• Richardson D

• Middle Aged
• Open Access Document
• Stroke
• Stroke Rehabilitation

Background: Stroke-related motor and balance deficits often persist for years, yet evidence shows neuroplasticity can be rekindled long after the acute phase2,6. We present two chronic stroke cases treated with an integrated programme of manual spinal adjustments, vestibulo-ocular reflex (VOR) exercises, multi-axis whole-body rotation, reaction-time drills, quantitative EEG (QEEG) tracking, and autonomic monitoring (Ocula) delivered in a regional clinic.

Case summaries: M58, 36‑months post‑ischaemic stroke with gait and cognitive deficits; M46, 8‑years post‑cerebellar infarct with imbalance and daily headache. With multiple sessions over several months, both showed improved posturography, oculomotor metrics, reaction time, and functional independence.

Interventions for both patients: (i) high-velocity low-amplitude spinal adjustments to segments with fixations; (ii) daily home VOR × 2 and dual-task balance drills; (iii) progressive multi-axis chair rotations (yaw, pitch, roll; 30–60 deg s⁻¹; 20–60 s bouts) with concurrent cognitive tasks; (iv) reaction-time panels (overlap, gap, anti- saccade paradigms); (v) lifestyle coaching and paced aerobic activity. QEEG and smartphone pupillometry (Ocula™) guided the session intensity. 

Outcomes: Both survivors demonstrated objective sensory-motor and cognitive gains well beyond the accepted twelve-month plateau.

Conclusion: These cases illustrate that chronic stroke deficits can improve when a sensory-rich, individualised, and autonomically titrated programme is applied. Multi-axis vestibular stimulation and spinal adjustments may act as potent afferent primers that amplify subsequent task-specific learning. Controlled studies are required, but clinicians should consider multimodal, data-informed approaches rather than accepting late-phase stasis. Of note is that long term treatment appears to deliver long term gains.

Author keywords: Functional Neurological Disorder; Chiropractic; adjustment; chronic stroke recovery; sensory motor integration; multi axis vestibular stimulation; qEEG; Pupillometry.

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