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Table 4 Treatment modalities used in Functional Neurology according to four sources in a scoping review

From: Unravelling functional neurology: a scoping review of theories and clinical applications in a context of chiropractic manual therapy

Sources of information Conditions or signs Tissues at fault Therapeutic modalities Specific comments General comments
Book Chap.19 Migraines and vertigo Right cerebral hemisphere SMT
Eye exercises
Breathing exercises
Nutritional therapy
  Most of the treatment modalities (e.g. SMT, sound therapy, eye exercises) are provided or performed to the opposite side of the targeted hemisphere.
Nutritional therapy consists mainly of vitamin B, omega 3 and C0Q10 supplementation.
Complex regional pain syndrome Cerebral hemisphere(s) Joint manipulations
Counting backwards
Breathing exercises
Nutritional therapy
Hot and cold compresses
Orthotics
The targeted hemisphere is probably the left because counting backwards is said by the author to stimulate the left cerebral hemisphere.
Attention deficit and hyperactivity disorder Right cerebral hemisphere and left cerebellum Joint manipulations
Sound therapy
Spatial rearrangement exercises
Breathing exercises
Nutritional therapy
 
Depression Cerebral cortex Joint manipulations
Sound therapy
Spatial rearrangement exercises
Looking at old photos and making up stories about them
Breathing exercises
Nutritional therapy
 
Low back pain with spinal root compression Right cerebral hemisphere Joint manipulations
Breathing exercises
Nutritional therapy
 
Post SMT symptoms Right cerebral hemisphere and left vestibulo-cerebellar system Joint manipulations
Soft tissue and trigger point therapy
Breathing exercises
Nutritional therapy
 
Chap.20 NA Cerebral hemisphere Activation:
Any complex chore
Manipulative therapy
Eye exercises
Cerebellar activation
Sensory stimuli: visual, auditory, olfactory
Transcutaneous electrical neural stimulation
Inhibition:
Earplugs, blinders
Visualize rather than perform activities
Evoked potentials at reduced amplitude
Some specific stimuli to stimulate the right and the left cerebral cortex are described. Moreover, some specific stimuli directed for the different lobes of the hemispheres are also described [39].
Stimuli directed to the cerebellum are described below.
In Chap. 20, the author does not deal with conditions but only with targeted neurological structures.
NA Cerebellum Manipulative therapy
Warming the auditory canal
Revolving chair
Eye movements
Passive muscle stretch
Squeezing a ball
Pointing
Specific exercises to stimulate the medial part and the lateral part of the cerebellum are also proposed [39].
NA Vestibule Cawthorne-Cooksey exercises
Balance exercises
For details concerning these exercises, see [39].
NA Brainstem Smell and/or taste food
Exercises and/or stimuli of muscles innervated by cranial nerves
Rectal dilation
Specific exercises to stimulate the mesencephalon are also mentioned [39].
NA Sympathetic activity Local application of warm
Transcutaneous electrical neural stimulation
These modalities are described to inhibit the sympathetic activity.
NA Caudate nucleus Visualizing pleasant stimuli In contrast, amygdala and/or hippocampus may be stimulated by visualizing unpleasant stimuli and “narrative recall” and list learning.
Scientific articles Carrick (1997) [9] Enlarged physiological blind spot Cerebral hemisphere SMT   In the articles listed here, the large majority of the therapeutic modalities, i.e. manipulation, vibration therapy, eye exercises, and mirror therapy, are provided or performed depending on the targeted structure(s) and its/their side(s),
except in the articles of Pedro (2005) (where this is not mentioned) and of Hirsh (2013) (where this is only mentioned for vibration therapy).
bThese studies were conducted on healthy subjects who were found with an enlarged blind spot of one of their eyes.
Pedro (2005) [41] Landau-Kleffner syndrome Left hemisphere and right cerebellum Manipulation
Eye movement exercises
Visual, olfactory, auditory, vestibular and somatosensory stimuli
Interactive metronome
Nutrition therapy
There was no precision of which modalities would alter one of the two targeted structure rather than the other.
Daubeny (2010) [57] Enlarged physiological blind spot Cerebral hemisphere Upper extremity manipulations  
Bova (2013) [43] Cervical dystonia Left cerebral cortex (frontal lobe) Eye movement exercises  
Right cerebellum SMT Vibration therapy
Right vestibular system Eye movement exercises
Left basal ganglia Eye movement exercises
Vibration therapy
Blue-lensed glasses
Kuhn (2013) [44] Migraines, attention deficit and hyperactivity disorder, obsessive compulsive disorder, and Tourette’s syndrome Right cortical hemisphere SMT Coordination activities associated with eye movements
Interactive metronome
 
Left cerebellum SMT
Coordination activities associated with eye movements
Interactive metronome
Right basal ganglia SMT Coordination activities associated with eye movements
Interactive metronome
Left pons SMT Coordination activities associated with eye movements
Hirsh (2013) [46] Attention deficit and hyperactivity disorder, primary nocturnal enuresis and musculoskeletal pain Right cortical hemisphere and left cerebellum SMT Blue-lensed-glasses
Optokinetic stimulation
Vibration therapy
Balance exercises
Vestibular stimulation
Timing exercises, including interactive metronome
Home exercises: inhibitory of primitive reflexes, muscles strengthening, and balance exercises.
Dietary changes
There was no precision of which modalities would alter one of the two targeted structure rather than the other.
Esposito (2013) [48] Symptoms related to traumatic brain injury Cortex (including frontal lobe) Off-axis rotational device Other modalities are used (see Additional file 2a) without clear mention of which neurological areas are targeted.
Vestibule Off-axis rotational device
Right lower brainstem Off-axis rotational device
Left upper brainstem Off-axis rotational device
Superior colliculi Red-blue-lenses
Bova (2014) [45] Parkinson’s disease Cerebral cortex SMT
Cross crawl exercises
Mirror therapy
Cross crawl exercises are performed to stimulate the frontal lobe.
Mesencephalon was also targeted without any mention of what modalities were used for.
Basal ganglia Vibration therapy
Blue-lensed glasses
Mirror therapy
Bova (2014) [40] Idiopathic hemiparesthesia Left cerebral cortex (parietal lobe) Vibration therapy SMT and cold laser therapy were also used.
Left vestibular system Eye exercises
Traster (2014) [47] Symptoms related to traumatic brain injury Left cerebral hemisphere Manipulative therapy
Passive complex movements of the extremities
Eye movement therapies
Earth-vertical axis rotations
Breathing exercises were also given to the patient.
Left brainstem (including the left superior colliculus) Optokinetic stimulations
Overall vestibule Eye movement therapies
Earth-vertical axis rotations
Websites Website 4 Symptoms related to traumatic brain injuries Vestibular system Off-axis rotational device   The content of each treatment is individualized, following the statements of the five websites.
All of the practitioners resort to eye exercises and to home exercises and/or lifestyle counseling, especially concerning nutrition (see Additional file 2b).
Interviews Informant 1 NA Temporal lobe(s) Riding a bike   The content of each treatment is described as individualized.
All the informants resort to home exercises.
The majority of them use manipulative therapy and eye exercises (see Additional file 2c).
Informant 2 NA Cerebral hemisphere Manipulative therapy  
Symptoms following traumatic brain injuries Brainstem Somatosensory evoked potential  
Informant 3 NA Cerebral hemisphere Manipulative therapy Coordination exercises and exercises for fine motor skills are performed to stimulate the lateral part of the cerebellum.
NA Cerebellum Manipulative therapy
Coordination exercises
Exercises for fine motor skills
  1. SMT Spinal manual therapy
  2. NA Not applicable