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Functional Neurology & Chiropractic
There are communication loops between your brain and body over the nervous system. A Functional or Chiropractic Neurologist is trained to assess your entire nervous system and locate areas of dysfunction along these pathways. The objective of treatment is to improve function by activating nerve pathways by stimulating any of the receptors that carry information to the brain. By repeatedly activating pathways, the treatment can create plasticity (learning) within the dysfunctional pathway giving relief and ultimately enhancing function.
Clinical Nutrition
The principles of Clinical Nutrition use a patient-centered approach to your healing. The axiom is treat YOU not the disease. Almost always, the cause of any disease and its symptoms is an underlying dysfunction and/or imbalance of bodily systems. It uses an evidenced-based approach which includes standard and advanced lab testing, physical examination and treatment that utilizes foods, supplements and lifestyle changes that restores balance in your body’s primary physiological processes and metabolism. The goal: the patient’s lifelong optimal health.
Laser Therapy & Acupuncture
Low Level Laser Therapy (LLLT), also known as photobiomodulation, is a laser or LED light therapy that improves tissue repair, reduces inflammation, and reduces pain wherever the beam is applied. LLLT works predominately on a protein in mitochondria (cytochrome c oxidase) to increase ATP (adenosine triphosphate), which is the main energy molecule of the cell. This reduces oxidative stress and produces a cascade of mitochondrial and intracellular downstream effects which leads to improved tissue repair, reduced inflammation, and decreased pain.
Comprehensive Evaluation
Physical, Neurological, Orthopedic
Your journey to better health starts with a comprehensive consultation and examination. It all starts with a detailed history and an interview/consultation where Dr. Schiller will ask you questions that have probably not been asked before. The answers will guide him to the underlying causes of your health challenges. An explanation will be provided that will allow you to understand the relationship of the various signs and symptoms. A thorough examination will then be performed and may include any or all of the following: physical, neurological, and orthopedic. The reason for your visit will determine the type of examination that will be performed. The findings of the exam will be explained to you thoroughly and your questions will be answered. It is essential that all patients understand why their body’s are malfunctioning. This entire process will provide you with the information that is necessary to give you the best chance of recovery and to allow you to learn how to maintain your health in the future. Once the examination is completed, Dr. Schiller will explain any further diagnostic testing that needs to be performed.
Diagnostic Testing
State-of-the-Art and Evidenced-Based
Computerized Posturography
Posturography is a non-invasive clinical assessment used to quantify how well you are able to control BALANCE and POSTURE. This function necessitates a complex interaction of sensory, motor, and central nervous system processes. The sensory aspect involves vestibular, visual, proprioceptive, and somatosensory inputs. The motor aspects include not only the principal skeletal muscles but also to a lesser extent almost every muscle in the body. The nervous system aspects include not only the vestibular nuceli but the spine, cerebellum, and practically all the central and peripheral nervous system. 90% of the brain’s energy is used to orient you in space. The global assessment of balance is the best way to assess your brain’s function.
Eye Movement Assessments
Analysis of eye movements provides insights into almost every area of your brain function. The cerebral cortex, brainstem, and cerebellum are evaluated through this testing. We have the ability to assess all types of eye movement functions: gaze holding, pursuing targets, or moving the eyes quickly (saccades). When the brain is injured, particularly with concussion and other traumatic brain injuries (TBI), it alters how your eyes move. Speed, accuracy, and reaction time can be altered and help us define the extent of your brain injury and central nervous system function. We use eye tracking by RightEye, video-oculography by FineGaze, and vestibular assessments by Vestibular First infrared goggles.
Autonomic Testing
The Autonomic Nervous System (ANS) is the part of the nervous system that is in charge of the functions that are performed automatically. These include functions like heart rate, blood pressure, hormone balancing, digestion, and temperature regulation. It controls appropriate blood supply or “fuel” to the body’s parts. Appropriate fuel to your nervous system allows the delivery of glucose and oxygen so energy can be produced to allow optimum function. The ANS is comprised of sympathetic and parasympathetic divisions. Sympathetic is considered your “fight or flight” and the parasympathetic is your “rest and digest.” The evaluation utilizes Heart Rate Variability, Pupillometry, and Tilt Table testing. If the ANS is malfunctioning, the consequences are detrimental to your body’s functions.
Concussion Assessment
C3 Logix is a cutting edge technology for traumatic brain injury protocols, baseline, and follow-up assessment. It goes beyond the standards in place for concussion management in today’s health care. C3 Logix is the only concussion management system that manages the whole condition instead of merely a singular domain specific test like ImPACT. C3 Logix is a multi-domain testing platform that has a NEUROCOGNITIVE, NEUROMOTOR, VISUAL, VESTIBULO-OCULAR REFLEX, and BALANCE assessment. C3 Logix was developed, built, and validated at the Cleveland Clinic’s Concussion Center and is the only mobile-based concussion management system that assesses six different domains for baseline and post-injury.
Laboratory Testing
To evaluate your metabolic needs, we use a variety of tests that may assess your blood, urine, breath, or stool. For a properly functioning nervous system, appropriate fuel is essential. Glucose, oxygen, and freedom from inflammation are the necessary ingredients to well-functioning nervous system and body overall. We can evaluate your nutritional needs as well as what lifestyle interventions we could incorporate to maximize your improvement. In addition to standard testing, we may utilize advanced laboratory testing to evaluate gut microbiome, metabolic utilization, integrity of the various barrier systems such as blood/brain and gut as well as testing for a variety of hormones.
Treatments
Customized to the patient's needs
Once the evaluation is completed, a treatment program will be developed and customized to your exact needs. Treatment goals are established according to the exam findings. If there were findings of autonomic dysfunction, this has to be treated first. Why? Because autonomic dysfunction affects ‘fuel.’ If fuel is affected, it alters energy production and in turn affects neurological function overall. Tilt table testing, pupillometry, and heart rate variability are used to establish autonomic function. The second priority is addressing the patient’s center of pressure (CoP). CoP is established with computerized posturography (balance testing) and is defined as the relationship of the center of your body to the ground. The Computerized Posturography diagnostic test will tell us how your body relates to gravity. You could be leaning abnormally forward or backward due to misperceptions of your relationship to gravity. This can cause muscles to abnormally fire or create imbalances in various muscle groups distorting posture or lead to maintenance of muscle tightness. As a result, these alterations can change your gait, balance or other functions. Ninety percent of your brain’s energy is orienting you to gravity. If CoP is altered, it will be difficult for you to function optimally and move through your environment safely and efficiently. Once the first two priorities are addressed, your brain can then be rehabilitated with one or more of the following brain-based or receptor-based therapies.
Whether your condition is neurologically based or metabolically based, both types will be considered as a viable treatment approach for the other. In other words, if you are presenting with any neurologically based condition including spinal or extremity pain, we will consider if Clinical Nutrition would help you recover. If you are presenting with a metabolically-based condition such as thyroid problems, blood sugar abnormalities, digestive disturbances or an autoimmune condition, we will consider if rehabilitating the brain would improve your chances of recovery.
The Vestibular System, when malfunctioning, can produce dizziness, vertigo, lightheadedness, incoordination, and falls (among other symptoms and signs). It consists of sensors in the inner ear, the visual system, and proprioceptive system (body sensors in the joints, tendons, muscles and skin). Therapy may consist of balance exercises, eye movements (oculomotor), eye-head movements, whole body movements, and others. After a thorough assessment of your balance, oculomotor functions, and autonomic nervous system, a specific program of rehabilitation will be prescribed. As just mentioned, the vestibular system when compromised, can cause dysfunction of the autonomic nervous system, affecting heart rate and blood pressure, which can affect blood flow to the head, and the symptoms of dizziness and lightheadedness. Re-establishing awareness of where you are in space, and where your environment is in relation to you, is essential for all proper body functions.
Eye movements are produced by muscles that are controlled by specific neurological pathways located in the brain, cerebellum and brainstem. Oculomotor function such as pursuits (moving targets), saccades (quick movements), fixation/gaze holding are analyzed in your evaluation and with our state-of-the-art diagnostic tools. These types of exercises are also used with patient’s presenting with concussion, dizziness, and cognitive issues. Oculomotor functions are also directly connected to spinal stability and may be used to assist with patient’s experiencing spinal and extremity pain.
Interactive Metronome® (IM) is an evidence-based assessment and training tool. As its name implies, IM works with timing within the nervous system. Appropriate timing in your nervous system is essential for its optimal function. IM is used to assess and train these timing functions by integrating sight, sound, and physical movements. A growing body of literature exists that describes the neural timing deficits in ADHD, Dyslexia, Autism, Reading Disorders, Auditory Processing Disorder, Parkinson’s, and other conditions. Traumatic Brain Injury and Stroke may also disrupt timing in the brain. It has been proven to improve cognition, attention, focus, memory, speech/language, executive functioning, comprehension, as well as motor and sensory skills.
The ATM-2 is an Active Rehabilitation Treatment that places the patient in a PAIN-FREE functional weight bearing position. Special resistive exercise are then performed thereby resetting central nervous (CNS) muscle activation patterns–allowing an immediate and significant reduction in pain, and restoration of function. Over the course of several Active Therapeutic Movement (ATM) sessions, abnormal muscle firing patterns are significantly reduced, and proper activation and strength are restored. This provides long lasting relief and correction of many musculoskeletal conditions.
RPSS is a form of therapy that delivers a low-dose electrical current (stimulation) in order to create a sensory input into the nervous system. Points are chosen depending on the goal of the treatment and include points on the arms, legs, and various points around the face. The goal is to stimulate points that reach different areas of the neural axis. They are directed toward reaching brainstem, cerebellum or cortex. It is often used to improve sensory loss, reduce pain, change the brain’s representation of a particular body area/part, activate or inhibit motor activity, and modulate activity in particular regions within the central nervous system. It is used with vestibular problems, TBI/concussion, and headaches among others. The treatment is comfortable and tolerated by our patients.
The FITLIGHT Trainer is a speed and cognitive training system that’s designed to completely transform the way you exercise, train, and measure performance. This innovative speed training system helps you strengthen the bond between the mind and body, enhance your reaction time, improve working memory, eye-hand coordination, decision making, processing, speed, and agility. This treatment is fun because for many patients it is a game.
Patients with cognitive difficulties complain of memory problems, brain fog, word finding, difficulties, attention problems, concentration issues, etc. Therapies for these problems include brain based treatments centered on addressing the exact brain (cortical) areas involved. It will also include Clinical Nutrition interventions to address brain and body inflammation, gut and brain barrier problems, neurotransmitter support and blood sugar issues. In addition to Clinical Nutrition, the latest research verifies that cognitive problems can be influenced with therapies that promote neuroplasticity. A home therapy program will also be provided for patients in order for results to be achieved more quickly and to be more long lasting.
Whether you are looking to increase flexibility, improve balance, add mobility or gain strength our brand new fitness facility provides the tools you need to achieve your goals. Functional movement, power, coordination, reaction time are all aspects of performance enhancement that can be addressed regardless of your age or skill level. In addition to in-office programs, a home based program will be provided to allow patient participation while not in the office.
To support your progress, a series of exercises will be prescribed for you to perform at home. The exercises may be neuromuscular, visual or vestibular rehabilitation. Some may be guided by ‘apps’ that are placed on smart phones or tablets that guide you through eye movements, balance, coordination or cognitive tasks such as working memory or visual or spatial processing to name a few. The exercises are programmed by Dr. Schiller or tailored by diagnostic programs themselves. Either way they are custom-tailored to your exam findings.
