By Jeri Anderson, DC and John Maltby, DC
Can you imagine a world where IME’s and insurers no longer control patient care? With US Patent 9,808,172 B2, there’s no need to imagine. The newly patented DynaROM Motion EMG is the Gold Standard per the AMA Medical Text on Range of Motion Assessment and has been named “the lie detector for back pain” by prestigious attorneys for its ability to detect the presence or absence of soft tissue injury.
The DynaROM technology is actually quite simple; it combines wireless dual inclinometry with EKG technology to simultaneously measure range of motion and muscle guarding. It’s commonly known that muscle guarding is the body's natural defense in response to pain in motion; so, when you measure these two together, the results become significantly more sensitive to soft tissue injury and symptom magnification. This is because a significant percentage of the population has normal range of motion yet show muscle guarding and pain. A fitting example is the yoga instructor involved in a rear end MVA: they had excellent range of motion prior to the MVA and won’t be considered abnormal post MVA. When the muscle guarding component is measured alongside ROM, their normal ROM now becomes an abnormal DynaROM, as their muscle guarding is exposed, and injury is clear.
So, is this a valid tool? Absolutely. Its validity was upheld through to the State Supreme Court in Merritt vs DOH. In this landmark case, the State of FL questioned the validity of the DynaROM and requested it be removed from the list of approved diagnostic devices. Mr. Marcarian, inventor of the DynaROM and the only expert witness to testify on behalf of the chiropractic profession, won against the State of Florida, 300 insurance companies, 75 attorneys and 9 expert witnesses. His testimony and exhibits not only led to a victory, but subsequent appeals lead to the Superior Court upholding the decision, and the State Supreme Court rejecting the insurance company appeal. You can download the Judge’s 47-page decision at www.dynarom.com.
The real test of the DynaROM came on March 26, 2018, (King County Superior Court Case # 16-2 29568-1 SEA) where an injured patient was seeking $85,000 in mediation. The insurance company refused to settle at mediation and went straight to jury trial. During this trial, a DC, MD and Mr. Marcarian testified on behalf of the patient. The defense came armed with the most prestigious expert witness in the state, who not only has a reputation for winning, but also maintains a high standard of ethics. With Mr. Marcarian’s testimony last, he demonstrated the DynaROM for the jury and interpreted the patient’s test data. Afterwards, the defense’s expert witness made the unprecedented decision not to rebut Mr. Marcarians testimony, leading to the $958,387.22 jury award 4 days later.
one case, the patient claimed to be in so much pain, they almost did not finish the test, yet there was no muscle guarding to support the complaint.
In the case study below, you can see that when the patient was at MMI, the DynaROM provided the data to justify the patients release, even though she continued to complain of significant pain. When shown her DynaROM results compared to a normal test, it was obvious she was not injured. She responded, “I just don’t want to go back to my job.” The reality check the DynaROM provided this patient was invaluable. Not only did it save taxpayers a significant amount of money in workers compensation payments but helped the patient deal with the real problem; that she hated her job. The doctor received a message 3 months later from this patient stating that she was thankful the test provided her with proof that her injuries were no longer severe, and by dealing with the real problem, she got a new job. Her quality of life improved dramatically. Bigger than this? For the doctor utilizing this tool, it would be impossible to be labelled biased towards the defense or plaintiff - instead, you develop a reputation of maintaining high integrity no matter the situation.
Many doctors are experiencing a new shift. It has been found that by sending DynaROM test results to both the IME and PCP, the referrals from the PCP increased dramatically. The notion that MDs don’t want to refer to chiropractors is no longer applicable. MDs are data driven. When you have a tool that provides solid data, their respect for you and the profession grows. Several doctors are even receiving referrals from orthopedic surgeons for DynaROM evaluations to determine whether a mechanical source of back pain can be treated through chiropractic care before considering potentially harmful, invasive procedures. The introduction of this truly objective data leads to a more efficient, cost-effective solution for both personal injury and workers compensation cases.
The bottom line? A tool that provides the objective proof of subjective complaints is invaluable to all parties. By determining whether a patient’s complaints of pain are real or not, you are able to confidently provide proper care, making you the most credible source of information not only for PI attorneys, but workers comp cases and insurance adjusters as well. The result? Injured patients are properly cared for and those not injured are redirected or removed from the system. With solid, court-proven objective data, we all win.
1. Nederhand MJ, IJzerman MJ, Hermens HJ, Baten CT, Zilvold G. Cervical muscle dysfunction in the chronic whiplash associated disorder grade II (WAD-II). Spine 2000 Aug 1;25(15):1938-43.
2. Sihvonen T, Partanen J, Hänninen O, Soimakallio S. Electric behavior of low back muscles during lumbar pelvic rhythm in low back pain patients and healthy controls. Arch Phys Med Rehabil 1991;72:1080-7.
3. Sihvonen T, Huttunen M, Makkonen M, Airaksinen O. Functional changes in back muscle activity correlate with pain intensity and prediction of low back pain during pregnancy. Arch Phys Med Rehabil 1998;79:1210-2.
4. Geisser, ME, Ranavaya, M, Haig, AJ, Roth, RS, Zucker, R., Ambroz, C, Caruso, M. A meta-analytic review of surface EMG among persons with low back pain and normal, healthy controls. The Journal of Pain, Vol 6, No 11 (November) 2005: pp 711-726.
5. Gerhardt, JJ, Cocchiarella , L & Lea, R.A. The Practical Guide to Range of Motion Assessment, 2009. Published by the American Medical Association.
6. Merritt vs. Florida DOH. Case # 04-1149RX Download case files at https://www.dynarom.com/supreme-court-case.html
7. King County Superior Case # 16-2 29568-1 SEA
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