Concussion research has proven that the most effective method to rehabilitate a mTBI is with thoughtful and specific neuraxis rehab strategies performed after a short period of rest (7-10 days). No two mTBIs are the alike, it is for this reason that our concussion rehabilitation program relies on an in-depth neurologic exam to identify components of the neuraxis requiring attention and which components can be used therapeutically to generate plasticity.
In order to accurately asses the severity of the mTBI, thorough testing is required in the following domains:
Blood Brain Barrier Integrity
Autonomic Nervous System Stability
Reflexive Muscle Activation
Motor Sequencing & Reaction Time
Brain-Gut Axis Evaluation
Figure 1 - View of our Concussion Rehabilitation Program, showing Photobiomodulation, Repeated Peripheral Somatosensory Potentials, Transcutaneous Vagus Nerve Stimulation and Vision Therapy
THERAPY & EVALUATION TOOLS
Photobiomodulation (PBM) is a form of non-invasive light therapy using red and/ or near-infrared light. PBM has extensive research showing its effectiveness for reducing inflammation, immunomodulation, tissue repair and increased production of Adenosine Triphosphate (ATP).
Evaluating the oculomotor system is critical to proper diagnosis and aids effective treatment. We perform multiple recorded oculomotor testing sessions on our patients to ensure consistent progress. A practical example of evaluation would consist of performing specific eye movements while the eyes are being recorded with infrared cameras, similar to a VNG/ VOG.
Repetitive Peripheral Somatosensory Stimulus
Repetitive Peripheral Somatosensory Stimulus (RPSS) is a non-invasive treatment modality that involves the application of a mild electrical impulse to the skin. RPSS has a wide array of uses, in our rehabilitation program it is commonly used to directly treat conditions such as vertigo or migraines/ headaches.
Transcutaneous Vagus Nerve Stimulation
Transcutaneous Vagus Nerve Stimulation (TVNS) involves application of mild electrical impulse to the outer ear in order to stimulate the Vagus nerve. TVNS has been shown to successfully treat conditions such as cluster headaches, migraines, epilepsy, trigeminal pain, mTBI, irritable bowel disease and many others.
Vision Therapy is a commonly used method to improve the precision of ocular movements. Practical examples of dysfunctional eye movements can appear as double and/or blurry vision, difficulty concentrating, difficulty reading, eye strain and headaches.
The Focus Builder App was created by a team of Board Certified Chiropractic Neurologists, dedicated to providing doctors with the latest brain rehabilitative techniques. Click here for more information.
Motion Guidance is a visual bio-feedback tool where a laser is mounted on a patient's body to encourage perfect sensorimotor integration. Click here for more information.
Oxygen Saturation is a reliable and recognized method used to evaluate the autonomic nervous system. It is performed through a fingertip monitor emitting an infrared light.
Neuro-muscular Electric Stimulation (NMES)
NMES is a modality used in identifying the neurologic origin of all physiologic symptoms rather than the symptoms alone
Ear Insufflation is a modern procedure involving gently puffing air into the ear canal. The purpose of this technique is to affect the Trigeminal nerve (CN V). As it plays a crucial role in facial/ scalp sensation and proper jaw function.
There are a number of variables that determine the induction of plasticity, the most commonly neglected variables of stimulation are specificity, repetition and intensity. The Ottawa Performance Care Concussion Program is specifically designed with these variables in mind.
Ottawa Performance Care doctors take pride in both, their abilities to properly evaluate and effectively diagnose conditions, this component of treatment is often overlooked/ neglected. The variables of repetition and intensity can only be addressed when a thorough examination and proper diagnosis have been made.
Once we have the necessary information we can create an appropriate treatment strategy designed specifically for your case with the variables of specificity, repetition and intensity in mind.
As per the latest Ontario guidelines: Masks are mandatory for all in-person appointments until June 11th.