“The strength of many of these techniques is the consistency of the results and testing.” Weinstock, the NKT protocol “allows the practitioner to have a conversation with the brain. The brain reveals to the practitioner what is not working and what is compensating for that. Then using the protocol, the practitioner re-leases the compensator and activates the underworking part. This reprograms the motor control center and reorganizes the movement pattern.” There are three courses for NKT available, taught over two days. Level 1 opens the student to the concept of the assessment and treatment protocols. Level 2 focuses on correcting dysfunc-tional movement patterns with a major focus on fascial slings, and Level 3 intro-duces neurological concepts that at-tempt to wrap everything together. The pros: This technique is by far the easiest functional neurology technique to learn and apply quickly. You find weak muscles associated with a painful prob-lem, you find the “where” on the body that negates the weakness, and you treat that area using whatever tools you have, resulting in the original muscle being corrected, along with the dysfunctional movement pattern, and hopefully, the patient’s pain. The cons: The explanation provided to the practitioners about how it works could be improved. As someone who has taken Level 1, I believe it is simplified to make it more palatable to the masses, including strength trainers, Pilates in-structors etc., and not to overwhelm. Assessment: This course is a definite must for anyone who wants to dip their toe into the world of functional neurol-ogy, without incurring a massive com-mitment of time and cost. The course opens your mind to unique ways in which the body can change and react to relatively simple treatment, but provide lasting results for cases that have resisted traditional therapy. B.C. has been subject to three com-plaints to the regulatory board due to inappropriate advertising techniques and using terms like “brain balancing,” and stating that they practice “Board Certified Neurology.” As reported in a CBC article in July 2019, the College of Physicians and Surgeons feels this is misleading, and also the term ‘brain balancing’ describes a therapy not spe-cifically taught anywhere. Not unlike what we see in complaints from individ-uals with dubious advertising, this case just shows there are bad apples every-where, and isn’t an example for practi-tioners who use functional neurology appropriately in their practice. practitioners will obtain similar results, showing the same changes before and after treatment. It is easy to state that the results are there, but the proof is in the pudding. Let’s expand upon the experiment at the top of the article, using two tests. First, find a patient, with or without low back pain, who has a weak quadratus lum-borum and a history of appendectomy. First, test the QL and, if weak, provide some quick soft tissue therapy to the scar, or acupuncture, or whatever tool you have at your disposal. It doesn’t need to be more than a few moments. Then re-test the weak quadratus lum-borum and see if it feels strong. If it works, you can include this in your treatment and rehab plan. Nociception is largely subconscious, although we focus on the conscious painful aspect. Seventy percent of noci-ceptive signals from structures around the body send messages to the brain to which the response may or may not be local to where the patient is feeling the problem. Dys-afferentiation from scars, surgical sites, etc., are just such exam-ples. In another example look at the cervi-cal spine, find an individual with poor flexion to the C/Sp, or poor rotation to one side. Look at the patient, see imbal-ances, or poor movement in related areas including the sternum, shoulders, tho-racic spine, or if treating a concussion, the skull. Touch this area and have the patient repeat the movement, until you find a location that improves the desired action. Treat that area you’ve touched however you see fit, using what tools you are most comfortable with. The im-provement in neck motion should be apparent, and lasting. Ensure to rein-force with the appropriate exercise. While these techniques remain some-what controversial to many traditional-ists, the true strength lies in being able to identify very subtle changes of move-ment with very pointed and specific as-sessment. Considering how poorly sensitive traditional orthopedic testing is (Cox, deGraauw, and Klein; 2016), yet still heavily relied upon in education, any ability to find problems along the entire dysfunctional spectrum enables the practitioner to be the most successful. cndoctor.ca Take home strategies Is it, or is it not evidence-based? Controversy The chiropractic profession is very used to controversy. The functional neurology branch is no different. A chiropractor in 24 Chiropractic and Naturopathic Doctor May 2020 Regarding the efficacy of functional neurology (FN) in a 2018 paper by Meyer and Leboeuf-Yde, in Chiropractic and Manual Therapies , the authors con-clude: “This journal contains no accept-able evidence on the effect or benefit of FN in relation to various conditions and purported indications for intervention.” The paper admits that this is largely the result of poor methodology existing in a poor selection of existing papers. Considering this field is relatively new, in comparison to other techniques, it can be expected that the financial resources and skilled scientific oversight might be lacking. So, in the strictest sense of the word, is functional neurology evi -dence-BASED, the answer is no. Evi-dence-INFORMED, this author would argue yes. However, not much in mus-culoskeletal medicine has much evi-dence beyond a grade of B, after a hundred years of practice and study. As chiropractors, we still argue over what we do, and how the chiropractic adjust-ment works, often failing on inter-exam-iner reliability studies, the centrepiece of assessment in chiropractic education around the world. The strength of many of these techniques is the consistency of the results and testing. When skilled in assessment methodology, many
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