Is the ketogenic diet the future for TBI treatment?


Ask any dietitian, and they’ll probably tell you that their clients are asking them about the ketogenic diet more than any other recent ‘fad’ diet. Popular headlines have proclaimed it the miracle diet to shed weight, boost energy, reverse diabetes and send cancer into remission.

But does this diet live up to its hype? What could it possibly have to do with recovery from traumatic brain injury (TBI)? And more importantly, is it safe?

The Ketogenic Diet

The ketogenic diet started out as anything but a fad. It was developed almost 100 years ago to treat children with epilepsy that didn’t respond to anti-epileptic medications. By definition, it is a very low carbohydrate (less than five per cent of total energy per day), high fat (about 80 per cent of energy) and moderate protein (15 – 20 per cent) diet.

This is vastly different from Health Canada’s recommended macronutrient distribution, which is 45 – 65 per cent carbohydrate, 10 – 35 per cent protein and 20 – 35 per cent fat. Since glucose (a carbohydrate) is our body’s preferred source of fuel, this high fat / low carbohydrate diet essentially tricks the body into believing it is in a state of starvation. The liver begins to convert fat into ketones (hence the name), and the brain’s cells are forced to adapt. The result, for someone with intractable epilepsy, can be a 50 to 90 per cent decline in seizures.

Once medical practitioners observed the effectiveness of ketosis for the treatment of epileptic seizures, they started to wonder whether it might help other neurological injuries and neurodegenerative disorders, including hypoxia, ischemic stroke, ALS, Alzheimer’s disease, Parkinson’s disease, and of course, Traumatic Brain Injury.

Benefits of Ketosis for Traumatic Brain Injury

For a multitude of ethical and practical reasons, it is next to impossible to perform randomized clinical trials on humans with TBIs, so the research we have that looks at the role of the ketogenic diet has been done in animals. The findings are promising though, and suggest that following injury, when the brain’s need for energy is high but its ability to metabolize glucose is impaired, ketones might provide an alternative and efficient source of energy.

Following trauma, brain cells are at increased risk of oxidation, cell death and DNA damage, and the presence of ketones and absence of glucose may reduce oxygen available for oxidation and guard cells against free radicals and DNA damage, while increasing cerebral blood flow.

Knowledge Gaps

This is an exciting prospect, but we still need a lot of answers before we can incorporate it into practice. We don’t know which type or severity of brain injury might respond well to ketosis, or whether it is best achieved through fasting, the ketogenic diet or even intravenous provision of ketones. It is unclear whether ketosis is helpful only initially after injury, or if it will support brain recovery if used for a longer period of time. It’s possible that a modified and less restrictive form of the ketogenic diet would work just as well as the standard diet, and some studies suggest that it might be even more effective when supplemented with certain nutrients, including medium chain triglycerides and branched chain amino acids.

Challenges of the Ketogenic Diet

There are several challenges with the ketogenic diet, the first being compliance. Since it is extremely restrictive, it is difficult for most people to stick to the diet long-term. It excludes entire food groups (grains, fruits and many vegetables), increasing the risk of nutrient deficiencies including sodium, potassium, chloride, vitamin D, calcium, magnesium, selenium and zinc. Among other issues, these deficiencies can impair bone healing and increase the risk of osteopenia and bone fractures. For people with pre-existing kidney disease or renal failure associated with trauma, the high protein intake that usually accompanies a high fat diet may not be appropriate. And of course, with a high fat diet there is concern about elevated cholesterol levels. Studies evaluating the use of the ketogenic diet in children found elevated triglyceride, and total, HDL and LDL cholesterol levels at 6 months and 10 years, making this diet risky for people predisposed to coronary artery disease. Long-term use has also been associated with growth retardation in children, low-grade acidosis, constipation, dehydration,  vomiting and nausea.

A grilled cheese sandwich made with cauliflower
Photo of a Cauliflower Crusted Grill Cheese Sandwich via

The Future of Ketosis in Brain Recovery

So, is the ketogenic diet the future for TBI treatment? Will it minimize brain injury and help to rehabilitate cognitive function, memory and recall? Maybe. We don’t have enough information yet to make it standard practice, and it certainly should never be implemented without careful monitoring from a physician and dietitian.

More research in humans is needed before we can give a final verdict, but what we know so far about ketosis and the brain is promising!

Melinda Edmonds is a Registered Dietitian with Aimee Hayes & Associates. She is a registered member in good standing with the College of Dietitians of Ontario and an active member of Dietitians of Canada. The focus of her practice is on the application of evidence-based nutrition therapies to optimize clients’ health, nutritional status and well-being in order to augment their quality of life and rehabilitation outcomes.

Aimee Hayes and Associates provides nutrition rehabilitation services to individuals with acquired and traumatic brain, spinal cord, and orthopedic injuries. Our diverse and dynamic team of Registered Dietitians works collaboratively with clients, families, caregivers and interdisciplinary rehabilitation teams to optimize nutrition in order to promote our clients’ wellness and recovery.


My traumatic brain injury: Sister caregiver experience.


I remember the last thing we did as a family. A week before everything happened we celebrated Eid Al-Fitr.

For those of you who are not aware, Eid is a Muslim festival that happens twice a year where we get together with family and friends, and share a big meal. Both Eids have distinct connotations. In particular, Eid Al-Fitr represents the celebration of 30-days of fasting known as the month of Ramadan. Eid is one of the happiest days of the year and to top it off, that Eid occurred on a hot summer day.

Close up of a plate of food served at Eid
A dish served at Eid Al-Fitr, Photo courtesy of Samira Omar

My family has nine children, and a total of 11 people, so traveling together is always challenging. That day, for the first time in a while, we all went out together. It was an amazing experience, one that we spoke of for days after.

I’ll never forget the way I felt when I first heard the news about my brother. I can vividly recall it as if it were yesterday. The same couple of moments and memories consistently flood my mind, and even though it has been over three years since it happened, I think about it every single day because it completely affected and changed all aspects of my life.

I can remember seeing him leave the house, and every time I closed my eyes I saw my brother’s face at the forefront of my mind. I can speak for everyone in my family when I say that my brother’s traumatic brain injury changed our lives because it affected every aspect of our daily living. Having said that, I always felt like it affected me the most.

Because of who I am as a person, and the role I play in my family dynamics, I spent every day at the hospital for two and a half years while my brother received care. I saw things I can never un-see. My time at the hospital changed every aspect of my life, and how I perceive the world.

3 empty hospital beds
PHOTO: 1662222 via

With so many siblings in my family, naturally, some of us are closer than others. My brother and I were, and are, very close. We told each other everything, and we always trusted one another. All of that factored into how much it really impacted my life, emotions, and day-to day-thinking.

Imagine one day you woke up in a hospital bed not able to do many or most of things that you were once able to do. How would you feel? Now imagine knowing that what happened to you was the result of a violent assault. These thoughts never left my head and I would constantly put myself in his shoes and think, “How would I feel if this were me?”

The doctors said my brother had an extremely poor outlook, and a slim to none chance of a meaningful recovery. These were the exact words that were used. It seemed as though everyone was treating him like he would not have a future, I never took that to heart. I could not give up hope.

There was and is still not a lot known about the brain. During this time, nothing else mattered but making sure my brother was doing well and being looked after. I did not feel comfortable leaving him in the hands of strangers, especially considering they did not believe he would get better or have a ‘meaningful recovery’.

A picture of a purple flower coming up through the snow,

I went on the Internet every day and looked for more information on traumatic brain injury. I read stories that people have shared based on their experiences. At the time, I felt like I was the only one who believed and had hope my brother would get better. It was the hardest situation that I have ever faced in my life as every day was a constant battle in making sure that his voice was heard, and he received the best care possible.

As the eldest daughter of nine children, and the daughter of immigrant parents, I felt as though it was my responsibility to always look out for the family by using my voice and knowledge to help them make decisions.

Everyone always came to me for support and advice. Yet, in this situation I did not know what to do. It felt like life was moving 200km/hour, ­much faster than I can actually process what was going on.

I was just trying to get through each day not knowing what would happen the next second, minute, or hour. Comforting everybody else was my way of coping because it was one thing to see a sister or brother cry but to witness my parents falling apart only meant what was happening was actually real, and I needed something to hold on to. Positive thinking, and remaining optimistic was the only way I would have been able to get through it all without losing my mind.

I often felt like I was alone but I always remained optimistic. I wanted to give my brother every chance to come back to who he was, and if I did not believe that it could be possible, I felt like I was robbing him of his potential to successfully recover.

A picture of bullrushes covered with snow

Consequently, I would spend 18 hours a day in the hospital, every single day for the past two and a half years that he was hospitalized. It never occurred to me how much time I spent being in a hospital.

I never once thought about myself as a I sought comfort from knowing what was going on in each step of his care. Without giving it any thought, I made the decision to never leave his side and put everything else in my life on hold. I felt guilty if I was doing something that made me happy but did not involve him. I couldn’t think about myself knowing my brother’s suffering.

At the time when this happened I was an undergraduate student. During my free time I used to volunteer at hospitals, engage in various extracurricular activities, and enjoy time with family. Since this happened I felt like I lost all motivation to continue living my “normal” life as nothing about it was normal anymore.

I put the word normal in quotation marks because it is a subjective term. It was extremely difficult to see someone I knew all my life suddenly go through all these struggles, challenges, and difficulties in everyday activities that as able-bodied humans we took for granted.

Furthermore, I found it particularly difficult to balance out what was important to me as I constantly thought of his well-being and would spend most of my hours at the hospital. My rationale for why I was happy to take on such a role was that I wanted everyone in my family to feel content, and not be overwhelmed with what was going on.

Most importantly, I did not want to see everyone miss out on life, friends, and the things that they use they use to do on a regular basis. It was easier for myself to take on this role and still be in high spirits with missing out on the daily things that I used to do, however, the rest of my siblings were just kids, and I did not want to rob them of their childhood. It seemed as though everyone was able to get back into their daily routines and still do what it was that was important to them such as school, and work but I just could not move past this part of my life.

As a caregiver, it is easy to forget about yourself as you are constantly caring for another individual day in and day out. I tended to bury my emotions and how I really felt from others. I never spoke to anyone about how I felt because I did not want to consciously think about it. Everything seemed surreal, and I could not come to terms or accept the situation.

It is through this experience that i have found something that I am immensely passionate about, improving and enhancing the lives of TBI survivors, and their caregivers

Whenever I thought of the circumstances, I felt lost, out of place, and that nobody knew how I was feeling or what I was going through as most of the time I would be alone at the hospital. Nothing in life prepares you for this nor do I think there is a manual out there that explains how to feel, what to do, and to how to cope when situations like this happen. Even if information like that exists, I strongly believe that every situation is unique in its own respects and that there are many other variables to factor into the equation.

“So the hospital phase is over, isn’t that awesome, now you can finally get back to your normal life!” This is what most people said, and the reality is that after you leave the four walls of the hospital, another chapter of the rehabilitation journey begins. It is a whole new world when you have been away from your ‘normal’ one for such a long time, and many people are not aware, or understand what that means. What happens next? What is life going to look like in the next five years, or even two? Nothing is certain, and every day should just be taken as it comes. Recovery is a lifelong process, no matter what the gains.

Fast forward to over three years since it happened, and about 11 months after leaving the hospital, I can say my brother is doing very well and is much happier to be home. He looks very healthy, much like his old self.  I am dealing with the challenges of returning to my old, previously ‘normal’ life, which doesn’t seem normal anymore.

Motivated to return to the life he once had, my brother never gives up. He works hard every day, challenges himself to new lengths, in therapy sessions with his occupational therapist, and physiotherapist, and in everyday tasks.

He once said, “What is it that I will do for the rest of my life? I want to do this, be this, and go here. There is nothing that I cannot do if I work hard. Yes, I had a TBI, but that does not define me, it is just a part of me. I’m still the same person, do not treat me any different.”

I am an avid believer of this quote from Indian author Ritu Ghatourey:

Everything happens for a reason. That reason causes change. Sometimes the change hurts. Sometimes the change is hard. But in the end its all for the best.

I want to take this moment to say that given how horrible and scary this situation was, I am deeply grateful for all that I have witnessed, and learned over the past three years. If it was not for this situation, I would not have known how little people know and understand about the nature of TBIs, the various stigmas and assumptions that society fosters, and how this shapes and influences the ability to successfully reintegrate back into the community, and work as rehabilitation is a lifelong process.

The lack of understanding and awareness in society is a major barrier to successful reintegration, and is a public health concern, considering that TBI will be one of the major leading causes of death and disability by the year 2020.

I made meaning of this situation by believing that for me what had happened was a turning point to help me realize where my passions lie, and what it is that I want to commit to for the rest of my life.

Before this happened, I learned about TBI in my studies but I never once imagined what it would look like first hand. I never understood what it meant to be able-bodied, and to be able to do day-to-day things that we normally do not think of and have taken for granted. Furthermore, I never realized how difficult it was for someone to get around if they were on a wheelchair, and this includes going to the grocery store, the park, or even the bank.

It is through this experience that I have found something that I am immensely passionate about, and it is improving and enhancing the lives of TBI survivors, and their caregivers.

Samira is an MSc Candidate at the University of Western Ontario, in the Health and Rehabilitation Sciences Program, specializing in Health Promotion. Her current research focuses on oral health in traumatic brain injury, where she is qualitatively exploring the lived experiences of health professional students in various rehabilitative programs such as occupational therapy, physiotherapy, speech-language pathology, and nursing.


Lights, Christmas, Action!


I remember lying in my hospital bed and looking out of the window at the smokestack that illuminated a soft purple glow when it got dark. I was six-years-old and recovering from encephalitis which had landed me in a coma for two-weeks.

outdoor Christmas Lights
Lights outside Mark’s home

Low level light therapy (near infrared) may have beneficial effects in the acute treatment of brain damage injury.Dr Michael Hamblin   

But, it is documented that: a number of individual cases in which patients with chronic mild brain injury showed marked improvement in cognition, executive function, memory and sleep with light emitting diode (LED) treatments. – BioFlex Laser Therapy: Shining light on brain injury – Benjamin Yuen, DC, MSc, MCC(UK); Fred Kahn, MD, FRCS(C); and Fernanda Saraga, PhD
Source: Meditech International Inc.

Fast-forward almost 40 years, and I still find comfort in lights, especially at Christmas.

I enjoy hanging Christmas lights around our house (though I try to finish it up before the weather gets too frigid and I freeze my hands and fingers.) Once they are all plugged in, I find it calming and almost mesmerizing to look upon them in awe.

Is this brain injury related? I don’t think Dr. Hamblin and the others were referring to Christmas lights when they spoke about light therapy. But they are a comfort.

We’re big on Christmas at home: our house explodes with Christmas decorations, we host an annual open house, I do the lighting inside for the tree and fireplace mantle, but my favourite are the outdoors lights.

I am no Clark Griswold in National Lampoon, but I like setting up a fair decent amount of lights on the exterior of our home. I may even think how to out-do myself, every so often.

I like the glow that shines in the darkness of night. Wrapping the lights around our flag pole like a giant candy cane, outlining the windows and doors with colour and thinking, yes, “What can I add this year?”

Mark Koning and his mother Ria
Mark and his mother, Ria

Maybe there is something to the effect of lights like this on my damaged brain, I don’t know. Or maybe it is the memory of the purple tower that I am drawn back to, something that made me feel safe and secure during a very vulnerable time of my life.

But maybe, too, it is simply the festive time of year.

Mark’s passion to lend a helping hand, offer advice and give back has developed into a moral and social responsibility with the goal of sharing, inspiring and growing – for others as well as himself. His experience as a survivor, caregiver, mentor and writer has led to his credibility as an ABI Advocate and author of his life’s story, Challenging Barriers & Walking the Path. Follow him on Twitter @Mark_Koning or go to


How we celebrate Christmas after my husband’s brain injury


My husband, Norm, has lived in a long term care home since acquiring his brain injury six years ago. Each holiday, be it Easter, St. Patrick’s Day, Halloween or Christmas, the facility decorates the common areas, in attempt to give residents and their families a more festive experience.

The McColl at the Elliott Christmas dinner Saturday December 17, 2016

A post shared by Theresa McColl (@mccolltheresa) on

To be honest, since Norm’s accident, I really haven’t felt like celebrating the holidays. Norm and I don’t have kids so why bother? It seems as though I am just going through the motions.

Thankfully, Norm and I have good people around us. We get a crew together to decorate Norm’s room each year. His brother, sister-in-law and friends come to help. They help bring out the holiday spirit – which is hard, as Norm doesn’t show many emotions.

Remember to take time for yourself. Even a walk around the block to clear your head, or sitting down to breathe can work wonders. If you don't look after yourself who will?

As much as possible, we try to keep things the same as before the accident. Christmas Eve we go to our parish church for mass. On Christmas Day we go to Norm’s brother’s to open presents and see the rest of the family. In the afternoon, Norm and I head over to our friends to wish them a Merry Christmas.

Despite this, our trips are more complicated now and planning is essential. When Norm and I go anywhere, I have to book the mobility van that is at his long term care facility. If the van is booked, I have to phone the taxi company. I have to strap Norm in with seat belts for safety. When we go out for Christmas dinner, to a restaurant or to friends, I have to make sure that Norm has a pureed meal to eat.

Remember to take time for yourself. Even a walk around the block to clear your head, or sitting down to breathe can work wonders. If you don't look after yourself who will?


At the end of the day, I think having family and friends around is all Norms needs as when they are around, he just beams.

After her husband’s injury, Theresa went back to school to become a Personal Support Worker. She has taken courses in brain injury, and is now a full time caregiver. You can follow her on Instagram, HERE

The challenges of understanding brain injury as a result of Intimate Partner Violence (IPV)


Sports injuries are often the first thing that comes to mind when people think about brain injury. A close second, motor vehicle collisions.

As a brain injury researcher, I am ashamed to say I hadn’t considered another population of people which are at high risk of a brain injury: those who have experienced intimate partner violence (IPV).

It wasn’t until the Brain Injury Canada conference in September 2016 that I started to hear about research relating to women who had experienced brain injuries as a result of IPV.

Close up of hands clasping

I’d like to take a moment here to note that persons of any gender may be either perpetrators of or victims of IPV. The majority of the studies I will be summarizing are regarding female survivors of IPV perpetrated by males. As more research becomes available we may gain further insight into other relationship dynamics. 

 Survivors of IPV

Anyone who has experienced injuries to the head and/or neck (including being shaken), should be assessed for a brain injury.

This includes people who have experienced strangulation, since brain injury can occur from lack of oxygen to the brain. People who are living with brain injury are at an increased risk of depression or anxiety and tend to experience frequent headaches, fatigue and dizziness. Many experience cognitive issues such as impaired memory and concentration as well as difficulty planning and making decisions.

Understanding these symptoms are the effects of the brain injury, and getting help dealing with them, may help a survivor make decisions regarding their living situation and plan to gain independence from a violent partner. It may also validate their experiences, knowing there are real health issues going on, and they are not ‘just making things up.’

Hospital Hallway

The good news is that research is starting to focus specifically on how females recover from brain injuries and how brain injuries from IPV and other forms of assault may be different from those sustained in other ways (such as a car accident).

As such, survivors of IPV who have sustained a brain injury (and feel they are able to so) may wish to participate in research in order to help further our findings with the goal of increasing the information base for other survivors.

Social Support is Crucial

Social isolation and loss of relationships are too common after brain injury, and those who have strong social support networks in place post ABI are more likely to have better outcomes than those who do not.

A reliable support system may be even more important for women with a brain injury as the result of intimate partner violence. Not only will they be dealing with the effects of a brain injury, but they may be leaving a violent partner, and / or dealing with the emotional and psychological impacts of having survived intimate partner violence.

Women may require financial support, legal information and a safe place to stay (with their children, if applicable) and temporary or ongoing caregiving.

While it is important to screen for brain injuries from IPV, it is complicated by issues regarding how safe a patient feels disclosing IPV. Some patients may fear retaliation if their partner finds out they’ve talked about the abuse and some may fear for the safety and custody of their children.

picture of person's shoes in the fall leaves

Survivors of brain injury from assault (including IPV) are much more likely to suffer from post-traumatic stress disorder (PTSD) and often have lasting psychological trauma.   There is now an ongoing research project with the aim of introducing a toolkit for frontline workers serving women with IPV, to improve the experiences of both the women and the workers when discussing and addressing this sensitive topic.

Research Challenges

Research findings from other studies often help direct future research.  I would caution that while past studies can be helpful, the literature may be missing more than we realize when it comes to survivors of IPV, for the following reasons.


Some survivors may choose not to participate in research or discuss their experiences. Depending on how risky they feel disclosing the IPV may be, survivors may not be seeking out medical assistance after injuries or they may not be forthcoming with details about how it happened.

Loss of follow-ups

If survivors seek medical attention, they may not return for follow-ups depending on whether or not they are trying to avoid alerting their partner about their medical visits.

Lack of details about injury

Unlike traumatic brain injuries from sports injuries or vehicular accidents where there are witnesses or first responders to provide information about the incident, survivors of IPV may have to rely solely on their own memories of the event (which can be difficult for anyone with a brain injury). They may not know how long they were unconscious or how many blows to the head they have sustained. Having accurate details about an injury can be helpful for research, especially when it comes to understanding post-injury recovery patterns and outcomes. While definitely not the fault of the survivor, having missing data may make it difficult to reach conclusions about the recovery of this population.

Incomplete representation of population

A study by the World Health Organization (WHO) found there are different societal standards for what constitutes IPV in countries where women have fewer rights. Therefore IPV may be underreported in other cultures or countries where males are viewed as having the right to punish their wives. Ideally there should also be more representation in the research from other relationship dynamics, such as those with trans partners, same-sex relationships, relationships where the female is the perpetrator and the male is the victim and relationships where both partners are violent.

Now, this is not to discount the value of research being done in this area. It is a historically under-represented group in the brain injury literature and researchers are now making great strides to shed light on how brain injury may differ for this population. It is hopeful that with continued research, we can tailor rehabilitation and support for this group with the aim of improving their recovery and quality of life.

 Alana is a researcher who recently completed her Master of Science degree at the Rehabilitation Sciences Institute at University of Toronto.  She has been studying brain injury for several years in topics including but not limited to: substance misuse, recovery, neurofeedback, sleep, and hospital-to-school transitions.  Her aim for her blog posts is to continue to learn about and promote learning about brain injury research, hopefully making it easier for interested persons (brain injury survivors, caregivers, loved ones, clinicians etc.) to access relevant information.

Making the subjective objective; how technology helps evaluate concussions


In the current climate of concussion clinics, many tools are being used to assess this type of serious injury, also known as traumatic brain injury (TBI), or acquired brain injury.

Assessments can include physical and mental status examination, Glasgow Coma Scale, Immediate Post-Concussion and Cognitive Testing (ImPACT) computer-based system, Balance Evaluation Scoring System (BESS), Inertial Sway measuring devices, and Optogait assessments. 1-3


Cognitive Symptoms of Concussion: difficulty remembering, feeling slowed down, feeling mentally foggy, difficulty concentrating, confused about recent events


Each assessment method is designed to evaluate the different aspects of the complex physical, cognitive and emotional disturbances that can result from a concussion.4

Establishing a ‘baseline’ with patients before a concussion occurs is useful in evaluating a person post-concussion to determine how the injury has affected them.1, 3, 5  This is not always possible given how and when a brain injury can occur.  An Assessment baseline can always be performed when commencing treatment and as an introduction to a rehabilitation program, and to compare against when re-evaluating a patient’s progress throughout their program.

One tool we are using to establish a patient’s baseline is the Optogait, which is considered a ‘gold-standard’ device for measuring gait (how a person walks), balance and movement symmetry.6-9


The simple 30-60 second test of walking on a treadmill can be recorded by a computer system using lasers to establish the individual characteristics of the patient’s gait, which can then be remeasured throughout the rehabilitation program.  This test gives objective data on all aspects of the gait cycle, as well as stability, balance and movement symmetry.

The amount you move when standing still (your postural sway), can also be measured by 3D accelerometers (which track acceleration), gyroscopes (which track orientation), and magnetometers (which, according to the journal, Karger, ‘measure the’ magnetic fields emitted by the brain, generated by neuronal activity).10 These tools allow a much precise measurement of sway  – up to 1,000 times per second more – compared to the current manual testing.


We also determine the speed of cognitive processing during walking by testing patients walking while counting backwards.  The movements of the eyes and head together (Vestibular Ocular Reflex) are also tested in order to determine concussive symptoms.

These tests are useful when a patient may feel that their concussion symptoms have resolved, but in fact, their cognitive processing is still poor.

The Gyko component of the protocol also tests sway, which is the movement of the centre of mass, and upper vs. lower body plus compensatory movement patterns made by the brain to return to a normal set point when standing and walking.

Screen Shot 2017-08-02 at 2.12.48 PM

These tests are blended nicely with the Optogait March in Place Tests (eyes open/eyes closed), and Gyko system to determine changes in physical functioning with changes in body position.

Most recently, a validation study was conducted to utilize the Optogait® equipment for evaluation of march-in-place tests traditionally used for vestibular (inner ear) testing, called the Fukuda or Uterberger Stepping Test. 3, 13-15




Using objective physical characteristics of the pathophysiology of TBI, the data collection with the OPTOGAIT equipment cannot be easily altered by the patient, thus you cannot under-estimate your symptoms with testing of gait, postural sway, or marching in place tests with your eyes open or closed.

This testing protocol provides an objective, evidence based protocol for both assessing, documenting and treating acquired brain injury.

Screen Shot 2017-08-02 at 2.13.07 PM

Dr. Philip Palmer is a chiropractor serving Toronto and the surrounding area. He is the clinical director of Genesis Rehabilitation, Physiotherapy and Sports Injury Clinic.


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  2. Gaudet CE, Weyandt LL. Immediate Post-Concussion and Cognitive Testing (ImPACT): a systematic review of the prevalence and assessment of invalid performance. The Clinical neuropsychologist. 2017;31(1):43-58.
  3. Engelson MA, Bruns R, Nightingale CJ, et al. Validation of the OptoGait System for Monitoring Treatment and Recovery of Post-Concussion Athletes. Journal of chiropractic medicine.
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  8. Gomez Bernal A, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME. Reliability of the OptoGait portable photoelectric cell system for the quantification of spatial-temporal parameters of gait in young adults. Gait & Posture. 2016;50:196-200.
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PHOTOS: Optogait Technologies Inc.