Glossary of important terms:
Functional Neurology - Functional neurology is the study of the inter-relationships of an individual's neuronal systems within the context of their wider health. Using anatomical and embryological relationships the functional neurologist diagnoses dysfunctions within the systems and uses those relationships to effect change within the neuraxis.
Central Integrated State – The central integrative state (CIS) of a neuron is the total integrated input received by the neuron at any given moment and the probability that the neuron will produce an action potential based on the state of the polarization and the firing requirements of the neuron to produce an action potential at one or more of its axons. Identifying the patient’s CIS helps to frame how much stimulation they can endure during a particular therapy.
Muscular Speed (Clinical) – The time at which a group of functional motor units (ex. Quadriceps) can activate when challenged. Does the quadriceps as a whole fire with a crisp, singular contraction? Or does delayed contraction exist demonstrating weakness and co-contraction of non-challenged tissues? Identifying an underperforming muscle group helps to target the neural premise of an injury.
Muscular Symmetry (Clinical) – Does the muscular speed testing prove equal left to right? Is the crosssectional area even in similar tissues bilaterally? Does muscle tone and length demonstrate similar features on both sides? Are tendon reflexes and traditional muscle testing even on the right compared to the left?
Muscular Sequence (Clinical) – The order in which the muscular system activates and fires in response to a conscious decision to move the body. For instance, a sprinter needs to engage the hip flexor prior to the abdominals and prior to the deep neck flexors when propelling forward. Is this occurring, or is the order abnormal for the desired motion?
Nervous System Fuel – Oxygen and glucose. It is important to evaluate fuel levels during
treatment to avoid neural fatigue.
Compensation – A neurological change in activation leading to a change in motor movement or patterning that is abnormal. This change is triggered by a traumatic/ stressful psychological or physical event. This is the primary feature of an injury that needs to be corrected.
Force - Any interaction which tends to change the motion of an object. In other words, a force can cause an object with mass to change its velocity (which includes to begin moving from a state of rest), i.e., to accelerate. Force can also be described by intuitive concepts such as a push or a pull. Absorbing force is a primary feature of the neuro-musculoskeletal system.
Injury – Injury is damage or harm caused to the structure or function of the body caused by an outside agent or force, which may be physical or chemical. Discovering where force enters the system is invaluable to solving the patient’s case.
Neural Stimulation – The singular or repeated activation of a specified neuronal pool in order to decrease the threshold of firing. This can occur in many forms and is targeted at a patient’s neural deficiency. This is the basis for our clinical application.
Motor Cortex – The motor cortex is the region of the cerebral cortex involved in the planning, control, and execution of voluntary movements. This is the top of the CNS food chain and attracts much of our clinical attention.
Cortical Hemisphericity - Hemisphericity is defined as the weaker side of cortical brain function.
Responsibilities of the ipsilateral cortex include the following:
- Inhibition of the ipsilateral dorsal root ganglion (DRG). The DRG is responsible for inhibition of extraneous sensations and pain.
- Inhibition of the anterior musculature above T6 and posterior musculature below T6
- Inhibition of the ipsilateral Intermedio-lateral fasciculus (IML). The IML inhibits the sympathetic nervous system allowing the parasympathetic system to reach threshold.
- Understanding this concept helps to explain the neuro-pathophysiology of the patient’s injury.
Neural Fatigue – Also known as synaptic fatigue, or short-term synaptic depression, is an activity dependent form of short-term synaptic plasticity that results in the temporary inability of neurons to fire and therefore transmit an input signal. It is thought to be a form of negative feedback in order to physiologically control particular forms of nervous system activity. We find this occurs clinically in cases of extreme injury or due to over-stimulation during therapeutic intervention.
Neural Endurance – The duration at which a specific neural pathway can maintain engagement without disengagement, deactivation or compensation arising. This is the single most revealing (positive) indicator for evaluating a patient’s progress.
Neural Unwinding – The theoretical change that occurs in neural activity as a patient undergoing neural therapy begins to have an unpredictable pattern/ or constellation of pain and increase in muscular tone. This helps to explain why symptomology can change location.
Muscle Activation – A therapeutic application designed to increase the activity on a specific neuronal pool in order to decrease the threshold of firing. This technique has a similar CNS effect to performing a Jendrassik maneuver to help elicit a DTR. The advantage is the activation seems have a longer lasting CNS impact. This particular therapy can increase the gain on the CNS promoting a more efficacious delivery of neural balancing and ARPwave therapy.
ARPwave - ARPwave neurological therapy is a supplemental therapy which treats the neurological origin of physiological symptoms. The ARPwave possesses specification characteristics that are not found in any conventional therapeutic neuromuscular electrical stimulator (interferential, microcurrent, galvanic, Russian stim, iontophoresis). The ARP uses direct current (DC) compounded with a high frequency double exponential, patented background waveform. This background wave is harmonious with the body and significantly reduces skin and fatty tissue impedance allowing much deeper penetration of the direct current without the side effects of skin burning. Also, the unique waveform produces minimal inhibitory protective muscle contractions allowing active range of motion during therapy and training. This permits eccentric (lengthening) contractions to occur which are critical to treatment. I don’t know that any other tool exists in the marketplace with similar features of objectivity and delivery for specific neuromuscular rehabilitation.
Post Concussion Syndrome - Post-concussion syndrome, also known as postconcussive syndrome or PCS, is a set of symptoms that may continue for weeks, months, or a year or more after a concussion – a form of traumatic brain injury (TBI).
Motor Reflexes - a reflected action or movement; the sum total of any particular automatic response mediated by the nervous system. A reflex is built into the nervous system and does not need the intervention of conscious thought to take effect.
Neural Inhibition - The concept of inhibition entails several meanings, including interruption or blockade of activity and restriction of activity patterns in both space and time. The importance of inhibition in the brain is aptly illustrated by the fact that in addition to excitatory principal cells, the brain contains diverse classes of specialized inhibitory interneurons that selectively innervate specific parts of the somatodendritic surfaces of principal cells and other interneurons. In the cortex, axon terminals of interneurons release
gamma amino butyric acid (GABA) onto their synaptic targets, where the inhibitory action can compete with the excitatory forces brought about by the principal cells. Conceptually, this is a difficult concept. But, the inability of the cortical cells to deliver an accurate inhibitory effect can cause a negative neural cascade. This has tremendous clinical applications.