The Impulse Adjusting Instrument, an electromechanical adjusting instrument, is a powerful option. It is easy to use and is an effective alternative to manual adjusting techniques. Although most people respond well to traditional manual adjustments, there are a number of patients looking for effective techniques which do not require the neck and back to be placed into the rotated posture necessary for the typical chiropractic adjustment. As a result, some patients are not comfortable with the sound often heard during the adjustment.