What is the difference in current Neuro Cognitive Testing and The ACNC Approach to Concussion Management?
The difference is clear. We provide a multi-modal approach that measures what current neurocognitive assessments cannot. We provide neuro-diagnostic testing that measures eye movements, balance, the inner ear, and hand-eye coordination.
At Arizona Chiropractic Neurology Center (ACNC), we utilize quantitative non-neurocognitive diagnostic testing of the oculomotor, vestibular, hand-eye, and proprioceptive systems. This allows for us to quickly collect accurate, non-fallible hard-data, measured down to the millisecond. We measure the brain and body’s ability to perform and react to external, and internal stimuli. We perform Saccadometry(1), Computerized Dynamic Posturography, Videonystagmography**, and SVI hand-eye testing and retraining – explained in our Concussion Diagnostic Testing and Treatment Options.
When the brain becomes injured in concussion and other Traumatic Brain Injury (TBI), its processing speed and reaction times slow down(1). Research notes that reaction times (latencies), and balance are key indicators, not symptoms, in concussion and TBI (1). When a player sustains a concussion and the brain’s reaction times slow down, THIS slow reaction time is what creates the high-risk for injury when returning to play too soon. If an athlete is not able to get out of the way of something they might normally be able to, they may get injured again, and this would be called Second Impact Syndrome, and it can be extremely harmful to someone’s brain.
Current research on neurocognitive testing (ImPACT, Concussion Sentinal, Concussion Resolution Index) suggests a multi-faceted approach to screening and testing concussion (2,3). This is because neurocognitive testing does not measure the 3 main systems that are injured in concussion and mTBI. By only performing a neurocognitive test, you’re missing vital information from the oculomotor, vestibular, and proprioceptive systems involved in reaction times (4,5).
ACNC is proud to offer a multi-faceted approach to baseline, acute, and chronic concussion testing and provides neurological rehabilitative therapies if you do become injured.
Concussion Diagnostic Testing and Treatment Options
With Concussions, we start by receiving your intake information, history and performing a review of systems. This allows us to meet and build a rapport with the you, and to determine the severity of your head injury.
We perform a neurological exam including blood pressure lying down, seated, then finally standing. This helps give us information about your brainstem and autonomic nervous system and how well it is functioning. We also perform multiple objective diagnostic tests to help determine as accurately as possible which area(s) of the brain might be injured. These tests include but are not limited to:
- Videonystagmography– infrared cameras capture your eye movements as they track a target, and it can tell us if they’re moving correctly, are off target, are slow, or unstable. VNG also helps us determine the integrity of your inner ear and vestibular function. This device helps us to measure the brainstem, vestibular system, frontal lobe, parietal lobe, temporal lobe, mesencephalon and your cerebellum.
- Saccadometry– lasers are projected onto the wall in front of you as a device captures your rapid eye movements with small infrared cameras. This helps us determine how well your frontal lobe, brainstem, cerebellum and reaction times are functioning.
- Computerized Dynamic Posturography– as you stand on a force plate, with and without a foam cushion, it captures information based on how you respond to changes in body position sense, visual changes and inner ear movement.
- SVI- Sanet Vision Integrator– interactively measures your ability to process (in real-time) things like visual focus, visual attention and attenuation, reaction times, visual motion, balance and vestibular input, and gives us real-time feedback and track progress. This helps emulate reaction times and accuracies before returning to play.
- Treatment Options entail all-access to the most up-to-date therapies available including but not limited to:
- Brain-based therapy, Specific Vestibular Rehabilitation, SVI Visual-motor retraining, SSEP, Peripheral Nerve Rebuilder Therapy, Laser Therapy, Structural and Musculoskeletal Therapy, FocusBuilder Oculomotor Retraining, Interactive Metronome and others.
Our approach is more comprehensive and accurate than the current testing and “screening” protocols available to athletes. All of our diagnostic and treatment options give us quantitative measurements, so the athlete cannot “throw” their baseline screens and our testing also allows us to track their progress as they return to normal and are eventually returned back to work, school, sports and other fun activities with minimal or even no symptoms. We gather real-time data about cortical processing and cognitive function, reaction times and performance measures. This allows us to guide you through your recovery and rehabilitation using data instead of symptoms.
Call now for your baseline, acute, or chronic concussion assessment
Br J Sports Med. 2007 Sep;41(9):610-2. Epub 2007 May 11.Saccadometry: the possible application of latency distribution measurement for monitoring concussion. Pearson BC1, Armitage KR, Horner CW, Carpenter RH.
J Athl Train. 2007 Oct-Dec; 42(4): 509–514.Test-Retest Reliability of Computerized Concussion Assessment Programs. Steven P Broglio, PhD, ATC,* Michael S Ferrara, PhD, ATC,† Stephen N Macciocchi, PhD, ABPP,†‡ Ted A Baumgartner, PhD,† and Ronald Elliott, MD†
J Athl Train. 2009 Nov-Dec; 44(6): 639–644. Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) Practices of Sports Medicine Professionals. Tracey Covassin, PhD, ATC,1 Robert J. Elbin, III, MA,1 Jennifer L. Stiller-Ostrowski, PhD, ATC,1 and Anthony P. Kontos, PhD2
J Neurosurg Pediatr. 2015 Jun 2:1-8. [Epub ahead of print] Vestibulo-ocular dysfunction in pediatric sports-related concussion.Ellis MJ1,2,3,4,5, Cordingley D4, Vis Reimer K4, Leiter J1,4, Russell K2,5.
J Neuroophthalmol. 2015 Mar;35(1):73-81. Diagnostic tests for concussion: is vision part of the puzzle? Ventura RE1, Jancuska JM, Balcer LJ, Galetta SL.