Jeremy Schmoe DC DACNB FACFN FABBIR Midwest Functional Neurology Center Brain-Gut Autonomic Connection How did my guts end up in my brain!?
Special Thanks Dr. Ryan Cedermark DC DACNB!
A good picture of the complexity we are assessing! 3
THE 7 LONGITUDINAL LEVELS OF NEUROLOGICAL LESIONS 1 2 3 4 5 6 7 End Organ Peripheral Nerve Spinal Cord Brainstem Cerebellum Thalamus/ Basal Ganglia Cortex 4
HOW DO WE EXERCISE THE BRAIN? UTILIZING 6 ReceptorBased APPLICATIONS TASTE 1 4 TOUCH/MOVEMENT SMELL 2 5 HEARING SIGHT 3 6 VESTIBULAR 5
Brain or Strain?
Brain or Strain?
Brain or Strain?
Brain or Strain?
Brain or Strain?
Brain or Strain?
Brain or Strain?
Brain or Strain?
Brain or Strain?
Brain or Strain?
Brain or Strain?
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Systems Approach 1. Does the patient know where her head is in relation to gravitational inputs? What systems are involved with her dizziness? Neck, Visual, Vestibular, Proprioceptive, Autonomic? 2. Do they have stable autonomics? What can we assess? 3. Tonic Vestibular stability and static positional stability before movement. What can we observe? 4. Activation of Vestibular Only Systems: examples of exercises. 5. Passive Vestibular and cerebellar feedback- supine, seated, standing, movement 6. Cervical Spinal Integration: Cervical Feedback with Head Laser training and manual therapy approaches. 7. Address Specific cortical regions and mapping: examples of exercises. 8. Integrate Visual, Vestibular and Proprioceptive 9. Active re integration into gravity: Body based activities. 10. Contextual Training 20
We Utilize advanced diagnostic testing to get a better idea of how your Brain is performing. By combining functional neurology, functional medicine and manual therapies we can help accelerate recovery.! Functional Neurology Examination and Clear Edge Brain Health Baseline Autonomic Assessment and Tilt table Challenge Gait Analysis Motor, Sensory and Reflexes Vestibular and Ocular Assessment Saccadometry Assessment Neuro-Sensory Integrator Auditory/Visual Integration/ Cognitive Dynavision D2 Assessment Neuro-Orthopedic and Structural Assessments Advanced Headache Peripheral Neurogenic Testing Functional Blood Chemistry Analysis
STEP 1: BRAIN INVESTIGATION
ITEMS FROM THIS MORNING CENTRAL PAIN INHIBITORS What does my exam look like? PAG: Vertical eye movements, VOR, Visually mediates eye movements RVM: BREATHING/RIB EVALUATION, EYE HEAD MOVEMENTS PMRF: AUTONOMICS, PINWHEEL, MUSCLE TONE
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QUICK AUTONOMIC TESTS TRY THEM! 1. Tissue Perfusion 2. Pupil Response 3. Red Saturation
Normal Breathing Mechanics Breathing is the LARGEST regulator of body ph ph is one of the determining factors of how much Calcium and Sodium exchange is able to occur. Less breathing = More hyperexcitability Better breathing = More stability Should have 2-3 excursion
ASSESS HEAD-EYE MOVEMENTS Gaze stabilization Pursuits horizontal and vertical VOR reflexes Rule out positional vertigo Saccades and OKN reflexes Combined head and eye movements: examples of manual therapy approaches Cranial Nerve examination: common findings
STEP 2: UNIQUE PLAN IMPLEMENTATION
APPLICATIONS Don t forgot all that you currently know and use about manual cervical therapy. CERVICAL SPINE MANUAL THERPY AND RIB/THORACIC ADJUSTING Clavicle and First Rib adjusting Vestibular Rehabilitation FNOR: prologel application, head-laser rehabilitation Tilt table: dysautonomia, vagal nerve stimulation Labs and functional medicine, laser and visceral manipulation.