Dr. Heidi Wise is the featured speaker at this year's Middle Atlantic Congress of Optometry meeting titled "Finding Balance in Visually Asymmetric Demands: Neurological and Optical Constraints." Also presenting at the two day event in Pittsburgh, PA on October 20-21, 2018, are Dr. Paul Harris and Dr. Gregory Kitchener.

Dr. Wise will be discussing evaluation, therapy and lens applications for disturbances of the visual process from a neurological perspective. Dr. Paul Harris will discuss the relationship between posture and the visual process, and Dr. Gregory Kitchener will offer topics related to organizing observations in visual training, recognizing the visual process in action, and re-directing training activities to develop visual abilities more consistently.

If you are an optometrist, CLICK HERE for more information on how to register for this event.

 

Posted July 23, 2018 at 7:14PM
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No matter what I pick up to read these days, it seems like this one message is clear: When it comes to the brain, it’s all connected. You can’t separate the visual process from any type of behavior, emotional, physiological, or physical. You also can’t separate the visual process from the rest of the senses. While there are some that are more heavily intertwined than others, the auditory system is so close it can’t be ignored.

We use the auditory process, including our sense of vibration, to help us determine our location in the spatial environment around us and to judge the location of objects producing sound and vibration. Vibration is also felt by our proprioceptive sense. Since the two main things we have to orient ourselves against gravity are the ground below us and the space around us, our ability to accurately perceive soundwaves is critical.

Besides being the geek that I am about vision and its pervasive role in human behavior, I also have a longstanding passion for music. I grew up playing the piano and added the flute and piccolo as I got older so I could be a part of marching and symphonic bands. I continued this through college, even picking a college largely because of the band programs there. My tastes vary widely, and there’s not really a genre that I don’t have a least a song or two from in my collection. What I listen to depends on my mood, as I’m sure it does for a lot of you reading this. Ever wonder why that is?

Kenny Chesney’s “I Go Back” echoes this sentiment. Music can transport you to a different place and time. For some, it even evokes other sensory experiences, such as smells or tastes. Many of us experience emotions when hearing certain songs, which may frequently be related to the lyrics. However, there are other qualities to music that often affect our brains, and therefore our behavior. It might be the beat of the song, including whether it’s fast or slow, subtle or strong. Can you feel the bass “thumping” your chest, or is there no identifiable drum? It may be the pitch of the vocalist or of the predominant instruments; are they singing high or low notes, female voice or male voice, is there a lot of lead electric guitar, horns, strings, piano, or bass guitar?

Some of our more challenging patients who have visual-integration dysfunction also have other sensory processing difficulties. This can range from the severe, as in the case of the patient who says “I tend to be sensitive to lots of things, including sound or the feel of materials in clothing,” to the more subtle case, who can’t identify a single symptom but yet can’t manage to use neutrality in a dynamic, functional sense. If we’ve given them the ability to be neutral through visual and physical intervention, and there are no orthopedic reasons why they shouldn’t be able to maintain it, we are forced to look at what other sensory processes might be obstacles.

This brings us to the Interdisciplinary Integration Symposium for 2016. It is such an exciting time to be in involved with PRI. For me, personally, it answers more of the “how did I get this way” question that I know many of you have as well. It also gives me a chance to bring two of my passions in this world together, vision and music. For our patients, it’s another tool we are researching and understanding more about every day. For a few of them, it’s already been the icing on the cake.

The thing I love about this most is that we know we will never have all the answers to why this amazing brain of ours does what it does; but it sure is exciting to keep trying to find out all we can.

Keep moving beyond sight!

Dr. Heidi

Posted September 17, 2015 at 9:17PM
Categories: Courses

This year we are offering an optional Interdisciplinary Integration evening series on Thursday, Friday, and Saturday of Advanced Integration. You must be signed up for Advanced Integration to attend these sessions. They will be offered from 5:15-6:30pm each night if you would like to attend. 
Thursday-Dr. Rebecca Hohl and Ron Hruska will present on Dental Occlusion. 


Friday- Dr. Heidi Wise will present on PRI Vision


Saturday- Dr. Paul Coffin will present on Podiatry.

Posted September 17, 2015 at 6:48PM
Categories: Science

IT’S ALL ABOUT THE SENSES
My first trip ever to California for Postural-Visual Integration this last weekend did not disappoint!  Sensory awareness (aka Vision) and how it can impact physical performance is what our two days were all about.  Between the truly amazing visual scenes at the course location and the coast, the smells and sounds from the ocean and a ballpark, and the sight and sounds of a group of people having fun learning it was a weekend I’ll always remember.  Sensory experiences change lives; this was reinforced by a text I received the morning after the course from an attendee working with an 82-yr-old who has serious balance problems who was walking better during his visit using visual techniques learned the day before.  I couldn’t be more fulfilled!  

Thanks to Skip George and John Swain for hosting at this incredible venue!  It could not have been more perfect for a course all about “sensing” the space around you and the ground under you.   Thanks also to all the attendees, a great mixed group of PTs, OTs, trainers, strength coaches, massage therapists, and a  behavioral optometrist, for indulging Ron and I for two days while we played verbal ping-pong!  Here’s to Moving Beyond Sight!

Dr. Heidi
 

----Ron demonstrating a technique from Phase II:  Mimicking

----Caleb, Matt, and John finding “new floors”

Posted August 27, 2015 at 6:38PM
Categories: Courses

I recently had the opportunity to take PRI’s Impingement & Instability (I&I)course for the first time.  The most important concept from this course, in my opinion, is that if patients can’t recognize, use, and integrate the sensory references need for upright, alternating, reciprocal function—the goal of any PRI program—then they will not be successful in their program.  And neither will you.  Definitely not something that excites most of us, regardless of whether you are a PT, strength and conditioning coach, trainer, or even an optometrist, dentist, podiatrist….the list could go on and include anyone working with this patient, whether  to improve performance, decrease/prevent pain, or treat their orthostatic or anxiety issues.   Impingement & Instability is the “bridge” course between the primary, “floor-up” PRI courses and the “top-down” secondary courses and the PRI Vision course.

I&I concepts are the type of thinking that, in some regards, are the only thing I really know how to do when it comes to PRI.  I am not a PT, nor do I have any formal educational background in human gait, movement, or physical performance.  The minute a term like “anterior pelvic inlet” or “late left stance” comes out of Ron’s mouth, I’m a little lost.  I’ve learned a lot over the past 5 years working with Ron and the other therapists here at the clinic, but this is why I keep taking and retaking courses!  Anyone who knows me knows how much I HATE that feeling!  But what I do clinically every day in PRI Vision with Ron is ALL about sensory awareness.  So for  the patients  that need me, I know if they can’t consciously “find & feel” the floor under their left foot—in  I&I the left calcaneus—nothing  I have done so far will help them and we have to keep going until they can.

There are, of course, other sensory references many patients need to increase or decrease.  Some of them are discussed in I&I, some are not, and these vary based on the patient.  Regardless of what these are, my job is to change the “top-down” brain’s sensory awareness so that the “bottom-up” activity from the primary courses can be effective.

The second concept for this course is the meaning of the words impingent and instability.  Impingement as a syndrome or diagnosis is usually associated with pain due to excessive or inappropriate contact between two points in the body.  Instability is usually associated with the lack of support or stability, often due to overstretched or lax ligaments or muscles.  But consider these definitions:

Impingement:  appropriate contact not only between two points in the body, but also between the body and a needed sensory reference, such as the floor.

Instability:  the freedom to “let go” of a contact point, sensory or physical, so movement can take place.  To obtain alternating, reciprocal function, you need proper impingement on one side paired with proper instability on the other, then the ability to reverse it—This is how “good gait” happens!

Every patient I see in PRI Vision needs less impingement and less instability in certain areas, and more of each in other areas.  Many have too much “impingement,” or reliance, on vision, and not enough on their left heel.  We also frequently have to change multiple reference areas for the patient to make use of the new “instability” I am giving them in Vision.   These changes can be the determining factor in the patient’s program success, and where I rely fully on Ron and the referring therapist to ensure this is accomplished when needed.

If you haven’t taken I&I, you absolutely should!  Ask some of the attendees that experienced the “right” PRI function for the first time during those two days.  If you’ve taken I&I, then the next step is to take the Cervical Rotation and Postural-Visual Integration courses.  These two courses will show you what to do when you have patients (or yourself!) that just can’t find and keep those sensory references from the I&I course.  The head, neck, and ultimately the BRAIN are the “top-down” drivers that can negate, or reinforce, all of your and your patients’ “floor-up” hard work.

Moving Beyond Sight!

Dr. Heidi

Posted January 30, 2015 at 3:21PM
Categories: Courses

After teaching the first two PRI Vision Integration for the Baseball Player courses in back-to-back weekends before Thanksgiving, I don’t know where the month of November went!  But I wouldn’t have had it any other way.  Ron and I really enjoyed writing and presenting this course for many reasons. 

First, I LOVE baseball, and Ron gained a new appreciation for the sport as well.  Having the Royals in the World Series during some of our heavy prep time was a bonus, giving us some exciting games to watch as we fine-tuned our day of material.  Second, because it’s only a one-day course and it’s geared for the not-so-seasoned PRI practitioner, we got down to the plain and simple approach to a complex subject and just had some fun with it.  No time for all the neurological discussions (which you ALL know we are geeky enough to enjoy way too much!); demonstrations and step-by-step guides dominated.  Third, it gave us a chance to tie our information into another course, which took place the two days preceding ours.  It was great to learn so much about the proper mechanics of the sport from Allen and James in their PRI Integration for Baseball material as we were preparing the course.  Hearing them present some of it was a gift; they truly love teaching and they make a great team!

Our courses were a nice mixture of practitioners from the baseball arena and those in more general modes of practice.  Having that mix gave us the opportunity to not only learn more about applications to the sport of baseball, but it allowed us to hear from those thinking outside the sport as well.

We want to again thank our hosts, the Arizona Diamondbacks and the Philadelphia Phillies, for all they did to make these courses go so smoothly.  The team at the Diamondbacks of Ken Crenshaw, Neil Rampe, Andrew Hauser, Ryan DiPanfilo, and Nate Shaw has been an instrumental part in helping us over the past year to develop this course.  Andrew was invaluable as the one trialing these concepts, communicating with me regarding outcomes, and helping me “see” what they do in players’ performances.  Many in the sport benefit from their “big picture” integrated approach.  James Ready, our host from the Phillies, is another great thinker who has a passion for integration, as I got the privilege of learning over the course of our day with him.     

As a Florida-born girl, I enjoyed the relative warmth of Phoenix and Clearwater while it was really cold back here in Nebraska.  Since my favorite things include beaches, baseball, and being around the #PRInation, these were weekends that couldn’t have been better!  Already looking forward to the next one, which is right after the New Year! 

To go with the great people pictures James posted in his course reviews, here are a couple of my must-see places: 

  Part of the Dbacks’ Complex at Salt River Fields

 Phillies’ Spring Training Stadium

Course Testimonials:

“Great course!  This course was an excellent introduction to the role that vision plays, not just in sports or rehab, but how it’s integrated with and influences the performance of the entire human system.  Ron and Heidi presented the course in such a clear way that I was able to begin applying many of these visual techniques in my rehab programs the next day.  This definitely changed the way I look at rehab programming for all of my athletes, but especially in baseball, where visual skill is so directly related to their success.  Thanks for a great experience.”

Josh Ogden, MS, LAT, ATC, CSCS, CES

“Fantastic course!  I have been involved in baseball for 25 years and have utilized PRI concepts, with much success,  in treating my collegiate baseball players for almost 15 years and the PRI vision course was unbelievable.  It changed how I look at treating my athletes, as well as how I look at baseball and baseball players in general when it comes to treating their complaints both on and off the field.  Thanks Heidi and Ron for an eye opening experience!”

Jeff Wood, MS, ATC, LAT

"I just participated in the PRI Vision Integration for the Baseball player, held in Clearwater Florida. I consider myself a connoisseur of PRI courses. I learn so much from every seminar--even if I have taken it before. As such, I was blown away with the concepts that I was able to grasp during this one day course. 

This seminar was an amazing starting point for understanding the role of vision in the PRI evaluation and treatment model. I work with a very varied clientele, and all principles/skills taught apply to all populations, not only my athletes. Heidi and Ron presented very complex material in such a systematic and logical manner that I was able to apply the techniques with patients the very next day (literally). I also believe that practicing and integrating the materials from this one-day program will enable me to learn at a deeper level, when I am able to take the 2-day vision course next year."

Donna Behr PT, MS, DPT, PRC

Posted December 10, 2014 at 8:00PM
Categories: Courses

Looking forward to the PRI Vision Integration for the Baseball Player course after seeing the materials that will be covered. The introduction of the PRI vision concepts into our player progressions have been a powerful adjunct, and a missing piece, for some of those hard to crack cases. Getting an apprecation for space in a sport that is constantly looking for more visual focus has allowed some of our players to get into a position of transition and reciprocation that they were previously unable to attain. 

Andrew Hauser, ATC, RSCC, PRT
Arizona Diamondbacks Minor League Medical Coordinator

Posted September 16, 2014 at 12:51AM
Categories: Courses

We are excited to announce a new PRI Vision course, PRI Vision Integration for the Baseball Player! This course will be taught by Dr. Heidi Wise and Ron Hruska, and will be offered the day after the PRI Integration for Baseball courses scheduled this November.

"This will be a different course from our Postural-Visual Integration course.  We we will be introducing assessments specific to baseball that help those working with the players in the training room understand when the visual process is affecting players’ physical ability to bat and throw.  There will also be concepts and activities taught that can be used in the training room and on the field to help reduce negative visual influences on the visual influences on these abilities, even without additional integration with an optometrist. “ – Dr. Heidi Wise, OD, FCOVD

To learn more about this course and to register click here.

Posted July 30, 2014 at 7:06PM
Categories: Courses Athletics

PRI Vision Question - What do you mean when you say “the patient needs more minus?”

PRI Vision Question- “Please discuss monovision and neutrality.”

PRI Vision Question - “Are there any self tests we can teach our patients to perform at home to determine neutrality?”

PRI Vision Question - “Are there any vision tools you would recommend we use to determine vision related issues?”

PRI Vision Question - Patient case study on history of cataracts and depth perception issues.

PRI Vision Question - Patient case study on treating astigmatism and convergence issues.

Posted November 22, 2010 at 10:51PM
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