Fundamentals of Intervention #2: Integrating Higher Level Sensory Systems Into Treatment 

If this is your first time tuning into the “Fundamentals of Intervention: An Approach For Treatment” series, catch up on my previous blog on treating pain prior to understanding the value of integrating higher level sensory systems into your treatment approach. The flow of information will make more sense when approached hierarchically, I promise!

The Vestibular System

All mental faculties, including vision, hearing, language and memory are dependent on the vestibular system, which includes the oculomotor areas, posture, spatial perception, spatial navigation, body representation, attention memory, mental imagery and social cognition. The specifics of the vestibular system is beyond the scope of this blog, however, recognizing the importance of the vestibular system in integrating all the systems proves valuable, considering the amount of sub-clinical integration issues that patients present. A vestibular system that functions suboptimally can potentially create a situation where the brain perceives gravity in an altered position – not on the ‘postural plumb line’. Therefore, the question “how does the brain perceive the body part?” needs to be asked; and strategies to assess this region should be employed.

Preparing the brain for musculoskeletal interventions, or “priming the system”, is useful for building brain space in patients with limited body maps and proprioceptive awareness. More specifically, touch can increase representation in the brain to a region and can be used as an effective intervention to improve proprioceptive awareness. While sub-clinical integration issues may not seem important, or be in the thought process of an orthopedically dominant movement professional, it should be. This statement holds true particularly for the patient whose pain returns if they do not perform their ‘corrective exercise’ daily, or for the patient with multiple injuries in the same region.

For a deep dive into how the vestibular system influences joint function and my other four fundamentals of intervention, watch my new 2 hour coursewhere I’ll share real-life exercise examples as it pertains to the Integrated to Isolated Spectrum and discuss my other four fundamentals of intervention.

More online education with Adam Wolf

The WebExercises Story:
WebExercises was created by clinicians who wanted to find a better way to help patients succeed with their exercise rehabilitation programs. As clinicians we are limited with time therefore WebExercises was developed to efficiently design home exercise programs. We offer an engaging patient experiencethat can be monitored virtually by the clinician keeping your patients motivated outside of your office.  Since 2005 we have delivered over 20 million exercises saving clinicians time and improving patient adherence. To find out more how WebExercises can improve your practice call us 866-411-4825 or visit

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Adam Wolf, PT

Author Adam Wolf, PT

Adam’s professional credentials include Licensure in Physical Therapy (IL) and Massage Therapy (IL) and Fellow of Applied Functional Science (Gray Institute)(’09). Some of his certifications include Enhance Running Technician, Functional Range Conditioning (FRC), Dry Needling Certified, Neurokinetic Therapy level 3(NKT), Functional-Neuro-Orthopedic Rehab (FNOR) provider, and he has his certificate of competency in vestibular rehabilitation. As a Physical Therapist of over 15 years in Chicago, he is the owner of REAL Physical Therapy and founder of The Movement Guild. He is the author of two books, including the most recently published Foundations of Movement: A Brain Based Musculoskeletal Approach. Adam is a Master Instructor on the Rocktape Education Team for the past seven years, and also teaches his own material.

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