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Thread: vestibular testing

  1. #1
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    vestibular testing

    moved from spinecor thread

    initial post by mum 37

    Sorry so late in the post but in private posts it was recommended I tell all of you. Vestibular testing is a medical testing reviewed and signed by an M.D. on reports. We were skeptical of it too. We saw Dr. Deutchman for our initial bracing and did the vestibular testing. My heath insurance paid for the vestibular testing, and in network, so I was reimbursed 100%. The brace and everything else was reimbured out of network. Due to progressive curve we had more physician opinions and an MRI was done. My daughter has Chiari I Malformation (detected by MRI) which a symptom is Nystagmus (involuntary eye movement), and difficulty in tracking objects, which is what that test is for. She also has Syringomyelia (MRI detected too) which scoliosis is one symptom of. Those are the cause of her scoliosis. These medical conditions can be found on www.asap.org if you are interested. My understanding is that many scoliosis patients have Nystagmus or difficulty in tracking objects and can benefit from this testing by following treatment of exercise therapy. My daughters was slight and therapy didn't hurt, but her other medical issues didn't help it amd probably caused it. On a side note, Dr. Deutchman's office called to check on her and her bracing, and I advised of this other medical condition and her surgery date. They were very concerned and wanted to know all they could about it. On day of her surgery, and today to they called to see how she was doing. They really showed they cared even though we are doing follow up on brace closer to us outside their practice, and went to them back in March 2006.
    --------------------------------------------------------------------------------

  2. #2
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    I think that in the context of treatment of scoliosis, there is nothing wrong with vestibular testing as long as it is made clear that it is only of academic interest, patients are advised that there is no evidence at all that "treatment" based on this testing does anything to improve scolosis or helps to maintain a curve, and ofcourse no large additioal payments are demanded (Did I pick up that dr d charges more than 1000 dollar forthis; correct me if i am wrong)

    gerbo

  3. #3
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    gerbo,

    Sorry folks that this is so long, but it's concise and makes a point. It's certainly more in depth and comprehensive than anything else that's being offered. I know you're [Gerbo] a spincor user, ...Are you really against this vestibular rehab? It is in fact an integral part of the premise behind the spincor brace as noted by the Doctors themselves.

    The Spinecor(TM) brace is fitted and worn home the same day. Adults can be fitted in New York, Chicago, Atlanta, Los Angeles and Phoenix as an ongoing clinical study to determine the long-term efficacy of Spinecor(TM) and vestibular rehabilitation in the adult population.
    Dr. Collaird (creator of spincor) and her team of physicians are now convinced the success of the program is due to changes in postural control from the brain.

    Through a collaborative effort, Scoliosis Systems(TM) and SpineCor(TM) are responsible for amazing advancements in spinal and neurological rehabilitation. Today's sophisticated medical equipment allows for monitoring of how the brain controls posture. An imbalance in specific parts of the brain including the vestibular cortex and the brainstem has been reported in scoliosis for nearly 25 years
    Vestibular tests can help determine if more expensive tests, such as magnetic resonance imaging (MRI), are needed. Recent studies (Levy and Arts, 1996) have shown that vestibular testing is much more accurate than clinical symptoms in predicting whether neuroimaging tests will be abnormal.
    Recent studies have documented that vestibular tests are more accurate than clinical examination in identifying inner ear disorders (Gordon et al, 1996).
    Abstract from Scoliosis Research Society (SRS) 2003 Meeting

    Matthew T. Provencher M.D., Derin Wester, Ph.D., Bruce Gillingham M.D.; Naval Medical Center- San Diego, CA. Orthopedic Research and Education Foundation- Resident Research Grant
    Conclusion: A central vestibular deficit is present in scoliosis patients. Central vestibular function is worse with larger curves, and the dysfunction is opposite to the curve. Curves with location in the mid-thoracic region demonstrated less central deficit than low-thoracic and lumbar scoliosis curves. The data supports a central vestibular dysfunction in patients with scoliosis
    In a study published in SPINE 1995, researchers tested linguistic processing, a higher cortical function, and concluded children with scoliosis had an entire brain dominance lateralized to one side, unlike unaffected children in the control group. This study demonstrates the need for advanced neuro-diagnostic testing and clinical correlations which leads to meaningful neurologically based rehabilitation.
    Patients with scoliosis are known to have neurological dysfunction which contributes to the progressive nature of scoliosis, as well as interfering with the rehabilitation of posture in the adult and child. Studies have identified an increased incidence of brainstem and cerebellar abnormalities such as brainstem hypoplasia and Arnold Chiari Malformation in patients with Scoliosis. Certain findings such as cervical lordosis, thoracic kyphosis, abnormal Somatosensory evoked potentials (SSEP) and nystagmus on electronystagmographic testing have been linked to neurogenic causes of scoliosis. In the event neurological dysfunction is identified, MRI imaging may be necessary. Other interventions may include neuromuscular rehabilitation which can be offered on an individual basis. Vestibular and oculomotor dysfunction has been shown to respond to personalized treatment programs, which are designed to re-educate the brain perception of subjective postural vertical.
    Physiotherapy techniques have been successfully utilized in scoliosis treatment for the past sixty years. Myofascial Release Technique (MRT) is designed to neurologically inhibit the connective tissues which become fibrotic when a muscle is in a shortened state for a prolonged period of time, thereby preparing the muscle to be lengthened.
    There are numerous studies lending to the efficacy of vestibular rehab.

    The evidence that it works as an integrative aspect of treatment is all over the place.

    Although, I certainly agree that there is no evidence or probability that it will ever change a scoliosis by itself (there are so many factors at play in attempting to "stabilize" a curvature that no one thing is going to do it. And certainly nothing but a forceful approach, i.e. - rods/fusion or bracing possibly, is going to hold it if the underlaying cause is never found). Therefore I do believe it has varying degrees of importance in the management of scoliosis, either pre or post operatively. To say that its purely "academic" is a brash assumption Gerbo. Considering the medical fact/reality that neurology is an extremely infantile field of study, it would be hard to formulate any definitive stance on this subject. Any neurologist will tell you that we know very little about the brain and how/why it works. This topic dealves into an abyss of unknown realities... no studies does not equate to illigetimacy. Maybe if we started giving this field some credibility we might start getting some answers. But until we give attention to it, we'll continue to remain ignorant on the matter. The creators of the spincor brace certainly see its relevance.

    structural

  4. #4
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    From the Scoliosis Care Foundation

    Beyond Only The Spine

    Current research in the U.S. and Britain is showing that idiopathic scoliosis is a multifaceted disease that compromises all five of the body’s systems: neurological, digestive, hormonal, muscular and osseous (bone). These newer insights about the impact of the disease of scoliosis on a patient recognize that the body’s systems work together in an integrated fashion. When one of the body’s systems suffers a malady it can create problems with one or more of the body’s other systems.

    Older 20th century based philosophy about scoliosis treatment considered only the osseous part of the equation, with the focus of treatment being just on stopping skeletal curvature from progressing. The attention was on supporting the spine, while ignoring the body’s four other systems.

    Take, for example, bracing, an important component in the non-surgical treatment of idiopathic scoliosis. Its purpose was to keep the curve from progressing while the patient is growing. Studies have shown bracing to be an effective treatment halting the progression of many a scoliosis curve; and that’s great. However, after skeletal growth has concluded and the brace removed, the curvature is expected to return. While bracing has traditionally been used to prevent things from getting any worse, there had not been simultaneous courses of action taken in non-surgical scoliosis treatment to attempt to make things any better.

    The new thinking in idiopathic scoliosis research holds that helping patients achieve their own level of optimal health in each of their five body systems can result in more effective non-surgical treatment.

    The Scoliosis Care Foundation supports research and non-surgical treatment for idiopathec scoliosis that takes into account all of the body’s systems.

  5. #5
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    Celia wrote:
    ...take methods which are completely unproven and make them sound mainstream and effective when in fact there is no scientific basis for their validity.
    Vestibular testing and rehabilitation is very scientifically based and valid as proven in studies.
    Timothy C. Hain, MD
    Professor of Neurology, Otolaryngology, and Physical Therapy/Human Movement Science, Northwestern University Medical School, Chicago IL, USA.
    OFFICE PHONE NUMBER: 312-274-0197
    OFFICE LOCATION: Chicago Dizziness and Hearing , 645 N. Michigan, Chicago 60611
    WEB SITE: http://www.tchain.com/
    EMAIL ADDRESS: cdb@dizziness-and-balance.com
    FAX NUMBER: 312-274-0198
    EDUCATION: MD and Neurology Residency: University of Illinois, Chicago IL. Fellowship: Johns Hopkins University (Neurophysiology and Neuro-ophthalmology). Board certified in Neurology (1981)

    Dr. Hain states:

    Why get vestibular tests ?

    1.Vestibular tests are tests of function. Their purpose is to determine if there is something wrong with the vestibular portion of the inner ear. If dizziness is not caused by the inner ear, it might be caused by disorders of the brain, by medical disorders such as low blood pressure, or by psychological problems such as anxiety. Recent studies have suggested that vestibular tests are more accurate than clinical examination in identifying inner ear disorders (Gordon et al, 1996). Hearing pathway tests (audiometry, ABR, ECOG) can also be used for the same purpose, and are frequently combined with vestibular tests. In a cost-effectiveness analysis for evaluation for vertigo it was concluded that hearing testing followed by either posturography or ENG (electronystagmography) was the most effective method (Stewart et al, 1999).
    2.To detect central disorders. Recent studies have suggested that internuclear ophthalmoplegia, a central eye movement disorder, is missed by 71% of physicians unaided by quantitative oculomotor testing (Frohman et al, 2003).
    3.To decide if more expensive tests like MRI (Magnetic Resonance Imaging) are needed. Vestibular testing is more accurate than clinical symptoms in predicting whether neuroimaging tests will be abnormal.(Levy and Arts, 1996)
    4.To document objectively vestibular conditions such as BPPV and Perilymph fistula, which commonly occur after head injury, vestibular neuritis, and Gentamicin ototoxicity, which commonly is a side effect of medication.
    http://www.dizziness-and-balance.com/index.html
    http://www.lifelinerehab.com/vestibular.html
    http://www.vestibular.org/index.php
    ETC.....

  6. #6
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    Structural,

    You have completely butchered the discussion we had under the Spinecor thread and I'm not even going to waste my time!

    Happy Holidays to you!
    Last edited by Celia; 01-13-2007 at 10:46 AM.

    Canadian eh
    Daughter, Deirdre born Oct 2000. Diagnosed with 60 degree curve at the age of 19 months. Serial casting by Dr. Hedden at Sick Kid's Hospital. Currently being treated by Dr. Rivard and Dr. Coillard in Montreal with the Spinecor brace and curve is holding at "2" degrees. Next appointment 2008

  7. #7
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    celia, please blame me, i asked for this, just to keep spinecor thread clean and as an opportunity to stake stock of the various arguments.

    i suggested stick to essentials only and get rid of the rest (specially non-factual and personal comments)

    apologies

    gerbo
    Last edited by gerbo; 12-24-2006 at 08:33 AM.

  8. #8
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    Gerbo,

    It's funny that structural conveniently omitted the one paragraph in response to your question above that sparked this debate. If I remember correctly, you responded by saying that patients shouldn't be required to fund studies of any sort.


    Originally Posted by gerbo:

    I think that in the context of treatment of scoliosis, there is nothing wrong with vestibular testing as long as it is made clear that it is only of academic interest, patients are advised that there is no evidence at all that "treatment" based on this testing does anything to improve scoliosis or helps to maintain a curve, and of course no large additional payments are demanded (Did I pick up that dr d charges more than 1000 dollar for this; correct me if i am wrong)


    Originally Posted by Structural:

    Gerbo - I know we all want more definitive answers to help loved ones... but to get those answers costs $$$ (for studies that you often demand). Donating to causes such as this just might get us some of those answers with the "studies" to back them up.???




    Who exactly is doing this study ? According to parents who have been to the chiropractors, claims are being made by the chiropractors that there is a study. Drs. Rivard and Coillard are not conducting such tests on their patients. How do these expensive tests affect how the brace works ? In fact, patients who are going to Montreal are getting better results than the chiropractors who are conducting these tests and recommending patients use wobble boards to enhance proprioceptive capacities! Furthermore...in one of your quotes you state that it can be used as a predictive test for chiari and the like however no red flags went up to the chiropractors who were treating Mom37's daughter - I'm not implying that you wouldn't have sent the young lady to see a neurosurgeon but that didn't happen in Mom37's case! So what exactly are these *tests* useful for ? Are the results being used in any meaningful way ?! As far as I know the chiropractors are charging patients $6,000.00 for the brace inculsive of tests/wobble boards versus $3,000.00 in Montreal.

    Children who present at chiropractic/osteopathic offices for these "tests" have scoliosis hence the "test" is worthless as a predictive measure. As for the exercises/wobble board... we all agree it doesn't work. I've noticed when I ask you a direct question you distance yourself and argue the case from an empirical stance. You have an uncanny ability to skirt around questions and take methods which are completely unproven and make them sound mainstream and effective when in fact there is no scientific basis for their validity.


    Here is a study: "Etiology of Idiopathic Scoliosis by T.G. Lowe, C.H. Rivard," Refer to page 1161 - 1162 under the heading: Neurological Mechanisms http://www.scoliosis-support.org/upl...ysfunction.pdf


    1: Clin Orthop Relat Res. 1980 Oct;(152):232-6.

    Equilibrium factors as predictors of the prognosis in adolescent idiopathic scoliosis.
    Sahlstrand T, Lidstrom J.

    Postural equilibrium factors were evaluated as indicators of the prognosis in 52 patients with adolescent idiopathic scoliosis. The hypothesis was that dysfunction in these equilibrium factors might imply a higher risk for the curve to progress. The postural equilibrium was studied by stabilometry, and the function of the central nervous system was assessed by electoencephalography (EEG) and the vestibular function by electronystomography (ENG). During a follow-up period averaging 2.9 years, ten patients showed progression of the scoliosis. No differences were found in the distribution and frequency of abnormalities between the patients with progressive and nonprogressive scoliosis. Stabilometry, electroencephalography, and electronystomography as used in this study did not seem to be of predictive value for the outcome in the individual case.
    PMID: 7438607 [PubMed - indexed for MEDLINE]



    1: Spine. 1980 Nov-Dec;5(6):512-8. Links

    An analysis of lateral predominance in adolescent idiopathic scoliosis with special reference to convexity of the curve.

    Sahlstrand T.

    An analysis of lateral predominance of 51 patients with adolescent idiopathic scoliosis is presented. Determination of handedness, the dominant foot, and the dominant eye was performed. Postural equilibrium was studied by stabilometry, and the vestibular function was evaluated with electronystagmography. Central and peripheral nervous function were evaluated as reflected by electroencephalography and nerve-conduction velocity measurements. Results were compared with those obtained for a control group and were evaluated with special reference to convexity and location of the curve. Significant differences were found between patients with right convex curves and those with left convex curves in the distribution of eye predominance and in labyrinthine sensitivity. The direction of convexity was correlated with the predominant labyrinth for both groups. An analysis of these findings indicates that they can be of pathogenetic importance.
    PMID: 7466460 [PubMed - indexed for MEDLINE]


    ARE ASYMMETRIC OTOLITH VESTIBULO-OCULAR REPONSES A PREDICTIVE FACTOR FOR IDIOPATHIC SCOLIOSIS IN CHILDREN?

    Sylvette R. Wiener-Vacher, and Dominique Antolini., Nn. 1

    In idiopathic scoliosis spinal deformities start to develop at the time of the initial rapid growth at the onset of puberty. A suggested cause of IS is a disequilibrium in the otolith vestibular control of the trunk muscles. Supporting this hypothesis our previous results (2) showed that 67% of children with IS, but no other inner ear or neurological abnormalities, had an asymmetry of their otolith vestibulo-ocular reponses to the Off Vertical Axis Rotation test. These were significatively greater than in a control age-matched
    group of normal children. We suggested that this asymmetry was a central otolith vestibular system disorder and could lead to a vestibulospinal system imbalance, which would then provoke IS.

    The goal of this study was to determine if this asymmetry exists prior to the appearance of the spinal deformities. Our preliminary results show that the vestibulo-ocular asymmetry appears before the spine starts to show any significant clinical and radiological deformity. In patients at risk for IS(e.g. a family with IS history) screening for otolith functional asymmetry could be used as predictive factor of scoliosis and help for earlier prescription of IS preventative treatment.

    1 Thanks to the Cotrel Foundation (Fondation de France) for supporting this research.

    2 S.R. Wiener-Vacher, K. Mazda. Asymmetric otolith vestibulo-ocular responses in children with
    idiopathic scoliosis. J. Pediatr 1998 ;132:1028-1032.
    Last edited by Celia; 01-10-2007 at 10:48 AM.

    Canadian eh
    Daughter, Deirdre born Oct 2000. Diagnosed with 60 degree curve at the age of 19 months. Serial casting by Dr. Hedden at Sick Kid's Hospital. Currently being treated by Dr. Rivard and Dr. Coillard in Montreal with the Spinecor brace and curve is holding at "2" degrees. Next appointment 2008

  9. #9
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    This is something Structural stated in the Spinecor thread:


    ...Despite the lack of studies on scoliosis/vest., the field of neurophysiology has a lot to offer many conditions. I am pleased to see it being used in combination with other things. There are methods being used everyday to help people learn to walk again following serious trauma/injury to the spine and/or head.... There are documented cases of formerly parapalegic/quadrapalegic individuals who learned to WALK again (despite the prognosis from their doctors) due, in part, to methods and excersices designed to correct vestibular dysfunctions, usually under the guidance of Physical Therapists and neurologists. (In fact, learning to walk again REQUIRES vestibular re-programming, otherwise it is literally impossible) From my working knowledge of these methods there is nothing mystical or airy fairy about it..... The evidence that it works as an integrative aspect of treatment is all over the place. Although, I certainly agree that there is no evidence or probability that it will ever change a scoliosis in and of itself


    Show me *one* documented case of vestibular rehab correcting a scoliotic spine! This is a scoliosis forum and you insist on bringing up matters which have absolutely nothing to do with scoliosis!
    Last edited by Celia; 01-10-2007 at 10:49 AM.

    Canadian eh
    Daughter, Deirdre born Oct 2000. Diagnosed with 60 degree curve at the age of 19 months. Serial casting by Dr. Hedden at Sick Kid's Hospital. Currently being treated by Dr. Rivard and Dr. Coillard in Montreal with the Spinecor brace and curve is holding at "2" degrees. Next appointment 2008

  10. #10
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    Celia,

    That is probably a good idea for us all... I think all of our points have been made.

    However, I don't believe there was even a "discussion" in the first place, and that was my point. After I deleted all of posts from the spinecor thread as Gerbo intelligently suggested, I went on to read the previous "discussion" he referenced on the matter. I was uphauld to see that you did the same thing to another member, denigrating the topic and again making the same false statements about it. Making condescending remarks about "eye exercises" and claiming the field is "bogus" is not a "discussion". You could have inquired with questions for clarification and understanding instead of dismissing what you didn't know. That's partly why we are gere, to learn something.

    We know now that it is: not a chiro thing, but an MD, not about the eyes/eye exercises per se, but the inner ears, and that the field is not "bogus, but very much scientifically validated for its importance/relevance in a variety of conditions including scoliosis. There may not be the studies you'd like to see at this time, but it is applicable and relevant nonetheless.

    I mean seriously now, Are there any studies proving the efficacy of the spinecor brace 20 -30 -40 years from now? Do we really know that it is going to stabilize the curve indefinitely/permanently, any moreso than other braces have? No, but I still support its use due to its integration of postural re-education via the nervous system(vestibular re-programming). And those folks using the brace are undergoing a generalized vest. re-programming by lessening the curvature and moving/activating the spinal soft tissue at the same time... that is largely the reason for its success... and that is vestibular rehabilitation.

    And by the way, I have nothing, absolutely nothing to gain from people utilizing this approach(financially or otherwise... I use my hands in treatment, no interst in fancy machines... I'll leave that up to the Docs). I do not do this "expensive" testing/rehab that the chiros/MDs do, but rather take a functional approach in working with the dysfunctions.(by the way, haven't I read that bracing costs/replacement parts/straps can be quite expensive. With x-rays, visits, etc.... why keep spending money on frequent x-rays when you know the curve "already exists" and you're using a "proven and effective" method?

    My only stake in this is to prevent the less educated from disseminating false information.

    Gerbo,

    ...just holding people accountable for their comments. What I have posted to end my contribution on this is quite factual.

    structual

  11. #11
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    Quote Originally Posted by structural75
    .. After I deleted all of posts from the spinecor thread as Gerbo intelligently suggested, I went on to read the previous "discussion" he referenced on the matter.
    Sure you did You knew it all along and I really don't see how it was your discussion to reference in the first place and take my words out of context! But since you chose to reference it, I'll post it here to save people the aggravation of going back 50 pages in the Spinecor thread!

    Posted by DizzyMom:
    New to site, interesting read. Have 14 yr daughter- been Boston bracing- 4 yrs- curve worsening. Referral to surgeon. now 30 in brace-thoracic.

    Looking at Spinecor..... Atlanta is closest for me- 7 hours- I'm in eastern NC. Do those of you who have used this awhile feel it is helping? I take it from the site, most kids prefer it over the hard brace.

    Anyone have trouble with getting approval thru insurance?

    Also saw where Shriners does it free. Any other info on this and are they as good there as Dr D and Dr L- except for the Canadian Docs.

    Actually got an appt in just 1 month when I called- but having difficulty with the $6000 up front. Any suggestions or helpful info would be great!



    Posted by Gerbo:
    blasted, $6000 upfront, that's a lot, is that the going rate??

    For what it is worth, and you might have seen this already, this is link to the spinecorwebsite http://www.spinecorporation.com/English/index.htm , with a list of treatment centres




    Posted by Sherie:
    I think we paid $4500, 6k sounds high to me.



    Posted by Celia:
    I think the chiropractors charge more *coughs* because they do some phoney baloney eye exercise testing to "correct" the scoliosis.



    Posted by Christine:
    We just went to Montreal 3 weeks ago. We paid a total of $3534.00 which include 2 x tra body suits. We are also expecting reinbursement of $2434. in out of network insurance. From all of the research we have done the placement of the brace is extremely important to get the best results!!!!

    Perhaps if you could get a referal from a orthopedic in network you may be able to fight for in network benefits.



    Posted by JGD1991:
    Celia, I would be careful to discredit someones work without giving good back up research to support your opinion. There seems to be a number of research articles connecting scoliosis to a vestibular problem. I think that the additional cost to evaluate the vestibular system is worth doing, based on my readings.

    For example i found this paper

    ARE ASYMMETRIC OTOLITH VESTIBULO-OCULAR REPONSES A
    PREDICTIVE FACTOR FOR IDIOPATHIC SCOLIOSIS IN CHILDREN?

    Sylvette R. Wiener-Vacher, and Dominique Antolini., Nn. 1

    The goal of this study was to determine if this asymmetry exists prior to the appearance of the spinal deformities. Our preliminary results show that the vestibulo-ocular asymmetry appears before the spine starts to show any significant clinical and radiological deformity.

    In patients at risk for IS (e.g. a family with IS history) screening for otolith functional asymmetry could be used as predictive factor of scoliosis and help for earlier prescription of IS preventative treatment.




    Posted by Celia:
    I don't see the point of expensive *tests* by chiropractors if the children that go there *already* have scoliosis and as the above study points out "vestibulo-ocular asymmetry appears before the spine starts to show any significant or radiological deformity". What exactly are the chiropractors planning to do with their results ????? Brain surgery ?????


    Posted by JGD1991:
    The vestibular Systems controls the muscle tone of the back muscles surounding the spine . If that system is not working symetrically, the scoliosis is being supported in negative way. Vestibular exercises have been well established and in the research. I rather have this system working with me then against me.


    Posted by Celia:
    You mean eye exercises ? Where is it well established ?



    Posted by Cheryl:
    This may be a factor in scoliosis, but it is one theory of possible causes. It may deserve further study, and probably does. But should the patient pay huge sums to be the recipient of such research? I highly question, not the study, but the profit from the study. That, I think, is where Celia is coming from...

    A true researcher is not going to charge astronomical sums. A true researcher rather is looking for a participant willing to take the risk to be a part of his study.

    The vestibular component of scoliosis and treatment of that component of scoliosis are still under research.

    I think this practice is a racket motivated by profit. It cannot cost 3000 dollars a patient to run these tests and teach the exercises. There is no documentation that these exercises do anything to help the scoliosis. Therefore, they are still experimental. I think it is highly suspect to charge such astronomical sums and prey upon the fears of the parents and patients.

    When and if this is ever a well documented treatment for scoliosis, it would be ethical to charge a reasonable fee.




    Posted by Christine:
    Well said Cherylplinder !!! Dr. Rivard's Office visit was only $100. and he spent approx. 3 hours on my daughters case.



    Posted by Celia:
    The man is a Saint! I have to agree with Christine that Cheryl made some EXCELLENT points!

    JGD: Nowhere in the studies that you have referred to, does it elaborate on how to *correct* this asymmetry. You are trying to legitimize these bogus eye exercises which are totally unproven by referencing studies conducted by *true* researchers such as the Cotrel Foundation.




    Posted by Cheryl:
    Yes, Dr. Rivard is a Saint. He asks so little for his time, I am tempted to make a donation!



    Posted by JGD1991:
    I have two neices in the Spinecor Brace. They both had vestibular imbalances that are being addressed with home exercises. The reason we brought them to NewYork City for Spinecor was that this was the only office that seemed to address other aspects conected to scoliosis. We also found that most of the other spinecor offices did not offer even the exercise program from spinecor. They offered testing that made sense to us. The Vestibular system controls balance and spinal muscle tone. The fees for the testing ranged from 800-1200 for my neices. This test is a well established medical test and these fees were normal for this test. I' m sure Spinecor also had this type of atitude from patients when they first came out. People were being charged for the spinecor brace and wondering why it should cost the same as a hard brace. Over time people are becoming very happy with results and are glad they found it at almost any price.
    In addition, when I was in the new York office for a quartly visit recently with my neices. There was a young child that had been in for 3 months earlier for an examination and had come back for a followup. I was told that the child had a 9 degree curve and was given only vestibular exercises. The parents were expecting that she may have progressed and need a brace only to find out that her curve reduced to less than 1 degree. I was very excited for them and was real happy that we didn't try to cut corners and miss out on any possible benefits from there program.

    Everybody has to do what they feel is the right thing to do. I only came on the forum with my coments because I thought people were being guided improperly.




    Posted by Celia:
    Oh...you're actually a patient ??? I thought you were a chiropractor! These tests are medically established and necessary? According to who ? Do you have studies that show that these eye exercises are nothing but pure fiction ?


    Posted by JGD1991:
    I'm at work but I found a study for you.

    Role of vestibular adaptation in vestibular rehabilitation.
    Herdman SJ. Department of Orthopaedics and Rehabilitation, University of Miami, Coral Gables, Florida 33146, USA.



    Posted by Karen Ocker:
    I see that one of the studies was published in 1979 from Scandinavia; are there any more than 3 such studies?
    Unless other studies ---with other populations by other researchers replicate those results there is not enough evidence suggesting validity as a basis for a treatment modality. Also, were there any flaws in the conduction of those studies? There were not very many subjects.


    Posted by JGD1991:
    I really think that this is going to be the next Ah ha. of course we should have been doing these exercises


    Posted by Celia:
    I think we may be on to something BIG... so, if I have scoliosis and I train my eyes to move in a certain direction this will straighten my spine ?
    Last edited by Celia; 12-27-2006 at 06:39 PM.

    Canadian eh
    Daughter, Deirdre born Oct 2000. Diagnosed with 60 degree curve at the age of 19 months. Serial casting by Dr. Hedden at Sick Kid's Hospital. Currently being treated by Dr. Rivard and Dr. Coillard in Montreal with the Spinecor brace and curve is holding at "2" degrees. Next appointment 2008

  12. #12
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    776
    We know now that it is: not a chiro thing, but an MD, not about the eyes/eye exercises per se, but the inner ears, and that the field is not "bogus, but very much scientifically validated for its importance/relevance in a variety of conditions including scoliosis. There may not be the studies you'd like to see at this time, but it is applicable and relevant nonetheless.
    to a patient with scoliosis there is only one issue which determines relevance; and that is whether effort, time and money spend results in stabilisation, improvement or slowing down of progress, which would not have occured without the particular testing/ treatment.

    With regards to vestibular testing exercises; if we do not have evidence that it improves matters, we do not have evidence that it doesn't make things worse neither.

    Personally i really think that you are a very caring, knowledgeable and responsible practitioner, and i believe that for you this testing is only a small part of your overall approach.

    What has been bothering both celia a nd me that it has appeared to us that some chiropracters has been charging their patients an awful lot of money for having the "benefit" of this testing, without being told about the lack of evidence about the method.

    Remember that the discussion started following a posting about vestibular testing done by doctorsr in the context of scoliosis, so no issue was taken as such about it being done for scientific reasons and/or for the treatment or diagnosis of other conditions by other practitioners, including yourself.

    I mean seriously now, Are there any studies proving the efficacy of the spinecor brace 20 -30 -40 years from now? Do we really know that it is going to stabilize the curve indefinitely/permanently, any moreso than other braces have
    no but the available evidence shows impressive results 2 or more years following completion of treatment, and we are awaiting the publication of the next study which is showing results over an even longer period. And i am sure that you know that if a curve can be maintained below 30 degrees by the time growth has finished the chance of deterioration in later life if much smaller that if the curve is above that level folllowing end of growth

    regards

    gerbo
    Last edited by gerbo; 12-24-2006 at 11:06 AM.

  13. #13
    Join Date
    Sep 2006
    Posts
    416
    Gerbo,
    Thank you for that honest and respectful post. I agree and I sincerely hope that the future studies you refered to on the spincor brace show additional promise.

    I myself, look forward to it, as well as the potential for more direct studies on neurophysiology as it relates directly to scoliosis.

    I'm very sorry that there are practitioners out there who put their financial interests in front of their patients' health. I'm not in any position to judge those said chiros on the matter, but I hope it's not the case.

    Although I stand behind the 'factual' and relevant content of previous posts, I am deeply ashamed for being a part of that kind of negative energy on this forum. I never had the intention of taking personal assualt on anyone, but in the heat of the moment it was all I could do to defend legitimate ground. I will continue to support complimentary, alternative and conventional approaches, but my days of poetic slamming are through. It simply serves no purpose if people aren't willing to listen to both sides.

    My apologies to everyone on this forum for my role in perpetuating a hopeless "discussion" from the start.

    structural

  14. #14
    Join Date
    Mar 2006
    Location
    DFW, TX
    Posts
    159

    Vestibular testing

    I just wanted all to know that my Insurance covered in it full, so I meant 100 percent, and considered it medically necessary. It is something that must be researched and decided upon individually. My understanding was that it was in connection with the whole Spinecor treatment. It is true not all doctors who fit Spinecor use that testing. It is like Spinecor, still being used by some doctors, but not all.

  15. #15
    Join Date
    Mar 2004
    Posts
    1,140
    Quote Originally Posted by structural75
    Celia,

    However, I don't believe there was even a "discussion" in the first place, and that was my point...
    True! The rest of us were having a discussion on scoliosis it was pretty clear to all you were out in left field arguing the relevance of vestibular rehab as it pertains to *other* medical conditions.
    Last edited by Celia; 12-26-2006 at 09:57 AM.

    Canadian eh
    Daughter, Deirdre born Oct 2000. Diagnosed with 60 degree curve at the age of 19 months. Serial casting by Dr. Hedden at Sick Kid's Hospital. Currently being treated by Dr. Rivard and Dr. Coillard in Montreal with the Spinecor brace and curve is holding at "2" degrees. Next appointment 2008

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