Chiropractic Neurology Rehabilitation

This form of rehabilitation is for those conditions which have both a musculoskeletal and functional neurologic component. This treatment is designed to comprehensively address the diagnosis from the root cause, not simply the symptoms. This ensures long term changes and reduces the risk of future injury or re-injury by retraining not only the joint and muscular components but also the central nervous system pathways that control these areas. A combination of the following forms of rehabilitation may be included in your treatment plan, this will be determined by the doctor.

Spinal Decompression Therapy

This form of therapy allows for improved function in the affected region by separating the vertebra (to reduce compression on the intervertebral discs), distracting the facet joints (the joints between two vertebral segments), widening the neural foramen (the region from which the nerve root exits the spine), and stretching very tight muscles that are contributing to the lack of motion. This therapy is used for both chronic and acute cervical and lumbar issues when indicated. 

Common conditions treated with decompression therapy:

• Cervicogenic headaches
• Cervical disc derangement (bulge, herniation)
• Lumbar disc derangement (bulge, hernation)
• Nerve root compression at the neural foramen
• Cervical degenerative joint disease
• Lumbar degenerative joint disease

Neuromuscular Re-education

This form of rehabilitation encompasses a variety of techniques focused on retraining the muscle spindles (the individual components of a muscle). 

It may include:

• Active myofascial release techniques: a form of stretching technique that requires active motion on behalf of the patient
• Proprioceptive neuromuscular facilitation: a form of stretching that combines both passive motion by our chiropractic assistants, in conjunction with isometric muscle contraction on behalf of the patient
• Percussor:  a vibration tool that helps to reduce muscular tension, relax hypertonic muscles, and increase blood flow to the region by activating certain nerve endings in the muscle that respond to vibratory stimulation

Electrical Muscle Stimulation

This is a form of muscle stimulation that utilizes small electrical currents which stimulate the nerve endings in muscle tissue to assist in reducing inflammation, relax hypertonic muscles, increase motion in muscle groups, improve blood flow, reduce pain.  It may also be used to increase strength and tone in atrophied muscles. 

Cold Laser Therapy

Cold laser is a form of treatment that utilizes a particular wavelength of light which is proven to increase mitochondrial activity in cells, thereby accelerating DNA synthesis and reducing inflammation in the injured tissue and expediting the healing process. 

Intersegmental Traction

This is a passive form of therapy which provides increased general spinal motion, promotes proper spinal curvature, relaxes hypertonic muscles.  It is often used in conjunction with spinal manipulation to improve segmental joint motion.

Kinesio Taping

This is a form of tape which provides both stabilizing support and proprioceptive activation in injured tissue to increase signaling from the affected region to the brain which promotes healing and proper muscle and joint motion signaling from the brain.

Balance Board Therapy

This is utilized to promote core stability, as well as increased activation to the cerebellum and vestibular system, the area of our brain that controls balance and coordination (including appropriate muscle tone and postural control in order for us to stand upright).

Strengthening Exercises

During the treatment process you will be instructed in specific exercises that will assist in increasing strength and stability in the affected areas.  These exercises, specific for your condition, will be prescribed by the doctor at an appropriate time during your treatment plan.  These exercises are a very important component to your care and your progress, and you will be expected to follow through with them as prescribed. 

Functional Neurology

By evaluating the brain and nervous system in its entirety, we can localize regions that are dysfunctional and misrepresenting sensory information to the brain. Autonomic dysregulation is often seen in neurological patients and we perform careful evaluation of this potential involvement. Oxygen delivery to the brain is an important aspect of brain rehab and is examined thoroughly. We're essentially looking at your brain from an integration perspective, ensuring all regions are sending appropriate afferent information to the brain, including the vestibular system, proprioceptive system, visuomotor system, autonomic system, and oxygenation system. Our core model of care is multi-modal, ensuring that all potential regions that may contribute to your condition are properly assessed to allow for resolution of symptoms. In order to do this, we must reset the Central Integrated State of the dysfunctional neuronal regions of the brain to reduce their resting membrane potential to an appropriate level that is healhy and approximately -65 mV, reducing hyperexcitablity that can cause many of the patient's symptoms. We attempt to achieve this through a specialized program that combines Neurology, Chiropractic, Physical Therapy, Vestibular Rehabilitation, Occupational Therapy and Oxygen. 

Neurology Core Testing Program:

• Videooculography (VOG, sometimes referred to as VNG) that measure eye movements that relate to specific regions of the brain, brain stem and vestibular system.
• Sensitive balance and coordination testing of proprioception and brain using Computerized Assessments of Posturography Systems (CAPS) that allow us to measure dysfunctional areas sensory input related to Migraine.
• Tilt Table Testing
• Autonomic Assessment
• Clinical Examination (Neurology, Proprioceptive, Respiration)
• Gait analysis
• Oxygen evaluation
• Metabolic capacity
• Objective measures
• Spatial and Temporal Summation (Treatment Plan)

Neurology Core Treatment Program:

• Tilt Table Treatment (TTT)
• Non-Invasive Nerve Stimulation (NINS)
• Vagus Nerve Stimulation (VNS)
• Oculomotor retraining (eye movement exercises) (OMR)
• Vestibular Rehabilitation (VR)
• Occupational Therapy (OT)
• Rib Manipulation (RM)
• Cervicovestibular rehabilitation (CVR)
• Specific Chiropractic Neurological Manipulations for Oxygenation L/S/T (SCNM-O)
• Mild Hyperbaric Oxygen Therapy (mHBOT)
• Postural Restoration (PR)
• Physical Therapy (PT)
• Functional Neurological Rehabilitation/Neuroplasticity Retraining Exercises (FNR/NRE)
• Co-treatment (Botox, Medications, etc..) (CT)
• Migraine dietary recommendations (MDR)

Why so much focus on Neuroplasticity?

Neurons require Activation, Oxygen and Fuel (glucose) to maintain a healthy state of -65 mV and undergo Immediate Early Gene Response to create more cellular contents such as sodium/potassium pumps, mitochondria for ATP formation, axonal and dendritic connections with neighboring cells, etc. The list you saw is how we target the dysfunctional areas with activation, oxygen and carry fuel to those cells. This has to be done in a very graded, careful manner so as to not exceed the metabolic rate of the neurons involved. We observe metabolic capacity for each individual and maintain levels of treatment that stay below those levels so as to keep a steady progression of healthy return to a normal state of function. Neurons respond through Temporal and Spatial Summation, so we can develop treatment plans based on your severity that will allow maximal response and long-term changes. This is known as Neuroplasticity and is at the core of our Concussion Program. I often tell people, I don't know how much I can help you, but in most cases, we're able to improve individuals at least 50% with the understanding that our goal is much higher. Your response depends on multiple factors, including genetics, central sensitization (chronicity), following our treatment plan and so forth. We are very open and honest with our patients and do our best to provide accurate information, but it is a functional issue and it is sometimes difficult to be exacting in our predictions. 

The Portland Chiropractic Neurology approach

Portland Chiropractic Neurology utilizes evidence based treatments in a multi-modal approach, patient centered model that allows individualized diagnosis and treatments by combining Neurology, Hyperbaric Oxygen Medicine (HBOT), Chiropractic, Physical Therapy and Occupational Therapy. It is recommended that evaluation occurs after concussive injuries by a trained professional, such as at PCN. Early intervention is encouraged, but not always necessary. As the leading Chiropractic Neurology office in Maine, the doctors at Portland Chiropractic Neurology (PCN) are highly trained in these areas and have a very successful track record for treatment of Post Concussion Syndrome. Dr. Aaron MacArthur is a Chiropractic Neurologist and has a fellowship in Brain Injury and Rehablitation as well as a fellowship in Vestibular Diagnosis and Rehabilitation. He teaches within the United States on various topics of concussion and migraine care. Dr. Haley Girard is also a Chiropractic Neurologist with extensive training in concussion.