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A typical chiropractor treats patients who present with disorders of the musculoskeletal and nervous systems.
These individuals often complain of neck, back or joint pain and chiropractors employ a hands-on approach that usually involves some form of spinal manipulation or adjustment. But what about patients with neurological deficits? How can chiropractic help this population?
According to Keri Chiappino, DC, and owner of New Life Wellness Center in New York, chiropractic neurologists have the knowledge and experience to treat functional neurological challenges. She explains that the modality will not cure some conditions, such as multiple sclerosis, Parkinson’s disease, brain tumors and hard lesions, but could slow progression of the illness. However, the discipline can effectively address another group of conditions, including attention deficit hyperactive disorder (ADHD), autism, depression and anxiety.
Long educational road
Chiapinno first learned of chiropractic neurology when she took a continuing education (CE) course in neurology. “I fell in love with the modality,” she says.
But earning certification turned out to be a long journey. “You have to take a minimum 300 hours of training in neurology to qualify for the board exam,” says Chiappino, who began advanced studies in 1997 and became a board certified chiropractic neurologist in 2002; she earned board certification in neurofeedback in 2013. At least 30 hours of CE and a certain amount of reading is required annually to maintain certification, she says.
Chiappino focuses on children in her practice and the additional expertise has served her and her patients well. While she was able to address ADHD symptoms in children with traditional chiropractic, her training in neurology takes treatment a step further. “Chiropractic neurology has changed everything. I can help more kids now than ever,” she says.
Intervention options
According to Chiappino, every patient receives a complete neurological exam to determine the location of the functional deficit in the brain. The practitioner also performs a nutritional assessment to ensure the patient is “supported nutritionally” and may prescribe specialized diets or supplements if necessary, she says.
This specialty uses a number of interventions, such as light and sound stimulation or a balance board, which can address a variety of problems. “One of my favorite modalities is neurofeedback,” says Chiappino.
Another key modality is mirror imaging. A patient with a left-side leg deficit would sit with a full-length mirror in between their legs and make repetitious movements with the functional leg.
“The replication creates neuroplasticity in the brain,” Chiappino says. “The brain thinks the left leg is moving. Neurons in the brain make new connections.”
Chiappino emphasizes that the practitioner must stay within a fatigue: ability ratio during a therapeutic session, and continually monitors the autonomic nervous system by taking blood pressure, pulse and oxygenation measurements and assessing pupil size. “Eye movement is also a huge part. We can see imbalances and make a specific treatment plan using eye movement,” she says.
Combining techniques
Chiappino says that almost every patient also receives a chiropractic adjustment. “For instance, if there is poor rib excursion when breathing, the person needs proper biomechanics to help them get deep breaths and may need a rib adjustment,” she says.
Although chiropractic neurology treatments are usually suited for all populations, in some cases, it may be contraindicated. For instance, patients with recent traumatic brain injuries require special consideration. “They could be fragile so we would treat them differently, monitoring the autonomic nervous system all the time. We evaluate every patient every time to determine the most appropriate treatment for the visit,” she says.
For Chiappino, the road to board certification was well worth the time and effort. “Matters related to the brain are changing all the time,” she says, asserting that she will continue to pursue education in the field.
