FUNCTIONAL NEUROREHABILITATION

Yes. People develop neurological symptoms when their fragile pathways and systems are pushed beyond their functional capacity and into fatigue or failure. Our neurodiagnostic testing reveals indicators that can objectively show us exactly when your system starts to fatigue. These can be autonomic measures such as changes in heart rate or pupil dilation, or something like a change in an eye movement. We can usually see these changes well before you start to notice them yourself, and can modify or stop an exercise before you get pushed into fatigue. 

No. This approach is far more precise, effective, and safe than pushing someone through an exercise until they fail. Those strategies may work for physical exercise, but are often the exact opposite of what is needed for functional neurorehabilitation. Many therapists take the approach that you may need to get worse in order to get better, and push people past their fatigue threshold and into symptoms. By monitoring your fatigue threshold and stopping your exercises before we reach it, we can avoid making you symptomatic and get a better therapeutic outcome.

We instead believe that if we are provoking your symptoms, we are either doing something wrong, or are doing the right thing at the wrong intensity. We immediately stop or change your therapies whenever they provoke any symptoms.

Our exercises and therapies are determined by your specific findings from your examination and diagnostic testing. Depending on what we find, your therapies may involve specific types of eye and head movements, balancing exercises, tilt table therapies, physical exercises, and so on. When we identify a pathway or system that needs help, we create a particular exercise that targets that system. We base the intensity and number of reps on your diagnostics to keep you within a safe therapy range at all times.

The NeuroRescue Program uses a three-phased approach to functional neurorehabilitation. In phase one, we use our examination and neurodiagnostics to identify fragile pathways or systems. We then we look for ways to stimulate that pathway using different types of sensory inputs. Rather that diving straight into exercising the fragile pathway, we will often use some form of targeted electrical stimulus, laser or LED therapy, or proprioceptive stimulation with passive movements to stimulate the pathway. These other inputs can help us gently and safely build up function in the damaged system, and increase endurance before we even begin with exercises. We may include supplemental or hyperbaric oxygen to further improve pathway endurance. This makes our exercises safer, more effective, and less likely to provoke symptoms. Only then do we begin to exercise the involved pathways. And as you improve, we may incorporate these other types of stimulation at the same time as you perform your exercises. 

Phase two involves neurological integration. Once we get your involved systems working again, our goals shift towards getting them working well together again with other systems. Your ability to function in the world depends on the integration between all of your different neurological systems. Neurological problems inevitably lead to failure of system integration. As early as possible, we begin to integrate your damaged pathways with other neurological systems. When you begin to master your eye exercises, we incorporate them with balance challenges. When you begin to master your cognitive exercises, we create challenging sensory environments to make them more challenging. As you continue to make progress, we layer in more systems to integrate, until we have everything working together as well as possible.

Phase three involves translating your improved function into real world activities. Once neurological function has been reestablished, we need to make things work again in the context of your daily life. We modify your exercises and therapies to help you use them in the real world, and show you how to make normal activities become neurotherapeutic. This can everything from rearranging your desk to provide better stimulation for your brain, to going shopping in our virtual reality grocery store, to hitting the basketball court with us and training a head and eye movement to improve your three-point game.

Functional Neurorehabilitation relies on the principle of neuroplasticity to make changes. Neuroplasticity is the ability of neural networks in the brain to change through growth and reorganization. These changes range from improving protein replication within a neuron, to individual neuron pathways making new connections, to systematic adjustments like cortical remapping.

The brain changes based on experience, and in particular, based on sensory experience. Your brain is a sensory-driven system, and relies on input from all of your senses to develop and adapt through life. As your neurons and pathways receive different types of stimulation, they can improve their endurance, become easier to stimulate and slower to fatigue, and grow new connections between neurons and pathways. Your brain is constantly reorganizing and adapting to inputs from the environment. Every form of therapy in your NeuroRescue Program takes advantage of neuroplasticity to create functional changes.

All neurons need three things to survive: oxygen, glucose, and activation. Oxygen and glucose are required to produce energy to drive cellular functions. Activation is needed to maintain protein replication within the neuron. When a neuron is stimulated by another neuron, neurotransmitters are released from the first neuron, and these bind to receptors on the receiving cell. These lead to chemical changes that create a receptor potential, which can cause the second neuron’s membrane electrical charge to become more positive. When this electrical positivity rises to reach the neuron’s activation threshold, it fires a pulse of electricity down its axon called an action potential. The axon connects with other neurons, and the action potential causes it to release neurotransmitters that stimulate other cells.

Every central neuron has thousands of other neurons that converge upon it, and they are all simultaneously firing neurotransmitters onto the cell’s receptors. Some of these are excitatory, which try to bring it to threshold, and some are inhibitory, which make it harder to fire. When the neuron is repetitively stimulated, it will begin to activate NMDA receptors. These ultimately turn on genetic mechanisms that cause the neuron to start producing more of the metabolic machinery necessary for it to sustain high firing rates. This will also lead to the neuron increasing connectivity with other neurons in the same pathway, and even the development of new connections between neurons and pathways. 

We determine which pathways are struggling through your neurological examination and neurodiagnostic testing, then create your unique NeuroRescue Program to stimulate neuroplasticity within the identified systems. We pay close attention to neurological fatigue to make sure you are only taking steps forward and no steps back. We take you through all three phases of functional neurorehabilitation, building neuroplasticity at every step in the process. This gives us our best opportunity to assist you on your path back to living your best life.

No.