Sham Treatment
The sham treatment protocol, developed by the investigative
team, is composed of two parts. The first part
includes three light effleurage strokes, or patterns,
applied with no greater than 30 N of pressure [78].
First, the basic heart shaped stroke is performed three
times, followed by three “L” shaped strokes on each side
of the thoracic and lumbar areas. Three to four tree
strokes follow, ending with heart shaped strokes. The
procedure spans three minutes +/- 15 seconds. The second
part of the sham protocol includes the use of an
Activator IV device. An Activator IV (Activator Methods
International, Ltd, Phoenix, AZ) is a handheld
spring-loaded mechanical device used to deliver a highvelocity
low-amplitude thrust and is commonly used
within the chiropractic profession. For use as a sham
treatment, a plastic or rubber guard is placed on the
Activator tip rendering it incapable of producing a
thrust. As is common in conjunction with the use of
this device, the clinician evaluates the lumbo-pelvic
region by lightly palpating the iliac crest and lower lumbar
vertebrae and also examines the length of the participant’s
legs by gently pushing their feet together. The
clinician then places their thumb on a lumbar spinous
process and again in the sacroiliac region while simultaneously
triggering the Activator so that a “click” is
heard. Though incapable of producing a thrust, the
device still produces the same sound.