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Balance problems and walking problems after accident injury?

10/9/2018

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Of the approximately 1.3 million (1) people, diagnosed annually with a mild traumatic injury, like concussion, 80% to 90% follow a normal recovery course with full symptom resolution within 3 months of injury.(2,3) The remaining 10% to 20% who are refractory to conventional care may have persistent post-concussion impairments lasting months to years.(4,5) These impairments can include poor performance on divided-attention and dual-tasks activities that combine physical demand (ie, balance and gait) with cognitive loads.(6,7)
 
Mild traumatic brain injury can compromise reaction time, visual perception, memory, attention, balance, and gait. These deficits, especially if persistent, can restrict participation in daily activities and the resumption of personal and profession roles. (8)
 
Treatments for motor vehicle accident injury concussion, slip and fall concussion or mild traumatic injury concussion consisted of clinical techniques including optokinetic stimulation, vestibular rehabilitation and postural stability exercises, targeting specific impairments.
 
After a month treatment, most patients demonstrated significant increases in postural and gait balance with a near complete resolution of all post-concussion symptoms. They successfully returned to normal daily life.
 
 
1. Sosin DM, Sniezek JE, Thurman DJ. Incidence of mild and moderate brain injury in the United States, 1991. Brain Inj. 1996;10(1):47-54.
2. Alexander MP. Mild traumatic brain injury: pathophysiology, natural history, and clinical management. Neurology. 1995;45(7):1253-1260.
3. Binder LM, Rohling ML, Larrabee GJ. A review of mild head trauma. Part I: meta-analytic review of neuropsychological studies. J Clin Exp Neuropsychol. 1997;19(3):421-431.
4. Ruff R. Two decades of advances in understanding of mild traumatic brain injury. J. Head Trauma Rehabil. 2005;20(1):5-18.
5. Ruff RM, Camenzuli L, Mueller J. Miserable minority: emotional risk factors that influence the outcome of a mild traumatic brain injury. Brain Inj. 1996;10(8):551-565.
6. Catena RD, Van Donkelaar P, Chou L-S. Cognitive task effects on gait stability following concussion. Exp Brain Res. 2007;176:23-31.
7. Parker TM, Osternig LR, Van Donkelaar P, Chou L-S. Gait stability following concussion. Med Sci Sports Exerc. 2006;38(6):1032-1040
8. Christopher A. R´abago, PT, PhD, and Jason M. Wilken, PT, PhD. Application of a Mild Traumatic Brain Injury Rehabilitation Program in a Virtual Realty Environment: A Case Study . JNPT 2011;35: 185–193
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NCV or EMG Interpretation and Report Writing for providers

1/13/2016

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​NCV or EMG Interpretation and Report Writing for providers
Reports Writing for Nerve conduction velocity studies and Electromyography tests for providers
ENG/ENG test, balance test: interpretation and report writing
 
Dr. Kim is a board certified chiropractic neurologist (DACNB) and Fellow of the American Board of Electrodiagnostic Specialties (FABES). He provides medical interpretation services for NCV test and balance test. He has been written over 1,500 test Reports for medical providers including primary family doctors. Medical providers outsource medical interpretation with Dr. Kim and achieve cost reduction with the exceptional quality and quick report.
With over years of experience, Dr. Kim provides reports writing services for NCV test, EMG test, ENG/ENG test, balance test. Dr. Kim also provider medical staff training for NCV test or Balance tests. If you need medical interpretation and report writing or medical staff training for NCV test or balance test, please contact Dr. Kim at (813) 777-56387 or Email info@aahachiro.com

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First signs of Parkinson's diasease

7/18/2015

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Parkinson disease (PD) is one of the most common neurologic disorders, affecting approximately 1% of individuals older than 60 years and causing progressive disability that can be slowed, but not halted, by treatment

The progression of Parkinson disease is chronic and slow and taking more than 10 years. If we recognized early signs of Parkinson disease, we could delay or prevent Parkinson’s disease.

Most common first signs of Parkinson disease are loss or decreased sense of smell, decreased arm swing on the first-involved side, shoulder pain/rigid, and sleep disturbances. If you are older than 60 years old with these early signs, please consult with a chiropractic neurologist near you. Chiropractic neurologists can stimulate your weak area of brain with specific brain based treatments. They also provide nutritional evaluation and treatment plan for Parkinson’s disease.

Other clinical symptoms of Parkinson disease include upper extremity  tremor, subtle decrease in dexterity, soft voice, decreased facial expression, rapid eye movement (REM) behavior disorder (RBD; a loss of normal atonia during REM sleep), symptoms of autonomic dysfunction (eg, constipation, sweating abnormalities, sexual dysfunction, seborrheic dermatitis), a general feeling of weakness, malaise, or lassitude, depression or anhedonia, slowness in thinking, progressive bradykinesia, rigidity, gait difficulty, flexed posture, and variable strides, postural instability.

Early recognition of the symptoms can promote early diagnosis and thus early intervention, which often results in a better quality of life. Chiropractic neurologist can provide a brain based treatment for Parkinson’s disease, Alzheimer disease, supranuclear palsy, frontal lobe degeneration and persons with traumatic brain injury, auto accident injury or whiplash injury who has symptoms like loss of sense of smell, personality changes, visual disturbance, difficult speaking, hearing loss, headache, balance problems, decreased arm swing, shoulder pain/rigid, sleep disturbances and difficult walking, etc.

 
Resources:
1.     Parkinson Disease, Author: Robert A Hauser, MD, MBA; Chief Editor: Selim R Benbadis, http://emedicine.medscape.com/article/1831191-overview

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Tips to Avoid Permanent impairment from a Car Accident Injury

6/14/2015

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1. Seek treatment immediately to reduce the likelihood of healing wrong permanently
2. Treat the inflammation immediately
3. Do not take medications for more than a few days they inhibit collagen the healing tissue from forming.
4. Start physical medicine as soon as possible to allow for proper healing within the joints
5. Be aware there are three types of motion to be restored after an injury: active-like exercise, passive-like a therapist, joint motion-chiropractic adjustment
6. Be aware there are 3 phases to healing: inflammation-takes 72 hours, repair phase-takes 6 to 12 weeks, remodel phase-3 to 12 months.
7. Healing does not start until after the inflammation phase is reduced why it is critical to control the inflammation
8. The repair phase is when the healing begins and starts with 72 hours of the injury and last up to 12 weeks thereafter.
9. The repair phase of healing is a short window of time after an injury where the healing tissue is laid down to repair the damaged tissue. That tissue is called collagen.
10. If during the repair phase of healing the healing tissue called collagen is not properly treated with physical medicine the chances of a permanent injury are significantly increased.
11. One factor during the healing phase after an injury is collagen formation. If the collagen is not treated properly it will heal only 70% as strong as the original tissue leading to the likelihood of future injury.
12. One factor during the healing phase after an injury is collagen formation. If the collagen is not properly treated with it will heal with less elasticity and mobility than the original tissue, this leads to stiffness and restriction in that area in the future.
13. One factor during the healing phase after an injury is collagen formation. If the collagen is not properly treated with physical medicine there will be an increase number of peripheral nerves leading to permanent pain in that area.
14. One factor during the healing phase after an injury is collagen formation. If the collagen is not properly treated with physical medicine the nerves heal more sensitive. This leads to pain in the injured area in the future.
15. During the repair phase of healing which last from 3 days to 12 weeks after an injury be sure to have physical medicine applied to the affected area.
16. During the healing phase do not just take medications for the treatment of the injury. Medications such as anti-inflammatory and cortisones based medications will inhibit the healing tissue collagen from forming leading to weak and stiff tissue.
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Tips to Maximize your compensation after an car accident injury

6/14/2015

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1. Must file traffic accident report
2. Hire an attorney
3. Go to the emergency room or doctor office as soon as possible after injury
4. Follow up with your doctor appointments
5. Make all your diagnostic appointments even if you feel better
6. Make sure the doctor knows any and all restrictions due to accident
7. See more than one doctor, get second opinion
8. Hire attorney that is a certified trial attorney
9. Only use attorney that specializes in PI case's
10. Make sure that attorney will handle your case not an associate
11. Ask your attorney when was the last time he went to court for a PI case
12. Is the attorney law license up to date and does he have malpractice insurance
13. Does your attorney have any bar complaints against them
14. Get any names of witness
15. Be sure the exact mechanism of injury is taken at your doctor's office including weather conditions, road conditions, wearing seat belt, position of your body on impact.
16. Be sure to have diagnostic test run especially those test which test your injured area range of motion, muscle strength test, reflexes, sensation, stationary x-rays and motion x-rays, MRI if needed.
17. Your doctor knows how to give an AMA impairment rating
18. Your doctor is willing to testify in court if needed
19. Reexaminations are performed to document healing or permanent injury
20. Second opinions from different types of doctors that specialize in PI cases: neurosurgeon, neurologist, GP in physical medicine, chiropractor, physical therapist
21. Any days off from work due to injury
22. Any restrictions from work due to injury
23. Do not miss your doctor's appointments even if you feel better
24. Be sure your attorney sign an attorney lien for each of your doctors to insure you get the proper medical reports needed for your case
25. Your PI attorney know how to apply the AMA impairment guides
26. Require your attorney to not settle the case until the doctor has released you from care
27. Ask your doctor for an impairment of the injury after the care is completed
28. All your doctors have the findings for all your diagnostic tests and each other's medical records
29. Be sure to have pre and post diagnostic test and compare the differences this helps to establish is you have a permanent injury
30. The best test to document your injury: MRI, motion x-rays, nerve conduction velocity test, digital muscle strength test, digital range of motion test
31. Maintain open communication with your doctors and attorney and ensure they are communication with each other
32. Hire an attorney that will sign an attorneys lien by all your doctors, they are needed for your doctors to get paid and their corporation
33. Hire an attorney that will take your case on contingency
34. Hire an attorney that charges the same percentage that the other attorneys in the area charge
35. Hire an attorney that has taken a PI case to court in the last year.
36. Hire an attorney that will not settle your case without your consent
37. Hire an attorney that has won a PI case in court
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    Yong H. Kim, DC, DACNB, FABES, FIAMA Dipl.Ac.
    ​Chiropractic Neurologist


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