula ala - medical
humerus - inferior
proximal ulna - medial/superior
posterior carpals - anterior


Medical scapula articular dysfunction use isolation test. The pt keeps their face turned to side of PD and squeezes elbow on side of PD against the body. What is are the contacts and LOD?

scapula ala - lateral
humerus - superior
proximal radius - anterior/inferior
anterior lunate - posterior


What are the steps to adjust the scapula?

CP lower 3rd scapula ala LOD straight medial
ADJ Humerus: CP proximal 3rd lateral humerus on deltoid muscle LOD inferior
ADJ Ulna: CP anterior proximal head of ulna LOD superior and medial towards olecranon process in a sup to lat direction


What are the steps to adjust the scapula?

1. CP lower 3rd scapula ala LOD straight medial
2. ADJ Humerus: CP proximal 3rd lateral humerus on deltoid muscle LOD inferior
3. ADJ Ulna: CP anterior proximal head of ulna LOD superior and medial Direct the trust in a superior to lateral direction towards olecranon process
4. ADJ Carpals: CP 2 of Posterior distal carpal raw


Describe the scapula isolation test
a. lateral
b. medial
c. why is this performed?

a. pt squeeze opposite elbow of PD against body
b. pt squeeze PD on same side of PD
c. to stress shoulder girdle


A medial scapula is usually found on which side?

PD side
Also: lateral is found on opposite side PD
Note: this deviation pattern usually a trauma is involved


What are the steps to adjusting a Medial Scapula?

1. ADJ Scapula: lower 3rd of ala scapula LOD Straight Lat
2. ADJ Humerus: Lat shaft of humerus, distal to deltoid tubercle LOD Superior
3. ADJ Radius: Posterior head of radius LOD Ant and Inf (swing pt arm up along side of head rest forearm-palm down-on table)
4. ADJ Lunate: Ant (volar) of lunate LOD straight posterior