Kelly recently did an interview with Lori Thomsen, one of the Postural Restoration Certified (PRC) physical therapists in the Hruska Clinic, about a patient she referred to PRI Vision. We hope this will be helpful for anyone who is unsure of when it is appropriate to refer a patient to us.
Q: What were the indicators you recognized that you used to refer your patient to PRI Vision?
My patient had chronic migraine headaches for over two years. On the day I saw her for the initial evaluation, she reported having a migraine for the last ten out of fourteen days. She also has a history of motor vehicle accidents (MVA) with whiplash injuries in both of them. Her first MVA was when she was in ninth or tenth grade while going through orthodontia. In addition to those factors, I took her through a PRI repositioning program and she could maintain neutrality in her pelvis, but not in her brachial chain (BC) or temporal mandibular cervical chain (TMCC) patterning. However, she was able to reposition and maintain neutrality through her BC and TMCC patterns if I put her in a dark room or if I patched her right eye. She did have a retinal surgery, which seemed to then escalate her symptoms, as she already had an unstable neck prior to the surgery.
Q: As your patient’s case manager, what process did you use to determine the importance of sending her/him to us now?
As my patient’s case manager, I knew at her initial evaluation with me that she would benefit from visual integration with PRI Vision. I referred her to PRI Vision at that initial evaluation for it to be more cost-effective for her, as she had already tried other healthcare professionals prior to seeing me. I also knew she was hoping to become pregnant and she was quitting her job secondary to her migraines. Her job requires her to be at a computer for six to seven hours per day and that is one of the triggers for her migraines. I knew she would have a better outcome in a shorter period of time if she started right away with visual integration. In addition to her staying repositioned with the dark room and eye patching, I knew she had a visual component.
Q: How did you demonstrate to your patient that she/he would benefit from the PRI Vision program and what were the consequences if she/he didn’t go through it?
I always explain to my patients that I refer to PRI Vision that the easy part is getting them neutral. The hard part is getting their body (the neurological system) to integrate with the glasses. It makes my job easier when the patient is neutral and maintaining neutrality to progress them with their program. In this case, the demonstrations of the objective PRI testing results that were positive, the effects the dark room, and eye patching had on my patient proved to her that there was a visual component that needed to be addressed. She could feel the difference in the dark room and with the eye patching that her neck was relaxed and her positive objective PRI tests were then negative. I also ruled out her jaw being a contributing factor, meaning she was on her TMJ discs. PRI Vision helped her to inhibit her neck muscles so I could teach her how to utilize stability through her pelvis and thorax. As far as the consequences go, I don’t think she would have had a positive outcome without visual integration and she would have been frustrated with a lack of progress.