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An Ottawa chiropractor is offering an alternative therapy to treat concussions — one endorsed by hockey superstar Sidney Crosby — but concussion experts caution there’s no proof that the practice of “functional neurology” can be of any real help to patients.
Joseph Lawrence, who has been a chiropractor for 27 years, is offering the technique pioneered by Canadian Ted Carrick, who uses eye-tracking and balance measurements to prescribe exercises that he says can speed recovery of areas of the brain damaged by concussions or head trauma. Carrick was enlisted to help treat Crosby in 2011 when the Pittsburgh Penguins captain was recovering from two concussions that kept him from regular play for more than a year.
Lawrence completed Carrick’s “chiropractic neurology” course and is now offering the service at his Broadview Avenue clinic.
It is, he says, one treatment for the “miserable minority” — the 15 per cent of concussion sufferers who endure lingering effects such as headaches, nausea and blurred vision many weeks after most others have recovered.
“The simple statistics is that 85 per cent of concussions will resolve in and around a two-week period,” Lawrence said. “But it is what we call the miserable minority that their symptoms do not go away after two weeks. Those are the individuals who have the headaches, the nausea, the dizziness the cognitive issues — and those are the individuals that with the type of treatment we do to stimulate the brain’s plasticity, that we can have them, in a fair number of cases, show significant improvement and get back to a normal lifestyle.”
Lawrence, 56, became interested in treating concussions after he suffered serious head trauma himself in 1978. The recovery was achingly slow. “If your brain isn’t working, then there’s not much in life that is enjoyable,” said Lawrence, who credits Carrick’s treatment for helping him get better.
After completing his bachelor of science degree at University of Toronto, Lawrence studied at the Canadian Memorial Chiropractic College and later earned a fellowship in functional neurology. Studying at Carrick’s centre in the U.S. has led to his being certified by the American College of Functional Neurology.
At his clinic, Lawrence uses techniques called videonystagmography, which measures how eyes track targets, saccadometry, which measures how fast eyes can hit a target, and posturography, which measures how well the brain works to maintain balance. The technology isn’t new, he said, but using it to diagnose and prescribe concussion treatment is.
But Canada’s leading expert on concussions, Dr. Charles Tator, who testified at the inquest into the death of Barrhaven teen Rowan Stringer, says Carrick’s methods and the techniques of chiropractic neurology have never been properly studied. Another expert, Dr. Kristian Goulet of the Children’s Hospital of Eastern Ontario, worries that the high cost of the treatment would only add to the stress of someone suffering post-concussion syndrome, which is already known to be stressful and debilitating.
“Post-concussion syndrome doesn’t need to come from concussions and often it doesn’t,” Goulet said.
“With chronic cases where people are going three, six, 12 months without getting better, we know that if you live with anything for three months it starts to wear you down. When you’re worn down, you’re more likely to have headaches and concentration difficulties, sleep problems, employment issues,” he said.
Goulet is a “huge fan” of allied health treatments, but says he still needs to see proof that they work.
“I’ve seen people go in for treatments that have not been proven to work, but people are drained $2,000, $4,000, $10,000. That is a real and true problem … Until you have true proof, you have to be very careful about what type of alternative therapies you do. Anecdotal evidence and testimonials do not count as true therapies.”
Chiropractic care is not covered by OHIP, though some private health insurance plans will cover at least a portion of the costs.
Tator, a professor of neurosurgery at the University of Toronto and the former top neurosurgeon at Sunnybrook Hospital, said he’s never heard of anyone being harmed by the Carrick treatment but added that no one has ever done a proper study. A controlled medical study could cost as much as half a million dollars, he said.
“A real study costs and that’s why they don’t do it. It’s less expensive to just advertise that it works and hope that nobody asks the obvious questions,” Tator said. “It can be very expensive and it may be an unnecessary diversion.
“Perhaps some of these treatments will work, but 20 years from now we’ll still be scratching our heads because no one has done the proper research.”
An initial assessment at Lawrence’s clinic costs $475 and follow up appointments are $185 per visit. It’s difficult to say how long a typical treatment lasts for someone with post-concussion treatment.
“Generally, we’d work with them for a six- to eight-week period and then reassess,” Lawrence said. “If we see the individual is getting significant improvement in that timeline then we’ll continue. But if there’s no change — and that doesn’t happen too often — we’ll recommend that continuing with us isn’t a plan of action.
“Usually, by the time they’ve seen me, they’ve been through everything under the sun. We’re usually near the end of the line for their protocol.”
bcrawford@ottawacitizen.com
Twitter.com/getBAC
查看原文...
Joseph Lawrence, who has been a chiropractor for 27 years, is offering the technique pioneered by Canadian Ted Carrick, who uses eye-tracking and balance measurements to prescribe exercises that he says can speed recovery of areas of the brain damaged by concussions or head trauma. Carrick was enlisted to help treat Crosby in 2011 when the Pittsburgh Penguins captain was recovering from two concussions that kept him from regular play for more than a year.
Lawrence completed Carrick’s “chiropractic neurology” course and is now offering the service at his Broadview Avenue clinic.
It is, he says, one treatment for the “miserable minority” — the 15 per cent of concussion sufferers who endure lingering effects such as headaches, nausea and blurred vision many weeks after most others have recovered.
“The simple statistics is that 85 per cent of concussions will resolve in and around a two-week period,” Lawrence said. “But it is what we call the miserable minority that their symptoms do not go away after two weeks. Those are the individuals who have the headaches, the nausea, the dizziness the cognitive issues — and those are the individuals that with the type of treatment we do to stimulate the brain’s plasticity, that we can have them, in a fair number of cases, show significant improvement and get back to a normal lifestyle.”
Lawrence, 56, became interested in treating concussions after he suffered serious head trauma himself in 1978. The recovery was achingly slow. “If your brain isn’t working, then there’s not much in life that is enjoyable,” said Lawrence, who credits Carrick’s treatment for helping him get better.
After completing his bachelor of science degree at University of Toronto, Lawrence studied at the Canadian Memorial Chiropractic College and later earned a fellowship in functional neurology. Studying at Carrick’s centre in the U.S. has led to his being certified by the American College of Functional Neurology.
At his clinic, Lawrence uses techniques called videonystagmography, which measures how eyes track targets, saccadometry, which measures how fast eyes can hit a target, and posturography, which measures how well the brain works to maintain balance. The technology isn’t new, he said, but using it to diagnose and prescribe concussion treatment is.
But Canada’s leading expert on concussions, Dr. Charles Tator, who testified at the inquest into the death of Barrhaven teen Rowan Stringer, says Carrick’s methods and the techniques of chiropractic neurology have never been properly studied. Another expert, Dr. Kristian Goulet of the Children’s Hospital of Eastern Ontario, worries that the high cost of the treatment would only add to the stress of someone suffering post-concussion syndrome, which is already known to be stressful and debilitating.
“Post-concussion syndrome doesn’t need to come from concussions and often it doesn’t,” Goulet said.
“With chronic cases where people are going three, six, 12 months without getting better, we know that if you live with anything for three months it starts to wear you down. When you’re worn down, you’re more likely to have headaches and concentration difficulties, sleep problems, employment issues,” he said.
Goulet is a “huge fan” of allied health treatments, but says he still needs to see proof that they work.
“I’ve seen people go in for treatments that have not been proven to work, but people are drained $2,000, $4,000, $10,000. That is a real and true problem … Until you have true proof, you have to be very careful about what type of alternative therapies you do. Anecdotal evidence and testimonials do not count as true therapies.”
Chiropractic care is not covered by OHIP, though some private health insurance plans will cover at least a portion of the costs.
Tator, a professor of neurosurgery at the University of Toronto and the former top neurosurgeon at Sunnybrook Hospital, said he’s never heard of anyone being harmed by the Carrick treatment but added that no one has ever done a proper study. A controlled medical study could cost as much as half a million dollars, he said.
“A real study costs and that’s why they don’t do it. It’s less expensive to just advertise that it works and hope that nobody asks the obvious questions,” Tator said. “It can be very expensive and it may be an unnecessary diversion.
“Perhaps some of these treatments will work, but 20 years from now we’ll still be scratching our heads because no one has done the proper research.”
An initial assessment at Lawrence’s clinic costs $475 and follow up appointments are $185 per visit. It’s difficult to say how long a typical treatment lasts for someone with post-concussion treatment.
“Generally, we’d work with them for a six- to eight-week period and then reassess,” Lawrence said. “If we see the individual is getting significant improvement in that timeline then we’ll continue. But if there’s no change — and that doesn’t happen too often — we’ll recommend that continuing with us isn’t a plan of action.
“Usually, by the time they’ve seen me, they’ve been through everything under the sun. We’re usually near the end of the line for their protocol.”
bcrawford@ottawacitizen.com
Twitter.com/getBAC
查看原文...
