RICHARD FEELY – Neuro-Ocular Release: The Course (10-11-12 February 2023)

Lecturer: Dr Richard A. Feely

750.00

Richard A. Feely inform, educate and train the participants to be able to diagnosis and treat appropriate patients in the new Indirect Method of Osteopathic Manipulative Treatment (OMT) called Neuro-Ocular Release (NOR).

Category:

Description

TARGET AUDIENCE

The course aims at osteopaths qualified with a 5-year full-time training programme or 6-year part-time training programme.

 

LANGUAGE

The course is in English with consecutive translation into Italian.

 

COURSE PRESENTATION

Purpose: To inform, educate and train the participants to be able to diagnosis and treat appropriate patients in the new Indirect Method of Osteopathic Manipulative Treatment (OMT) called Neuro-Ocular Release (NOR).

 

Goals

The participants-trained Osteopaths will be able to,

– Explain what NOR is.

– Describe and explain the neurophysiological principles, and biomechanical reasoning behind how and why NOR works to relieve pain and dysfunction.

– Determine and explain where and when NOR is indicated and contraindicated.

– Describe and preform NOR diagnostic and treatment procedures/technique on a patient in the axial

– Describe and preform NOR diagnostic and treatment procedures/technique on a patient in the appendicular skeleton and

 

PROGRAMME

FIRST DAY

Goals

The participants-trained Osteopaths will be able to,

– Explain what NOR is.

– Describe and explain the neurophysiological principles, and biomechanical reasoning behind how and why NOR works to relieve pain and dysfunction.

 

Introduction – Preview:

– The NOR Course “the 3 Second Osteopathic Technique”

– Taking you from Zero to 200KM/HR in 3 days.

 

Pain – The most common complaint Osteopath’s see

– Definition, mechanisms of action, neurophysiology, biomechanical, biochemical, biopsycho-social

– The most common diagnosis by an Osteopath; Somatic Dysfunction

– Definition, neurological, biomechanical, biochemical/metabolic, respiratory-circulatory, behavioral

 

Lab – Identifying Somatic Dysfunction (SD)

– Palpatory examination skill development-The mechanism of touch, layered palpation, screening, regional joint and segmental examinations

– Postural and visceral signals of SD

 

Indications and contra indications for Osteopathic Manipulative Treatment (OMT)

– Writing an Osteopathic Manipulative Prescription (OMP)

– Diagnosis: medical codable; Osteopathic general/regional, specific/segmental/joint

– Situation: location, time,

– Patient situation: physical/mental/emotion condition, preferences, age, sex, weight, height

– Osteopath’s: physical/mental/emotional condition, knowledge, skill, ability, experience, preferences, age, sex, weight, height

– To treat the memory of somatic dysfunction or not? Treating the general afferent pain and efferent response pathways or to treat both ascending and descending motor tracts, thus resetting/restoring the cerebellum and cerebrum normalization of function.

 

NOR Neurophysiology-Theory of Mechanism

Ascending Pain Pathway

– Skin/joints-Nociceptors’ – proprioceptors’ – mechanoreceptors’

– General sensory afferent (GSA) – spinal ganglion – posterior horn – Rex laminae I, II, IV, V, VI

– Primary somatosensory (S1) cortex – pain localization, quality, intensity

– Secondary somatosensory (S2) cortex – memory

– Temperature, pain, and position

– Neospinothalamic tract – Thalamus – intralaminar nuclei – S1, S2, cingulate gyrus & prefrontal cortex

– Paleospinothalamic tract – Thalamus – intralaminar nuclei – hypothalamus – limbic system

– Rex lamina-Spinomesencephalic – Periaqeductal Gray (PAG)

– Rex lamina-Spinoreticulothalmic – reticulothalmic – medial thalamus – hypothalamus – reticular activating system

– Third Order Neurons – sensory – thalamus – postcentral gyrus of S1 cortex

– Pain and Temperature Pathway

– Skin – spinal ganglion – posterior horn of spinal cord gray matter – rex laminae – lateral spinothalamic tract – ventral-posterior nucleus of thalamus – postcentral gyrus of central sensory cortex.

– Unconscious Proprioception Pathway

– Muscle, spindles, tendon, joint, skin receptors – spinal ganglion – Primary neuron, afferent nerves -dorsal column gray matter – anterior spinocerebellar tract – cerebellum – cerebellum peduncle

– Posterior spinocerebellar tract – posterior horn gray matter – cerebellum peduncle

– Conscious Proprioception vibration, touch Pathway

– Vater-Pacini corpuscles in skin, muscles, tendons – spinal ganglion – nucleus Gracilis, nucleus cuneatus – medial lemniscus – ventral posterior lateral nucleus of Thalamus, postcentral gyrus sensory cortex.

– Vestibulo-ocular reflex (VOR) provides gaze stabilization when head is turning. Slow phase opposes head rotation to keep gaze steady, fast phase saccades allow for recentering if the slow phase overshoots. Reflex is initiated by semi-circular canals. Bipolar cells in canals via CN VIII synapse on premotor cells of vestibular nuclei.

– Oculocervical reflex connects vestibular system with proprioceptive afferent and efferent communication – spinal tract – producing trunk rotation as a response.

– Optokinetic reflex maintains a moving object on the retina while the head is stable. Optokinetic nystagmus is slow alternating, compensatory movement in line with the object movement, and fast anti-compensatory movement opposite the object movement. Mediated by geniculo-transcortical-floccular pathway and works in conjunction with VOR.

 

Descending Pain Pathway

– Cortex – PAG – Raphe Nucleus Magnus (RNM) – Rostroventromedial medulla (RVM)

– RNM monoamine pathways to dorsal horn = excitatory and inhibitory

– RVM facilitates or inhibits nociceptive input

– Visual activation and resting connectivity is present between PAG – visual cortex, S1, thalamus, medulla, prefrontal cortex, occipital cortex, cerebellar lobes.

– PAG-RVM is influenced by stress and emotions, it is the target for opioids The result is inhibition of presynaptic primary afferents and post synaptic inhibition at the spinal projections.

– Cortical areas, amygdala and hypothalamus exert top-down control modulating pain experienced by stress, emotion, and cognition.

 

Neurophysiological Summary

The ascending, descending pathways, and afferent proprioception, vestibular afferents and ocular feedback coalesce to produce efferent neuromuscular and pain modulating responses in the body. Afferent pathways ascend within the spinal cord and synapse throughout the cortex and CNS. Disruptions along the way influence adjacent pathways and descending CNS response. The Pain Matrix describes this very complex system. Functional MRI revealed pain memory and its integration occur throughout the brain and is compounded by comorbid conditions, polypharmacy, and genetics.

 

Review:

What is NOR?

How does NOR theoretically work?

What are the neurological components that bring about change in the pain perceptions of somatic dysfunction?

In theory, what are the neurological components that bring about change in the memory of somatic dysfunction?

 

 

SECOND DAY

Goals

The participants-trained Osteopaths will be able to:

– Explain what NOR is.

– Describe and explain the neurophysiological principles, and biomechanical reasoning behind how and why NOR works to relieve pain and dysfunction.

– Determine and explain where and when NOR is indicated and contraindicated.

– Describe and preform NOR diagnostic and treatment procedures/technique on a patient in the axial

 

NOR

Recap Neurophysiology

Indications

– Contraindications- Relative, Absolute

– NOR requirements- Patient, Osteopath

– Complications

– Effectiveness

 

Clinical integration

– How can I use this technique in case X, Y, Z?

– When is it most effective?

 

NOR Diagnosis and Treatment – Demonstrations – Lab

– Cervical Spine

– Thoracic Spine and Ribs

– Lumbar Spine

– S-I Joint/Pelvis

 

Review:

Explain by examples where and when NOR is indicated and contraindicated.

Give an example of how you will integrate NOR into your routine diagnostic and treatment pattern.

Preform NOR diagnostic and treatment procedures/technique on a patient in the cervical spine, or thoracic spine or lumbar spine.

 

 

THIRD DAY

Goal

The participants-trained Osteopaths will be able to:

Describe and preform NOR diagnostic and treatment procedures/technique on a patient in the appendicular skeleton and cranium.

 

NOR Diagnosis and Treatment – Demonstrations – Lab

 

Recap: Indications-contraindications, NOR diagnostics and treatment to spine

Upper Extremity

– Sternoclavicular joint

– Acromioclavicular joint

– Glenohumeral joint

– Elbow

– Wrist and Fingers

Lower Extremity

– Hip

– Knee

– Ankle

– Foot and toes

Cranial

SBS restrictions

Review:

Preform NOR diagnostic and treatment procedures/technique on your partner’s S.D. in the axial, appendicular and cranium

 

TIMETABLE

FRIDAY 10th FEBRUARY 2023

From 9 a.m. to 1 p.m. and 2 p.m. to 6 p.m.

SATURDAY 11th FEBRUARY

From 9 a.m. to 1 p.m. and 2 p.m. to 6 p.m.

SUNDAY 12th FEBRUARY

From 9 a.m. to 1 p.m. and 2 p.m. to 6 p.m.

 

COST

820 €

If you sign up and complete the payment before December 15th, the cost il 750 €

 

LOCATION

The course will be held at the centre in Via Cardinale Mezzofanti n.13, Milan (Milano Forlanini Railway Station).

We recommend the following facilities for those who need to stay overnight in a hotel.

 

 

Additional information

Durata

3 giorni

Sede

Advanced Osteopathy Institute (via Cardinale Mezzofanti 13, Milano)