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Epigenetic Influences On Brain Development And Plasticity

Epigenetic Influences On Brain Development And Plasticity

Epigenetic: A fine interplay exists between sensory experience and innate genetic programs leading to the sculpting of neuronal circuits during early brain development. Recent evidence suggests that the dynamic regulation of gene expression through epigenetic mechanisms is at the interface between environmental stimuli and long lasting molecular, cellular and complex behavioral phenotypes acquired during periods of developmental plasticity. Understanding these mechanisms may give insight into the formation of critical periods and provide new strategies for increasing plasticity and adaptive change in adulthood.

Introduction

During early development, neuronal circuits are created and connections between neurons undergo remodeling as they develop their adult functional properties in response to the surrounding environment. The adult brain loses this extraordinary plasticity. Recent findings support a key role of epigenetic factors in mediating the effects of sensory experience on site-specific gene expression, synaptic transmission, and behavioral phenotypes. Here we review recent evidence implicating multiple epigenetic mechanisms in experience-dependent changes during development and discuss their role in critical period expression in the developing and adult brain.

Epigenetics: Molecular Mechanisms Of Gene Regulation

The term �epigenetic� refers to chromatin modifications which alter gene expression without affecting DNA sequence. The factors that contribute to the epigenetic regulation of transcriptional activity are numerous and include microRNA [1], DNA methylation [2,3] and post- translational modifications of nucleosomal histones [2,4]. DNA methylation refers to a chemical modification to DNA whereby cytosine is converted to 5-methylcytosine with the consequence of reduced accessibility of the DNA to transcription factors (Figure 1a�d). These modi- fications can be stable and heritable and provide a critical mechanism in cellular differentiation [3]. The process of methylation is dependent on the presence of methyl donors (provided by nutrients such as folic acid, meth- ionine and choline) and methyltransferases which med- iate either maintenance (i.e. DNMT1) or de novo DNA methylation (i.e. DNMT3). Transcriptional repression associated with DNA methylation is further sustained through methyl-binding proteins such as MeCP2 [5]. Epigenetic control of gene expression is also mediated through multiple post-translational modifications of histone proteins, including methylation, acetylation and ubiquination, which can alter the accessibility of DNA and the density of chromatin structure (Figure 1e,f). In particular, histone acetylation is associated with increased transcriptional activity whereas histone deacetylation is associated with transcriptional repression. The acetylation state of these nucleosomal proteins is controlled by the presence of histone acetyltransferases (HATs), histone deacetylases (HDACs), which are recruited by methyl-binding proteins, and by HDAC inhibitors, which effectively increase gene expression through shifting histones to an acetylated state [2,6]. The timing and degree of gene expression are controlled through these complex mechanisms, thus providing a link between single genotypes and multiple phenotypes.

Epigenetic Factors & The Influence Of Early Life Experiences

In mammalian development, the prenatal and postnatal periods are characterized by rapid changes in neuronal organization, thus providing a critical window of opportunity during which environmental experiences can lead to long-term influences on brain and behavior. There is increasing evidence for the role of epigenetic factors in mediating the relationship between these experiences and long-term outcomes. Mueller and Bale [7] have recently demonstrated decreased DNA methylation of the corticotrophin-releasing-factor (CRF) gene promotor and increased methylation of the glucocorticoid receptor (GR) exon 17 promotor region in hypothalamic tissue of adult male mice born to gestationally stressed females. These epigenetic modifications are associated with exposure to stress during the early stages of prenatal development and may involve dysregulation of placental gene expression. The nutritional environment during fetal development has likewise been demonstrated to influence growth, metabolism and brain development and there is increasing evidence that dietary levels of methyl-donors can epigenetically alter gene expression in offspring [8,9]. In rats, Lillycrop et al. [10] illustrate that GR 110 and PPARa (peroxisome proliferator-activated receptor alpha) gene promotor methylation is reduced in the hepatic tissue of offspring born to protein restricted dams whereas methylation is increased in offspring of dams whose diet is supplemented with methyl donors [10,11]. These effects may be related to DNMT1 expression, which is likewise decreased with dietary protein restriction [11]. Prenatal nutritional regulation of DNA methylation has similarly been observed in brain tissue associated with levels of DNMT1 expression [12], suggesting that in the rapid period of cell division ocurring during fetal development, the level of methyl donors can have a significant impact on transcriptional activity that is maintained into adulthood.

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The role of epigenetic modification in sustaining the effects of environmental experience has also been demonstrated in the context of postnatal mother�infant interactions. Individual variations in maternal care during the immediate postpartum period in rats are associated with changes in offspring hypothalamic-pituitary-adrenal (HPA) activity, neuroendocrine systems involved in reproduction and hippocampal plasticity [13]. Analyses of levels of promotor methylation within the hippocampal GR 17 and hypothalamic ERa genes in offspring of rat dams that provide high vs. low levels of maternal care indicate that high levels of care are associated with decreased promotor methylation and thus increased gene expression [14,15]. Though the route through which these epigenetic changes are mediated is not yet clear, there is evidence for increased binding of nerve growth factor-inducible protein A (NGFI-A) to the GR exon 17 promoter amongst offspring who receive high levels of care in infancy [15] and in vitro models suggest that NGFI-A up-regulation is associated with histone acetylation, DNA demethylation, and activation of the exon 17 GR promoter [16]. The relevance of these effects in humans has recently been demonstrated by Oberlander et al. [17] in the analysis of methylation status of the GR promotor at NGFI-A binding sites in cord blood mononuclear cells of infants exposed to third trimester maternal depressed or anxious mood. Maternal depression was found to be associated with increased GR 1F promotor methylation in fetal blood samples and these methylation patterns predicted HPA reactivity in infants at 3 months of age [17]. Analysis of hippocampal tissue from suicide victims with a history of childhood abuse similarly indicates lower GR expression and higher GR 1F promotor methylation associated with disruptions of the early environment and confirms the findings from rodent studies that differential NGFI-A binding is a functional consequence of these epigenetic effects [18]. However, the impact of perinatal mother� infant interactions is not limited to GR regulation as illustrated by Roth et al. [19] examining the effects of postnatal abuse on offspring brain derived neurotrophic factor (BDNF) methylation [19]. In rats, an increase in methylation of exon IV of the BDNF promotor and consequent decrease in BDNF mRNA in the prefrontal cortex was found in association with exposure to periods of abusive maternal care (dragging, rough handling, etc.). As was the case with the effects of individual differences in maternal care, these effects emerged in infancy and were sustained into adulthood. Moreover, these effects on BDNF exon IV methylation are perpetuated to the F1 generation suggesting a role for epigenetic mechanisms in transgenerational effects [20].

Development Across The Lifespan: Epigenetics & Experience Dependent Plasticity

The previous section highlights the stable effects of early life experiences and how these events become encoded at a molecular level. Another approach to the study of epigenetics and development comes from studies of synaptic plasticity during the expression of long-term potentiation (LTP) and memory consolidation. High levels of maternal care and exposure to juvenile environ- mental enrichment (EE) have been demonstrated to improve capacity for learning and memory associated with LTP enhancement [21,22]. Moreover, recent evidence suggests that EE modulates NMDAr/p38/LTP signaling pathways in the hippocampus and improves contextual fear memory formation across generations such that offspring of enriched mothers likewise show enhanced LTP even when cross-fostered at birth to non- enriched mothers [23]. Environmental enrichment has been associated with increased histone acetylation in the hippocampus and improved spatial memory [24,25]. Pharmacological targeting of the epigenome has been used to demonstrate the role of histone acetylation and DNA methylation in the consolidation of long-term memory [26]. Treatment with zebularine (an inhibitor or DNA methyltransferases) has been shown to block memory formation and reduce histone acetylation following con- textual fear conditioning in adult rats [27] whereas treatment with the HDAC inhibitor sodium butyrate lead to enhanced formation of contextual fear memories [28]. The particular HDAC target of these inhibitors may be HDAC2 as recent evidence has emerged illustrating decreased synaptic plasticity and memory formation in mice over-expressing HDAC2 but not HDAC1; with the converse effect in HDAC2-deficient mice [29]. These studies illustrate a possible relationship between synaptic activity and histone acetylation/DNA methylation in mature neurons, suggesting that there is continued plasticity in these epigenetic systems beyond the prenatal and postnatal periods of development.

Epigenetic Mechanism & The Regulation Of Synaptic Transmission

Activity-dependent changes in gene expression within neuronal pathways during development may serve as a critical pathway linking experience of the external environment and epigenetic modifications within the cell nucleus. In a recent study, Monteggia and colleagues elegantly demonstrated that spontaneous synaptic trans- mission in hippocampal neurons is regulated by alterations in DNA methylation that occur in response to synaptic activity [30]. Treatment with a DNMT inhibitor lead to a significant decrease in frequency of miniature excitatory post-synaptic currents (mEPSCs) and rate of spontaneous synaptic vesicle fusion correlated with a decrease in BDNF promoter I methylation and increased BDNF expression. This effect was blocked with inhibition of synaptic activity and reductions in mEPSCs were prevented in the absence of MeCP2. These results strongly suggest a role for DNA methylation/MeCP2 pathways in the control of synaptic function. Activity- dependent phosphorylation of MeCP2 via Ca2+-calmodulindependent kinase II has been shown to cause MeCP2 dissociation from target genes and relieve transcriptional repression [31]. Consequently, genes such as BDNF are increased in expression leading to normal dendritic patterning and dendritic spine development [32]. These findings suggest an epigenetic mechanism through which neurons can monitor alterations in activity level and adjust neurotransmitter output via altered gene expression with consequences for network excitability and circuit refinement. Impairments in these MeCP2 pathways may lead to several neurodevelopmental abnormalities including Rett syndrome, infantile autism, mental retardation, and schizophrenia [33] and targeted deletion of MeCP2 in the amygdala has recently been demonstrated to impair learning and memory and lead to increased anxiety-like behavior in mice [34].

Epigenetic Control Of Critical Period Plasticity

Though epigenetic mechanisms have certainly been implicated in mediating the high levels of plasticity in early development, it is also possible to view the decreased plasticity and sensitivity that occurs later in development from an epigenetic perspective. Neocortical circuits are extremely sensitive to manipulations of the sensory environment during restricted temporal windows of postnatal development called �critical periods�. For example, an imbalance in binocular vision during child- hood affects perception leading to amblyopia or �lazy eye�. Monocular deprivation (MD) reproduces this classical paradigm of experience-dependent plasticity [35]. The striking physiological effect of MD is a shift in visual cortical neuron response in favor of the non-deprived eye; an example of ocular dominance (OD) plasticity. The critical period during which this OD plasticity occurs is defined by the activation and subsequent inhibition of specific molecular pathways involving signaling molecules such as aCaMKII, calcineurin, PKA, ERK, and CREB [36]. Recently, Pizzorusso and colleagues identified rapid increases in ERK-dependent phosphorylation of histones associated with activation of the juvenile visual cortex and a developmental downregulation of this effect in older mice [37]. In adult mice, the reduced OD plasticity can be reinstated through treatment with the HDAC inhibitor trichostatin A (TSA). Multiple cellular mechanisms might contribute to experience-dependent plasticity expression [38]. Further work is necessary to understand if epigenetic mechanisms are generally acting in all cellular substrates or only within a specific subset.

Myelin maturation has also been proposed as one of the major factors contributing to decreased neuronal plasticity. During the onset of critical period plasticity, oligodendrocytes start to express specific myelin structural proteins, including myelin basic protein (MBP), myelin-associated glycoprotein (MAG), myelin oligodendrocyte glycoprotein (OMgp) and myelin-associated oligodendrocyte basic protein (MOBP) [39]. As myelination reaches adult levels, OD plasticity is strongly reduced or absent. MAG and OMgp may contribute to critical period closure through activation of Nogo receptors. Indeed, mice lacking Nogo receptors exhibit OD plasticity even in adulthood [40]. Manipulation of epigenetic status of oligodendrocytes may also be an effective strategy for modulating plasticity. Casaccia-Bonnefil and colleagues have shown that histone modifications are involved in oligodendrocyte precursor cell (OPC) differentiation during development and in recovery from injury [41� 43]. Administration of the HDAC inhibitor valproic acid during the critical period of myelination onset was found to prevent the OPC maturation into myelinating cells. These results suggest that HDAC activity during a specific temporal window of postnatal development is required for OPC differentiation and myelination. At later developmental stages, histone deacetylation subsides and is replaced by repressive histone methylation and the establishment of a compact chromatin structure, characteristic of the differentiated oligodendrocyte phenotype [43]. Shen et al. [44] found that in response to damage of oligodendrocytes, robust remyelination occurred in juvenile but not in older animals with the new myelin synthesis preceded by down regulation of oligodendrocyte differentiation inhibitors and neural stem cell markers and the recruitment of HDACs to promoter regions. This HDAC recruitment is inefficient in older brains, allowing for the accumulation of transcriptional inhibitors and prevention of myelin gene expression. This age-depend- ent effect can be induced in young mice treated with HDAC inhibitors during the period when damage to oligodentrocytes is occurring. Thus, there are epigenetic changes that are characteristic of periods of developmental plasticity that could provide a target for therapeutic intervention in the event of CNS damage. The use of HDAC inhibitors to increase plasticity in the brain may be a promising therapeutic approach as there is conver- ging evidence from rodent models that treatment with these compounds (1) can lead to dramatic shifts in gene expression and behavior in adult offspring who have received low levels of maternal care [15] and (2) mimic the effects of EE on reversal of neurodevelopmental abnormalities [24]. Rather than producing a generalized increase in transcription, these compounds lead to acti- vation of a specific subset of genes [45�47], suggesting possible targeted intervention to reinstate plasticity in adult brain.

Conclusions

There is converging evidence for the role of epigenetic modifications such as histone acetylation and DNA meth- ylation in both the stability and plasticity of developing neuronal circuits. The persistent effects on gene expression that can be achieved through these mechanisms provide a biological route through which environmental experiences can become embedded, leading to long-term changes in neurobiology and behavior. Enhancing plasticity in the adult brain is an exciting prospect and there is certainly evidence emerging that suggest the possible use of epigenetic factors to induce a �younger� brain. The challenge of future studies is to establish the pathways through which site-specific and gene-specific transcriptional modifications can be achieved and to better understand the route through which experiences across the lifespan induce this molecular plasticity.

Michela Fagiolini 1, Catherine L Jensen 2 and Frances A Champagne 2

Current Opinion in Neurobiology 2009, 19:1�6
This review comes from a themed issue on Development
Edited by Takao Hensch and Andrea Brand
0959-4388/$ � see front matter Published by Elsevier Ltd.
DOI 10.1016/j.conb.2009.05.009

Corresponding author: Champagne, Frances A (fac2105@columbia.edu)

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Close Accordion:
Introduction To The Cerebellum | El Paso, TX. | Part II

Introduction To The Cerebellum | El Paso, TX. | Part II

El Paso, TX. Chiropractor, Dr. Alexander Jimenez continues with the cerebellum overview. The cerebellum is one of the most identifiable parts of the brain based on its unique shape and location. It is an extremely important part of the brain. It is responsible for being able to perform everyday voluntary tasks likes walking and writing. And it’s essential for being able to keep balance and remain upright. People who have suffered from a damaged cerebellum struggle with balance and maintaining proper muscle coordination.

EVERYTHING PERIPHERAL HAS A CENTRAL CONSEQUENCE!

CASE STUDY

Cerebellar Ataxia

54-YEAR-OLD FEMALE PRESENTED TO OUR CLINIC FOR FEELINGS OF �UNSTEADINESS�

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  • Patient woke up one morning over one year ago with vertigo.cerebellum el paso tx.
  • Patient has difficulty with balance and walking. She sometimes resorts to using a cane. Extreme difficulty walking downstairs
  • Patient has been proactive in her weight loss, however, this has served as a speed bump in her plan of getting back to health.
  • She has not been able to exercise like she had in the past.
  • Patient has been to several vestibular rehabilitation clinics to no avail.

 

 

 

 

 

PHYSICAL EXAMINATION HIGHLIGHTS

  • cerebellum el paso tx.Cranial nerves I-XII WNL
  • Wide-based gait
  • Right cerebellar findings
  • Provocative Romberg testing produced significant sway in the right posterior and left anterior canal position.

 

 

 

 

 

 

 

 

THERAPEUTIC INTERVENTIONS

 

 

 

 

 

 

 

 

AFTER 1ST DAY

  • cerebellum el paso tx.Marked improvement in balance.
  • Comfortable walking and standing with more narrow- based gait.
  • Ability to walk down stairs without holding handrail.

 

 

 

 

CASE STUDY

Meet Aaron & McKayla

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**Permission given to use names, images and whatever else needed to spread the word

A 39-year-old retired Explosives Ordinance Disposal Technician who in 2011…

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And in 2015…

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WHAT CAN FUNCTIONAL NEUROLOGY DO FOR AARON?

HOW CAN WE HELP HIS BALANCE?

 

IF YOU DON�T USE IT….

cerebellum el paso tx.WHAT DO YOU SEE?

cerebellum el paso tx.WHAT DO YOU SEE?

cerebellum el paso tx.

WHAT DO YOU SEE?

cerebellum el paso tx.

WHAT DO YOU SEE?

WHAT DOES IT MEAN?

cerebellum el paso tx.

cerebellum el paso tx.AFFERENTATION WITH METABOLIC CONSIDERATIONS

A-BETA – MECHANORECEPTORS
  • Merkel�s disc � slow adapting to pressure and texture. Sharpest resolution for spatial patterning. �steady light pressure�
  • Meissner�s Corupuscle � superfiicial motion detection. Two point discretion.
  • Ruffini�s Corpuscle � located in dermis. Steady skin stretch and joint pressure.
  • Pacinian Corpuscle � rapid adapter, Associated with vibration.
GOLGI TENDON ORGAN IB FIBERS
  • Responds to muscle tension changes.

cerebellum el paso tx.

1A IIA SOMATOSENSORY
  • Muscle spindle fiber is the largest fiber in the human body.
  • Respond to the rate of change in muscle length, as well to change in velocity, rapidly adapting.
  • This will require the most demands on metabolic capacity.

BACK TO THE CASE

  • cerebellum el paso tx.In 2011, Aaron had lost both of his eyes in an IED explosion.
  • Due to the blast, Aaron also lost his sense of smell and taste.
  • After several months of rehab, Aaron learned how to �be really good at being blind.�
  • Although he could not see, balance was no major issue. �I was climbing mountains, running marathons, kayaking…you name it.�

 

 

 

 

 

  • In 2015, a few months after running the Boston Marathon, Aaron was on the phone with Mckayla.
  • �He said he was not feeling well and was going to go lie down. I was concerned but did not think much of it.�
  • After a day and a half of waiting for his call, McKayla found out Aaron contracted meningitis and was intubated in the ICU.

cerebellum el paso tx.

  • Finding out Aaron is completely deaf after meningitis…

cerebellum el paso tx.

  • The meningitis obliterated his hearing and left him completely deaf for 5 months.
  • Not only that, the meningitis wreaked havoc on Aaron�s balance centers (his vestibulocerebellum) and he suffered from severe vertigo and difficulty standing and walking.
cerebellum el paso tx.After recovering from meningitis:
  • �You can see how he’s walking on the treadmill in the very beginning. It took so much out of him to be able to do that.� � Mckayla
  • Remember �metabolic capacity?�

cerebellum el paso tx.

  • Aaron was actually able to get himself back into running shape and ran one of his best times in Ohio, but not without struggle.
  • �Every little change in pace and every little movement was a huge calibration for me and it took a lot out of me.�
  • �I still have a lot of work to do…�

cerebellum el paso tx.

cerebellum el paso tx.CHALLENGE ACCEPTED

  • Sooooo….back to the basics!

cerebellum el paso tx.

  • We utilized different surfaces to challenge his balance system (foam pads, wobble boards, etc….
  • We also had him do most of his therapies barefoot to increase afferentation to the somatosensory cortex

cerebellum el paso tx.Updates from McKayla:

  • �Pace is a 7:30 and he’s doing 6 miles. Completed core work too.�

cerebellum el paso tx.

  • Typically in the OVARD we would spin Aaron in specific directions and he would tell us which direction he was spinning in.
  • At first this was very difficult and he could not perceive the movement, however it was not long until he was sensing each direction of his spin.
  • We let him have a little fun in this particular video….

cerebellum el paso tx.

  • I asked Aaron and McKayla how they felt therapy was going.
  • They responded �great, but we won�t really know until he goes for a run outside…�
  • So we went on a seven mile run at an 8 minute pace.
  • Here we are working on turns.

cerebellum el paso tx.

  • Cured!
  • Aaron is back home in Florida continuing his training for Boston in two weeks.
  • He is continuing at-home exercises and vestibular rehab with specialists
  • He and I are running a half marathon together in the not-so-distant future

cerebellum el paso tx.SOME SIMPLE CEREBELLAR THERAPIES

GENERAL CEREBELLAR EXERCISES

  • Spinning in desk chair will stimulate ipsilateral cerebellum
  • Passive muscle stretch will stimulate ipsilateral cerebellum
  • Squeezing tennis ball will stimulate ipsilateral cerebellum
  • Passive or active non-linear complex movements will stimulate ipsilateral cerebellum
  • Finger to nose pointing will stimulate ipsilateral cerebellum

Vermal & Paravermal Exercises

  • Passive and active gaze stabilization exercises with central fixation
  • Wobble board/unsteady surface exercises
  • Balance beam exercises and tandem walking
  • Bouncing a ball against the ground or throwing it against the wall
  • Core exercises such as planks, sit-ups and yoga
  • Learning how to balance on a bicycle
  • Supine cross crawl activity

Lateral Cerebellum Exercises

  • Cognitive processes
  • Learning a musical instrument
  • Tracing a maze
  • Playing �catch�
  • Tapping fingers/hand or toes/feet to the beat of a metronome
  • Trying to write with eyes closed
  • Strategic board games

THE LANGUAGE OF THE BRAIN IS REPETITION!

By RYAN CEDERMARK, RN BSN MSN DC DACNB

Cerebellar Rehabilitation Exercises in El Paso, TX

Cerebellar Rehabilitation Exercises in El Paso, TX

Although the cerebellum has many responsibilities, its central function is to coordinate and handle motor activities. Balance, coordination, posture, equilibrium and eye motion are controlled in part by the cerebellum. Additionally, it works to calibrate motor actions in order for our movements to have a smooth, flowing nature to them. The cerebellum receives data from various other structures, like the inner ear and the vestibular system, and fine-tunes incoming sensorimotor information to achieve naturally smooth movements.

 

Cerebellum Exercises

 

Many cerebellum exercises are available which help the cerebellum enhance the operation of its neurons. Essentially, neurons want stimulation to be able to function accordingly. When neurons do not get enough stimulation, they become unstable, which can lead to a lot of behavioral difficulties, such as the ones connected with ADHD, among others. But, exercising the cerebellum can increase operation as well as decrease negative symptoms.

 

Exercises that require focused attention are demonstrated to help cerebellar development. Deliberate and purposeful physical movements, such as balancing on a balance board or working with a rehabilitation ball, will help neurons get the stimulation they need to maximize their functioning. Because there’s a substantial connection between physical activity and mental functioning, pairing physical tasks with psychological exercises is also very beneficial towards enhancing cerebellar functioning. By way of instance, a child diagnosed with ADHD may be requested to keep their balance on a balance board whilst simultaneously reciting the alphabet.

 

If a child or individual demonstrates weak cerebellar development in one quadrant, doing physical exercises between the legs and arms on the exact same side of the body is able to help that portion of the cerebellum “catch up” to the level of development of it’s other half. These exercises might involve arm or leg stretches or complex motions that include the hands, wrists, elbows and shoulders. Vestibular-based actions, such as catching and throwing a ball or performing balance exercises such as standing on one leg, are also great cerebellum exercises that ease the stabilization, growth and development of neurons.

 

Cerebellar rehabilitation programs incorporate each of these exercises into an extensive regimen for tapping into the brain’s neuroplasticity. The exercises involved require patients to perform tasks that involve balance, spatial judgments, and motor actions, all which enhance cerebellar functioning and operation. Basically, since the brain’s neural networks arrange the incoming sensory information, they improve their functioning and become more effective.

 

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Dr. Alex Jimenez’s Insight

Cerebellar ataxia is a disorder which affects the normal functioning of the brain and the nervous system by decreasing balance and coordination, most commonly in the back, arms and legs. Cerebellar rehabilitation exercises are often utilized to help alleviate the symptoms associated with cerebellar ataxia. Cerebellar exercises can also be recommended by a chiropractor or physical therapist for children and individuals in order to stimulate the brain and help with cerebellar development. Participating in cerebellar exercises has been demonstrated to improve balance, coordination and posture as well as promote more natural and smooth motor activities.

 

Many cerebellar exercises can be utilized in order to help stimulate specific regions of the brain, particularly the cerebellum. Each zone of the cerebellum is in charge of performing essential functions, therefore, enhancing these different regions is fundamental towards ultimate function and operation. Below, a series of exercises have been divided to enhance specific zones of the cerebellum.

 

General Cerebellar Exercises

 

  • Spinning in a desk seat can stimulate the ipsilateral cerebellum
  • Vertical muscle stretch can stimulate the ipsilateral cerebellum
  • Squeezing a tennis ball can stimulate the ipsilateral cerebellum
  • Passive or active non-linear complex movements can stimulate the ipsilateral cerebellum
  • Finger to nose extending can stimulate the ipsilateral cerebellum

 

Vermal and Paravermal Exercises

 

  • Passive and active gaze stabilization exercises using central fixation
  • Wobble board/unsteady surface exercises
  • Balance beam exercises and tandem walking
  • Bouncing a ball against the floor or throwing it against the wall
  • Core exercises, such as planks, sit-ups and yoga
  • Learning how to balance on a bicycle
  • Supine cross crawl action

 

Lateral Cerebellum Exercises

 

  • Cognitive procedures
  • Learning a musical instrument
  • Tracing a maze
  • Playing “catch”
  • Tapping fingers/hand or toes/feet to the beat of a metronome
  • Seeking to compose with eyes shut
  • Strategic board games

 

Cerebellar Rehabilitation Exercises for Cerebellum Dysfunction

 

When the cerebellum is damaged or not fully developed, individuals can display erratic or slow movements, demonstrate an inability to judge distance, have difficulty performing rapid moves, and walk with an unnatural gait. Dysfunction from the cerebellum have also been linked to symptoms of ADHD and other behavioral disorders. Cerebellar rehabilitation exercises can be helpful towards enhancing the indications of cerebellum dysfunction, most commonly, cerebellar ataxia.

 

Cerebellar ataxia is a disease which originates from the cerebellum. Cerebellar ataxia can happen as a result of several ailments and presents with symptoms of an inability to coordinate balance, gait, upper/lower extremity and eye motions. Healthcare professionals frequently use visual monitoring of people performing motor tasks so as to look for signs of ataxia. Research studies have shown that cerebellar rehabilitation exercises can be helpful towards improving symptoms related to cerebellum dysfunction.

 

Exercises for Cerebellar Dysfunction

 

 

Treatment of cerebellar ataxia generally involves treating the underlying illness in addition to the symptoms. Cerebellar rehabilitation exercises are used to improve balance and increase the independence of the patient using methods focusing on balance, posture and coordination control. Stabilizing the back and proximal muscles ought to begin with mat activities, like moving onto the forearms out of a lying face down position and crawling/moving onto the knees into a sitting posture. Gait training should also be performed, since it’s an excellent indicator of balance and insertion.

 

Cerebellar rehabilitation exercises for cerebellum dysfunction can also improve proprioception. Proprioception is controlled by the cerebellum and involves knowing which body parts are situated in space and in connection with each other. Treatment entails plyometric exercises, balance board and mini trampoline exercises. Vibration and match treatment can also be utilized to enhance proprioception, posture and movement. Yoga and other body-awareness exercises might also be included in the treatment plan to increase proprioception.

 

Rehabilitation goals include enhancing balance and posture against external stimuli, increasing joint stabilization as well as creating independent, practical gait to promote independence. Training principles include progressing from simple to complicated exercises and providing support with home exercise and sports activities. Cerebellar rehabilitation exercises should be prescribed by a healthcare professional who specializes in cerebellum dysfunction, such as a chiropractor or physical therapists. The language of the brain is repetition, and rehabilitation can enhance brain function. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .

 

Curated by Dr. Alex Jimenez

 

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Additional Topics: Sciatica

Sciatica is medically referred to as a collection of symptoms, rather than a single injury and/or condition. Symptoms of sciatic nerve pain, or sciatica, can vary in frequency and intensity, however, it is most commonly described as a sudden, sharp (knife-like) or electrical pain that radiates from the low back down the buttocks, hips, thighs and legs into the foot. Other symptoms of sciatica may include, tingling or burning sensations, numbness and weakness along the length of the sciatic nerve. Sciatica most frequently affects individuals between the ages of 30 and 50 years. It may often develop as a result of the degeneration of the spine due to age, however, the compression and irritation of the sciatic nerve caused by a bulging or herniated disc, among other spinal health issues, may also cause sciatic nerve pain.

 

 

 

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EXTRA IMPORTANT TOPIC: Chiropractor Sciatica Symptoms

 

 

MORE TOPICS: EXTRA EXTRA: El Paso Back Clinic | Back Pain Care & Treatments

Knee Injuries And Chiropractic Care | El Paso, TX. | Video

Knee Injuries And Chiropractic Care | El Paso, TX. | Video

Knee Injuries: Alex Jimenez was a wrestler for 15 years when he suffered an ACL tear. Once diagnosis confirmed his knee injury, Alex Jimenez began an extensive care regimen, consisting of chiropractic care with Dr. Alex Jimenez and crossfit rehabilitation, in order to help him recover. Now that Alex Jimenez dedicates himself to health and fitness, he’s always mindful of engaging in the proper exercises to avoid suffering another sports injury. With a positive mentality, Alex Jimenez was able to find his life plan when his ACL tear healed completely.

Chiropractic Care For Knee Injuries

The anterior cruciate ligament (ACL) is one of the most commonly injured ligaments of the knee. The prevalence of ACL injury is higher in athletes who take part in sports, such as basketball, soccer, skiing, and football. Roughly half of ACL injuries occur together with injury to the meniscus, articular cartilage, or other ligaments. Furthermore, patients may have lumps of the bone beneath the cartilage surface. These might be seen on a magnetic resonance imaging (MRI) scan and might indicate injury to the overlying articular cartilage.

knee injuries el paso tx.

We are blessed to present to you�El Paso�s Premier Wellness & Injury Care Clinic.

Our services are specialized and focused on injuries and the complete recovery process.�Our areas of practice include:Wellness & Nutrition, Chronic Pain,�Personal Injury,�Auto Accident Care, Work Injuries, Back Injury, Low�Back Pain, Neck Pain, Migraine Headaches, Sport Injuries,�Severe Sciatica, Scoliosis, Complex Herniated Discs,�Fibromyalgia, Chronic Pain, Stress Management, and Complex Injuries.

As El Paso�s Chiropractic Rehabilitation Clinic & Integrated Medicine Center,�we passionately are focused treating patients after frustrating injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility and agility programs tailored for all age groups and disabilities.

If you have enjoyed this video and/or we have helped you in any way please feel free to subscribe and share us.

Thank You & God Bless.

Dr. Alex Jimenez DC, C.C.S.T

Facebook Clinical Page: www.facebook.com/dralexjimenez/

Facebook Sports Page: www.facebook.com/pushasrx/

Facebook Injuries Page: www.facebook.com/elpasochiropractor/

Facebook Neuropathy Page: www.facebook.com/ElPasoNeuropathyCenter/

Facebook Fitness Center Page: www.facebook.com/PUSHftinessathletictraining/

Yelp: El Paso Rehabilitation Center: goo.gl/pwY2n2

Yelp: El Paso Clinical Center: Treatment: goo.gl/r2QPuZ

Clinical Testimonies: www.dralexjimenez.com/category/testimonies/

Information:

LinkedIn: www.linkedin.com/in/dralexjimenez

Clinical Site: www.dralexjimenez.com

Injury Site: personalinjurydoctorgroup.com

Sports Injury Site: chiropracticscientist.com

Back Injury Site: elpasobackclinic.com

Rehabilitation Center: www.pushasrx.com

Fitness & Nutrition: www.push4fitness.com/team/

Pinterest: www.pinterest.com/dralexjimenez/

Twitter: twitter.com/dralexjimenez

Twitter: twitter.com/crossfitdoctor

Injury Medical Chiropractic Clinic: Sport Injury Treatments

Introduction To The Cerebellum | El Paso, TX. | Part I

Introduction To The Cerebellum | El Paso, TX. | Part I

El Paso, TX. Chiropractor Dr. Alexander Jimenez presents an introduction to the cerebellum. The brain is a complex structure that has billions of nerve cells. The basic anatomy is easily understandable. But there is one part of the brain, the cerebellum, which is involved in virtually all movement. This is the part of the brain that helps a person drive, throw a ball, or walk across the street.

Problems with the cerebellum are uncommon and mostly involve movement and coordination difficulties. This article will give an overview of the anatomy, purpose, and disorders of the cerebellum, as well as, how to keep the brain healthy.

FAGIOLINI ET AL. EPIGENETIC INFLUENCES ON BRAIN DEVELOPMENT AND PLASTICITY CURR OPIN NEUROBIOL, 2009

cerebellum el paso tx.

  • �Enhancing plasticity in the adult brain is an exciting prospect and there is certainly evidence emerging that suggest the possible use of epigenetic factors to induce a �younger� brain.�
  • �Recent findings support a key role of epigenetic factors in mediating the effects of sensory experience on site-specific gene expression, synaptic transmission, and behavioral phenotypes.�

 

 

 

 

 

TAYLOR ET AL. CUTTING YOUR NERVE CHANGES YOUR BRAIN BRAIN, 2009

  • �Animal studies have established that plasticity within the somatosensory cortex begins immediately following peripheral nerve transection, and that 1 year after complete nerve transection and surgical repair, cortical maps contain patchy, noncontinuous representations of the transected and adjacent nerves.�
  • �Here, we have demonstrated for the first time that there is functional plasticity and both grey and white matter structural abnormalities in several cortical areas following upper limb peripheral nerve transection and surgical repair.�

cerebellum el paso tx.

THE CEREBELLUM

cerebellum el paso tx.

cerebellum el paso tx.

cerebellum el paso tx.

IMPORTANT FUNCTIONAL AREAS OF THE CEREBELLUM

  • Spinocerebellum
  • Vestibulocerebellum
  • Cerebrocerebellum

cerebellum el paso tx.

SPINOCEREBELLUM

  • cerebellum el paso tx.Responsibilities:

  • Regulation of muscle tone for posture and locomotion
  • Balance
  • Patient Complaints:

  • Difficulty with balance
  • Difficulty walking in the dark
  • Difficulty going down stairs
  • Sway to one side while walking
  • Examination Findings:

  • Wide based gait
  • Sway in Romberg�s position

 

 

cerebellum el paso tx.www.neuroexam.com/neuroexam/content.php?p=37

cerebellum el paso tx.www.neuroexam.com/neuroexam/content.php?p=37

WHAT DO YOU SEE?

cerebellum el paso tx.

cerebellum el paso tx.WHAT CAN YOU DO?

  • cerebellum el paso tx.Have the patient perform balance exercises:

  • Practice Romberg�s
  • Practice one leg standing
  • Bosu Ball exercises
  • Foam Pad exerscises
  • Balance Board exercises
  • Increase core stability:

  • Plank�s
  • Yoga
  • Increase proprioception:

  • Adjust!
  • But which side?

VESTIBULOCEREBELLUM

  • cerebellum el paso tx.

    Responsibilities:

  • Regulation of vestibular system
  • Regulation of balance
  • Assistance with eye movements (encoding retinal slip)
  • Patient Complaints:

  • Postural muscle fatigue
  • Dizziness
  • Disorientation
  • Difficulty riding in a car
  • Nausea
  • Examination Findings:

  • Wide based gait
    Sway in Romberg�s position
  • Nystagmus
  • Impaired VOR
  • Impaired smooth pursuits
  • Hypermetric Saccades

cerebellum el paso tx.www.neuroexam.com/neuroexam/content.php?p=37

cerebellum el paso tx.

cerebellum el paso tx.

cerebellum el paso tx.www.neuroexam.com/neuroexam/content.php?p=37

VOR

cerebellum el paso tx.

cerebellum el paso tx.

WHAT DO YOU SEE?

cerebellum el paso tx.EYE MOVEMENT REVIEW

cerebellum el paso tx.

cerebellum el paso tx.WHAT CAN YOU DO?

  • cerebellum el paso tx.Have the patient perform gaze stability exercises:

  • Sit arms length away
  • Fixate on dot
  • Rotate head in different directions
  • Rotation exercises:

  • Activate VOR
  • Activate side less active
  • Provide OPK stimulation:

  • Which side do you stimulate?

CEREBROCEREBELLUM

cerebellum el paso tx.Responsibilities:

  • Coordination of fine movements
  • Coordination of speech
  • Coordination of thought
  • Patient Complaints:

  • Clumsiness with hands
  • Clumsiness with feet
  • Tripping over feet
  • Hand shaking with intention
  • Examination Findings:

  • Intention tremor
  • Termination tremor
  • Dysmetria
  • Dysdiadochokinesia

cerebellum el paso tx.www.neuroexam.com/neuroexam/content.php?p=37

cerebellum el paso tx.www.neuroexam.com/neuroexam/content.php?p=37

cerebellum el paso tx.www.neuroexam.com/neuroexam/content.php?p=37

cerebellum el paso tx.www.neuroexam.com/neuroexam/content.php?p=37

WHAT DO YOU SEE?

cerebellum el paso tx.WHAT CAN YOU DO?

  • cerebellum el paso tx.Have the patient perform coordinated movements!
  • Example: piano playing, finger taping, finger to nose, etc.

 

 

 

 

 

 

 

TAYLOR ET AL. CUTTING YOUR NERVE CHANGES YOUR BRAIN BRAIN, 2009

  • �Animal studies have established that plasticity within the somatosensory cortex begins immediately following peripheral nerve transection, and that 1 year after complete nerve transection and surgical repair, cortical maps contain patchy, noncontinuous representations of the transected and adjacent nerves.�
  • �Here, we have demonstrated for the first time that there is functional plasticity and both grey and white matter structural abnormalities in several cortical areas following upper limb peripheral nerve transection and surgical repair.�

cerebellum el paso tx.

By�RYAN CEDERMARK, RN BSN MSN DC DACNB

Epley Maneuver Used by Chiropractors for BPPV in El Paso, TX

Epley Maneuver Used by Chiropractors for BPPV in El Paso, TX

Benign paroxysmal positional vertigo is a common type of vertigo, a sensation of spinning or whirling and loss of balance, which has been reported to account for as many as 17 percent of all cases of dizziness. Benign paroxysmal positional vertigo, or BPPV, is believed to be caused by a health issue in the inner ear. While it is typically associated with aging, head injuries have also been found to cause BPPV.

 

BPPV occurs when several of the small crystals found in the inner ear, known as otoconia, become loose and wind up in one or more of the three fluid-filled semicircular canals of the ear. Whenever these crystals move around the inner ear, they can cause the fluid in the semicircular canals to become displaced. This ultimately results in a spinning or whirling sensation, otherwise referred to as vertigo. The symptoms of BPPV can often come on suddenly when an individual with benign paroxysmal positional vertigo moves their head in a certain position. By way of instance, symptoms may trigger when turning over in bed during night time. Symptoms of BPPV can last anywhere from several seconds to several minutes, and may include:

 

  • Dizziness;
  • A feeling that surroundings are spinning or moving (vertigo);
  • A loss of equilibrium or balance;
  • Nausea; and
  • Vomiting.

 

BPPV Treatment

 

Although many healthcare professionals often prescribe drugs and/or medications for BPPV, there is not enough evidence to support their use as treatment for this condition. In other, very rare cases, surgical interventions are considered. However, in the majority of instances, BPPV can safely and effectively be adjusted mechanically.

 

Once a healthcare professional specializing in vestibular disorders, such as a vestibular rehabilitation therapist, a chiropractor, a specially trained physical therapist, an occupational therapist or audiologist, or an ENT (ear, nose & throat specialist who specializes on vestibular disorders), has properly diagnosed the individual’s type of benign paroxysmal positional vertigo by performing tests like the Dix-Hallpike Test, then they’ll have the ability to understand which of the semicircular canal(s) the crystals are in, and whether it is canalithiasis, where the loose crystals can move freely in the fluid of the tube, or cupulolithiasis, where the crystals are believed to be ‘hung up’ on the bundle of nerves that feel the fluid motion, then they can recommend you the appropriate therapy maneuver.

 

Other Auditory & Vestibular Function Tests

 

The Dix-Hallpike Test is commonly used to diagnose BPPV, however, if the diagnosis is negative, healthcare professionals may utilize a variety of other auditory and vestibular function tests in order to properly diagnose the patient’s source of their symptoms.

 

Dix-Hallpike Test to Diagnose BPPV

 

 

The most common treatment for benign paroxysmal positional vertigo, or BPPV, is called the Epley maneuver. The Epley maneuver, sometimes referred to as canalith repositioning, is a procedure which involves a succession of head movements, normally performed by a healthcare professional who is qualified and experienced in the treatment of vestibular disorders, in order to relieve the symptoms associated with BPPV.

 

Research studies have demonstrated that the Epley maneuver is a safe and effective treatment for the condition, offering both immediate and long-term relief. The Epley maneuver, named after Dr. John Epley, has been named the canalith repositioning maneuver because it�helps reposition the small crystals in a individual’s ear, which may be causing the sensation of dizziness. Repositioning these small crystals, also known as otoconia, ultimately helps to relieve BPPV symptoms.

 

Epley Maneuver to Treat BPPV BPPV

 

 

The Epley maneuver is performed by placing the patient’s head at an angle from where gravity can help alleviate the symptoms. Tilting the head can move the crystals from the semicircular canals of the inner ear. This means that they will stop displacing the fluid, relieving the dizziness and nausea they may have been causing. In this way, the Epley maneuver alleviates the symptoms of BPPV. But, it may need to be repeated more than once, as occasionally, some head movements can once again displace the small crystals of the inner ear, once they had already been repositions after the initial treatment.

 

Epley Maneuver Diagram | El Paso, TX Chiropractor

 

When a healthcare professional carries out the Epley maneuver, they’ll perform the following measures:

 

  • Ask the patient to sit upright in an examination table, completely extending their legs out in front of them.
  • Rotate the patient’s head in a 45-degree angle to the side they’re experiencing the worst vertigo.
  • Instantly push the patient back, so they are lying with their shoulders touching the table. The patient’s head is retained facing the side most negatively affected by vertigo but at a 30-degree angle, so that it is lifted slightly off the table. The healthcare professional holds the patient in this position for between 30 seconds and two minutes, until their symptoms stop.
  • Rotate the patient’s head 90 degrees from the opposite direction, stopping when the other ear is 30 degrees away from the table. Again, the doctor holds the patient in this position for between 30 minutes and two minutes, until their symptoms cease.
  • Next, the healthcare professional will roll the patient in precisely the same direction that they are facing, onto their side. The moment they encounter the worst vertigo on will be facing upward. The physician holds the patient in this position for between 30 minutes and 2 minutes, until their symptoms stop.
  • Eventually, the healthcare professional will bring the patient back up into a sitting position.
  • The whole process is repeated up to three times, until the patients’s symptoms have been completely relieved.

 

A healthcare professional specializing in vestibular disorders, such as a chiropractor or physical therapist, will utilize the Epley maneuver to help alleviate an individual’s dizziness and nausea, among other symptoms, when they have decided that BPPV is the cause. As mentioned before, the Epley maneuver isn’t suitable to treat vertigo brought on by another health issue aside from BPPV. If the individual is unsure of what is causing their vertigo, they ought to talk to a doctor and ask to be properly diagnosed. Other causes of vertigo may include:

 

  • Migraine headaches
  • Ear infections
  • Anemia
  • Cerebellar stroke

 

After performing the Epley maneuver, a doctor will advise the patient who has BPPV to prevent specific movements that may dislodge the crystals. These movements include:

 

  • Bending quickly
  • Lying down fast
  • Leaning the head
  • Moving the head back and forth

 

Many research studies have been done on the safety and effectiveness of therapy maneuvers for BPPV, such as the Epley maneuver, together with results and outcome measures demonstrating that the rates of recovery are well into the 90 percent range by 1 to 3 treatments. The more infrequent cupulolithiasis, or ‘hung-up’ version of BPPV, can be a little more stubborn to resolve, as this type of BPPV is generally the consequence of trauma or injury.

 

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Dr. Alex Jimenez’s Insight

If you’ve ever experienced a sudden spinning or whirling sensation, dizziness and nausea when you make certain head movements, especially while rolling over in bed at night or when getting out of bed in the morning, you may be suffering from a common condition called benign paroxysmal positional vertigo, or BPPV. This type of vertigo can be frustrating to deal with and it can tremendously affect an individual’s quality of life. A healthcare professional who specializes in vestibular disorders, including chiropractors and physical therapists, frequently diagnose BPPV using the Dix-Hallpike Test before following up treatment for benign paroxysmal positional vertigo using the Epley maneuver.

 

Benign Paroxysmal Positional Vertigo, or BPPV, is a frequent health issue, and will be encountered more and more as our population ages. The effect can vary from a mild annoyance to a highly debilitating condition, and can affect function and safety as well as increase the risk of falls. Fortunately, symptoms tend to decrease in intensity over time as the brain gradually adjusts to the strange signals it is receiving, or as the condition resolves on its own. However, with a healthcare professional who’s suitably qualified and experienced in the diagnosis and treatment of BPPV, most patients will find overall relief of their problem once it readily corrected and their world stops spinning or whirling. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .

 

Curated by Dr. Alex Jimenez

 

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Additional Topics: Sciatica

Sciatica is medically referred to as a collection of symptoms, rather than a single injury and/or condition. Symptoms of sciatic nerve pain, or sciatica, can vary in frequency and intensity, however, it is most commonly described as a sudden, sharp (knife-like) or electrical pain that radiates from the low back down the buttocks, hips, thighs and legs into the foot. Other symptoms of sciatica may include, tingling or burning sensations, numbness and weakness along the length of the sciatic nerve. Sciatica most frequently affects individuals between the ages of 30 and 50 years. It may often develop as a result of the degeneration of the spine due to age, however, the compression and irritation of the sciatic nerve caused by a bulging or herniated disc, among other spinal health issues, may also cause sciatic nerve pain.

 

 

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EXTRA IMPORTANT TOPIC: Chiropractor Sciatica Symptoms

 

 

MORE TOPICS: EXTRA EXTRA: El Paso Back Clinic | Back Pain Care & Treatments

Skateboarding Injury Treatment | El Paso, TX. | Video

Skateboarding Injury Treatment | El Paso, TX. | Video

Skateboarding: Javier Mata has entrusted Dr. Alex Jimenez for many years now, receiving trustworthy chiropractic care after experiencing several low back pain injuries throughout his life. Javier Mata first considered the non-surgical treatment choice following his own father’s recommendation to seek chiropractic care after he himself received treatment with Dr. Alex Jimenez. Javier Mata has found tremendous relief through spinal adjustments and manual manipulations and he highly recommends chiropractic care with Dr. Alex Jimenez.

Skateboarding Injury Treatment

Skateboarding is a popular recreational activity among children and teenagers. Although it is an enjoyable and exciting activity, skateboarding carries with it a serious risk for injury. Roughly 70,000 injuries requiring a trip to the emergency department occur each year. There are many things that parents and children can do to help prevent skateboarding injuries, such as carefully selecting safe places to ride and wearing protective gear, especially helmets. Many accidents happen when a child loses balance, falls off the skateboard and lands on an outstretched arm. Skateboarding accidents often involve the wrist, ankle, or face and sprains or strains may occur.

skateboarding el paso tx.

We are blessed to present to you�El Paso�s Premier Wellness & Injury Care Clinic.

Our services are specialized and focused on injuries and the complete recovery process.�Our areas of practice include:Wellness & Nutrition, Chronic Pain,�Personal Injury,�Auto Accident Care, Work Injuries, Back Injury, Low�Back Pain, Neck Pain, Migraine Headaches, Sport Injuries,�Severe Sciatica, Scoliosis, Complex Herniated Discs,�Fibromyalgia, Chronic Pain, Stress Management, and Complex Injuries.

As El Paso�s Chiropractic Rehabilitation Clinic & Integrated Medicine Center,�we passionately are focused treating patients after frustrating injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility and agility programs tailored for all age groups and disabilities.

If you have enjoyed this video and/or we have helped you in any way please feel free to subscribe and share us.

Thank You & God Bless.

Dr. Alex Jimenez DC, C.C.S.T

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Information:

LinkedIn: www.linkedin.com/in/dralexjimenez

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Injury Medical Chiropractic Clinic: Accident Treatment & Recovery