title: Clinical effectiveness of the activator adjusting instrument in the management of musculoskeletal disorders: a systematic review of the literature.
abstract: OBJECTIVE
  The purpose of this study was to conduct a systematic review of the literature investigating clinical outcomes involving the use of the Activator Adjusting Instrument (AAI) or Activator Methods Chiropractic Technique (AMCT).
  
  
  METHODS
  A literature synthesis was performed on the available research and electronic databases, along with hand-searching of journals and reference tracking for any studies that investigated the AAI in terms of clinical effectiveness. Studies that met the inclusion criteria were evaluated using an instrument that assessed their methodological quality.
  
  
  RESULTS
  Eight articles met the inclusion criteria. Overall, the AAI provided comparable clinically meaningful benefits to patients when compared to high-velocity, low-amplitude (HVLA) manual manipulation or trigger point therapy for patients with acute and chronic spinal pain, temporomandibular joint (TMJ) dysfunction and trigger points of the trapezius muscles.
  
  
  CONCLUSIONS
  This systematic review of 8 clinical trials involving the use of the AAI found reported benefits to patients with a spinal pain and trigger points, although the clinical trials reviewed suffered from many methodological limitations, including small sample size, relatively brief follow-up period and lack of control or sham treatment groups.
authors.affiliation: Professor, Chair of Department of Chiropractic Therapeutics, CMCC, 6100 Leslie St. Toronto, Ontario, M2H 3J1. E-mail:  bgleberzon@cmcc.ca.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Huggins
authors.forename: Ana Luburic
authors.initials: AL
authors.lastname: Boras
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Gleberzon
authors.forename: Mara
authors.initials: M
authors.lastname: Popescu
authors.forename: Lianna A
authors.initials: LA
authors.lastname: Bahry