Physical Therapy Services

At High Definition Physical Therapy (HDPT) in Denver, CO, Englewood, we offer the following physical therapy, brain rehabilitation, vestibular rehabilitation, and sport performance services:

Our Philosophy for Physical Therapy

We believe that in order to improve human function you must challenge it. To that end, our physical therapy approach is a customized challenge for each patient. Our approach starts with a physical therapy evaluation, a balance assessment, use of evidence-based measurement tools, and VNG testing.

Then we utilize multiple therapeutic treatment options including sensory motor exercise, use of a multi-axial rotational system (MARS) targeting visual, auditory and task oriented stimulation, and manual physical therapy. Our goal is to maximally challenge each patient and promote brain healing.

The standard process:

1. Evaluation
2. VNG Testing
3. VNG Results discussed with patient
4. Treatment – multiple sessions utilizing MARS
5. Re-evaluation
6. Manual Therapy
7. Education and Maintenance

Your Rehabilitation Plan

After your initial evaluation we set up the necessary diagnostic tests for you and perform them. Once we get the results, we bring you in for a consultation concerning the results and outline your treatment plan. Although plans are individualized, here is a typical HDPT rehabilitation plan.

1. Multi-axle rotational chair by Ultrathera: This chair can spin 360 degrees forward and backward as well as 360 degrees side to side and is utilized to rehabilitate central and peripheral vestibular issues.
   • Peripheral vestibular dysfunction: If a crystal is dislodged and goes in to the canal we use the chair to reposition it on the membrane by using gravity and momentum with a process called the Barany Maneuver. The Barany maneuver typically takes 2 treatment sessions to be effective with a minimum of one-day rest and a maximum of one-week rest in between treatment sessions. If there is a peripheral vestibular dysfunction we address this before we address any central vestibular dysfunction.
   • Central vestibular dysfunction: In order to rehabilitate central dysfunction, we need to stimulate the brain to a point where it begins to heal itself (a process known as neuroplasticity). The brain will heal itself in response to appropriate stimulation by either repairing pathways or creating new ones. The chair allows us to stimulate the vestibular system while also stimulating the brain and visual systems to repair central dysfunction. We use a 7 treatment cycle (Central TRX) to accomplish this. The treatment cycle occurs over a three-week time period in which we have 3 treatment sessions in 3 consecutive days the first week and 2 treatment sessions a week with a day of rest in between for the last 2 weeks.
2. Exercises: Performed during the cycle

In order for full rehabilitation to occur, we also include exercises designed to rehabilitate the visual and balance systems that have been disrupted. This is done through a variety of exercises in the clinic and at home and will be directed by your treating therapist.

Safety

At HDPT we are committed to ensuring the safety of all our patients throughout the entire treatment process. Below are some of the safety practices we use to ensure safe treatment for all our patients.

• Our Multi-Axial Rotational System (MARS and also known as a GyroStim) has been vigorously tested for safety and has a fail-safe design. Fail-safe design means there are redundant stop controls that protect the patient against any malfunctions.
• Our multi-axial rotational chair has been inspected and deemed safe by Intertek Testing Services NA, Inc. and has been cleared for use in research with human subjects by multiple institutional review boards around the country and world.
• At the highest speeds our chair can produce, we do not exceed 3 G forces which is less than the average 5+ G forces that roller coasters produce.
• The most important part of treatment is communication with your therapist. At HDPT we are committed to providing an all around positive and beneficial experience to all our patients and encourage questions throughout our process.
• The process of brain treatment and recovery can be uncomfortable and at times provoke symptoms related to injury. Our goal at HDPT is to get our patients back to their prior level of function. Before starting treatment, please ask your therapist any questions you may have related to potential symptoms, safety of the machine, how our process works, etc. We are here for youand look forward to being a part of your rehabilitation journey.

Below is an image of MARS and its associated safety features:

Recovery

There are some factors involved in recovery that we can control (for example time spent in front of TV screens) and some that are simple out of our control (for example how fast your body naturally heals). Below is a list of factors we have found can be barriers to speedy recovery and things we ask you to consider while undergoing treatment. If you have any further questions about this list, please ask your therapist.

• Compliance with treatment protocol: We have used evidence and past experience to develop this protocol and have found the best results when patients adhere to the above noted treatment schedule. We understand things come up and are ready and willing to work with you but understand our best results come with the above noted treatment schedule.
• Stress: Life continues even when you are recovering from an injury and to a certain extent we cannot eliminate stress from our lives completely; however too much stress can impede recovery. During your treatment cycle we ask that you try and limit stress to your brain to the best of your ability.
• Screen time: Light from screens (TV, computer, cell phone) is highly stressful to the brain. Although we understand that currently we cannot avoid screens completely, we ask that you try and reduce your screen time to allow for the greatest potential for recovery.
• Use of THC/marijuana and alcohol: Research suggests that use of THC/marijuana and alcohol can stunt the brains ability to heal itself after injury and we recommend that you refrain from using these substances throughout your entire treatment cycle.

Potential Reactions to Treatment

During the process of physical therapy it is normal to have increased symptoms and/or new symptoms that arise as the brain heals. The following lists potential reactions to treatment. Please note that it is not a comprehensive list.

• Temporary worsening of pre-existing symptoms
• Potential new symptoms that may arise:
  • Headache
  • Nausea
  • Dizziness
  • Mental fogginess
  • Fatigue
  • Pressure and ringing in the ears
    
  • Changes in vision, hearing, or balance
    
  • Changes in light or noise sensitivity
    
  • Difficulty finding words
    
  • Difficulty with memory or organizing thoughts
    
  • Changes in mood
    
  • Increased anxiety and irritability
    
  • Vivid dreams or nightmares
    
  • Changes in quality of sleep

We are aware of these reactions and want to hear from you about new or worsening symptoms in order to adjust your physical therapy treatment accordingly. If you ever are concerned about your response to treatment, please call the clinic and speak to your treating therapist.

World-Class Physical Therapy in Denver CO, Englewood

In Colorado, you can see a physical therapist as a first line of care without a doctor’s order. Always consult with your insurance provider for coverage details. Contact HDPT today to schedule a free phone consultation.