17 Burst results for "Dr Debbie"
The Essential Oil Revolution
"dr debbie" Discussed on The Essential Oil Revolution
"So I do have a website at doctor Deb for U dot com. It's DRD EB, the number four, the letter U, doctor dev for U dot com. Or I'm on Facebook and Instagram. You can just type in doctor dev for you or shalom wellness with doctor Deb and you'll find me I'll pop up for sure. Fabulous, thank you so much, Deb for your wisdom here today that you've shared with us. I really appreciate it and love all the work that you're doing. So thank you for spending your time with us here on the essential oil revolution. And thank you, what a great blessed opportunity I appreciate you. The essential oil revolution is created by me, Samantha Lee right. Thank you so much for tuning in. If you want to reach out to me directly, find me on Instagram at Sam fleet, right. And if you're looking for any recipes or resources mentioned in today's episode or past episodes, go to revolution oil's podcast dot com. There you can check out our DIY dugout, past episodes and our amazing swag shop. We'll catch you here next week as always our new episodes come out on Tuesdays, so make sure you hit that follow button wherever you're listening to this podcast in your app, whether that be Apple, Spotify, iHeartRadio or wherever, but a exclusive perk for those who listen on Apple podcasts if you prefer an ad free version of this show, you can get completely ad free listening on Apple podcasts for less than the cost of a fancy latte. Simply find the essential oil revolution in the Apple podcast listening.
The Essential Oil Revolution
"dr debbie" Discussed on The Essential Oil Revolution
"You don't get to know your oils a little bit then when you really need them, you're gonna feel overwhelmed and you're gonna second guess and you're gonna be like, oh, I don't know which one to use or how to use it. So they really are to me like my Friends, you know, and you need to get to know your Friends so that they can be there for you when you really need them. Man, I would just love to sit and talk with you for hours and hours. You just, so many things that you said which, to me, as someone who works with a lot of moms, there's so much hope and what you just said. And because your mommy heart and your mommy brain knew what it needed, you know, and you did have some education on that, but doesn't that give you it just gives moms who are listening to this hope that they really know what they need and if they just get quiet and listen, their bodies will definitely direct them. There's a scripture that says talk to the earth and it will teach you. So, you know, these the plants that God gave us in his gardens. They are there for us to learn from and to experience and to experiment with. And doing it with the sense of smell gives us a whole nother depth because our emotions service in some really powerful ways. So I love hearing that you have that great experience. Yeah. Well, I love your talk about the pineal gland in its relationship to frankincense as well. And because that's something that doesn't come up a whole lot, so I'm curious if you could teach us a little bit more about that connection and the pineal gland. Is there anything else in this world that can activate our pineal glands so easily? Well, I can tell you some things that are detrimental to the pineal gland that we can avoid in our lives and that would be things like fluoridated water, fluoridated toothpaste, chemicals in your environment because we have found out now that they will go in and calcify that gland, which kind of shuts off your ability to hear your intuition and listen to God during your pro time. So I like to just, in addition to getting the bad stuff out of my household, put a drop of frankincense on the tip of my tongue and just kind of hold it up. I can't talk and do it at the same time, but hold it up to the roof of my mouth. Take some deep breaths. It'll get right up to that pineal gland and help to take away some of those deposits that are on there. There are so many amazing molecular constituents in these oils that literally go in and we talked a little bit about the detoxification, but did you know Samantha that they can actually get down to the DNA level and help to remove garbled information and chemical assaults to our DNA and help to repair some of those. And when you said, I felt myself kind of going back into that old pattern and when you sniff that frankincense oil, it helped to kind of release all that. That is such a profound statement because the molecules, the monotypes assess which turpins in these oils literally help to do that with our DNA. So, so powerful. It's just so powerful. I'm sure have you taken some classes on the emotional benefits of the oils and how they work as ligands and neurotransmitters in the emotional system. If you haven't, it's just such a great such a great topic to explore because you had also mentioned it seems so easy and simple. And you know what? Things are easy. Think, well, no, I shouldn't say that. Things are simple. God kind of laid things out for us in a very simple way. We like to we like to make them a little more difficult, don't we? We like to complicate things. And so one of the benefits of using these oils is it helps to bring us back to center so that we can see the simple solution and then have the confidence you had mentioned that earlier, learning about these oils gives us confidence to really move forward and make a more sound decision for our families. And that's one thing that I love so much about using the oils in an emotional sense. Yeah, absolutely. And they can be, I like to call them a gateway drug to health because sometimes they're that little tool that for some people, it's just that little toe in the water that they need that then allows them to move forward making another healthy decision. And then another healthy decision. And then another, and it really builds. So you know, when people sometimes we can get a little carried away about how essential oils will cure the world. You know, it's all essential oils can cure everything. When to me, as much as I love my essential oils, obviously, I almost find it a disservice to discount how there's so many other tools that can help us essential oils can sometimes be that perfect gateway for someone to then embrace those other tools like nutrition or healthy eating or IV. Yes. There's a reason why we have lots of great choices because they all work together so well. And there's rarely a silver bullet, but sometimes we do get blessed in that way. But it's really about making the whole host of lifestyle choices that like you say build on each other. And allow your body to utilize all those beautiful tools in its playbook to be able to express a higher level of health. Debbie this has been so much fun chatting with you and before you go, we want to ask your closing questions, of course, but before that, I was wondering if you could just share with us one story, whether it's a personal story of your own use of essential oils or a client that you've worked with or friend. To just leave us a little bit inspired about how much we love these oils and how diverse they are in their ability to help us. Take your time if you want to take your time thinking of the stuff because I have one pop to my head and I know that one of your favorite products is a product that we call progesterone plus. Now it isn't it does have some it has the Mexican wild yam in there. So but it also has some beautiful oils. The frankincense, the Cedar with the peppermint. So as I was moving into that age of transition, I like to call it. I think I was 50 at the time I started using oils. I was 52, I was having some symptoms that, in my mind, even with all of my education and all of my experience with natural health, I'm thinking, oh my gosh, do I have MS? Do I have diabetes because I was having tingling of my feet, you know? Well, then I got a brain, and I thought, oh, well, you know, I am in menopause and tingling feet, sleep issues were the only two menopausal symptoms I really ever had. But those are in the top 30 symptoms. I never had hot flashes, anything like that. I had just learned about the oils in about ten years ago. I've only been using them for about ten years, not even. And someone had told me about this oil called progesterone plus. So I started to use it. And I'm telling you within ten days, I was almost a new person, which, of course, my husband appreciated as well. But it was so nice to be able to get up and about and not have those tingles in my feet. And so that is almost a miracle oil to me. I just love it. I have a lot of ladies in my practice who use it. And I would imagine that 9 out of ten women that you talk to will have a positive testimony of progestins plus. So that's mine. I could go on and on. I have so many favorites, but that's the one that popped in my mind. I love that one. I think we've got time for one more. I could just listen to your stories all day. So I'm telling you that oil. So I deal with a lot of babies. And now that I have two grandchildren of my own, my 20 month old is, you know, she's teething. She's getting all four molars at once. So she can not say cope by ibo, as she calls it her ba. So we'll ask her, do you need your ball?.
The Essential Oil Revolution
"dr debbie" Discussed on The Essential Oil Revolution
"And wellness every day. And there's a relationship between the care institute and young living and I know you know some of that story personally. I think a lot of the young living listeners would really enjoy hearing that. It's such a beautiful story. So as you might know, because you've seen Gary speak. He's very, very intuitive in the way he approaches his use of oils, his understanding of oils, how he found oils out there in God's garden. And when he would go out and teach people how to use the oils, he started with this raindrop technique. Since he was so intuitive every time he taught people how to do it, it was different. Every single time it was different because he would tap into what that person needed for their body at the time. And so down in Dallas in 1999, doctor David Stewart and his wife Lee, were there at one of the trainings. And they noticed that he did the raindrop two times in a row exactly the same. So it sparked an interest in them to standardize the education of essential oils in this country. And so that's how they founded care. And in the beginning, Mary and Gary were working with David and Lee Stewart to found that institute. And then they kind of separated, but it was always a great relationship working forward. Yeah. There was a lot of love there absolutely. So you can see. So many not just young living members, but aromatherapist or just laypeople who wanted to understand more about, wow, how do these oils really work? And how can I use them most effectively would go through those classes or those trainings and learn so much and build so much confidence and then be able to turn around and help other people with their oils. It was really such a movement that we owe a lot, I think to the care practice and the work that was done during that time. And you're absolutely right. And you really touched on a great point and that is giving, especially moms with new babies. They're very, very sensitive to what they're putting on their baby's body. So when you go through a care training, you really develop that confidence that you're using them safely and effectively the essential oils. So Debbie, you've been a chiropractor for three decades. That is a very long time. I'm curious what got you interested in pursuing that career and when did oils become a part of that journey and when did that practice start becoming combined for you? So as a child, I was always really sick. I had asthma, food allergies, animal allergies, migraine headaches, and skin rashes. Who knows? Where they all came from. But my parents kind of did the traditional medical route. And I just was never getting better. And so by the time I was 16, my dad, who was an electrician, was doing the electrical wiring on a chiropractic office. He did not even know what a chiropractor was. But he knew that it was some kind of doctor because he saw the x-ray view box and the blood pressure cuff and the reflex hammer. And so they started to have a conversation about me. And they actually bartered for my care. Now I never had back pain, but I was not able to live to my fullest potential and quite honestly at 16. I was watching my Friends being able to do things that I was not allowed to do because my parents were afraid I'd go away on a girl scout camp as an example. And go into a full blown asthma attack. So I went through a course of care, and this chiropractor taught me how to use nutrition and reflex points. And he adjusted my spine and after about a few months, I really started to feel better. And as I got older thinking about what I wanted to do in life, I always remembered that because I thought, what if my parents would have known about chiropractic when I was a baby? How many years of suffering could I have prevented in my body just by having that information? And so that's one of the reasons why I became a chiropractor. And then the doula on top of that because I really want to help mommies. You know, ideally, and you know this is a dual if we can get to those mommies before they get pregnant and really build their health up from the inside out, then that baby has a better environment to grow and develop in, but for sure if we can if we can get that baby when they're tiny and make sure that their bodies are aligned properly and that mommy knows about nutrition, things like that. Then they certainly have a better chance at living a fulfilling and healthy life. Yeah, I think a lot of listeners are thinking, well, you can do chiropracty on a baby. What does that even look like? You know, that's not. You don't hear about that very often, but it sounds like you work on a lot of babies. I do. I work on a lot of babies. I attend a lot of births. I'm so blessed and honored to be there when that baby is brought into the world. And I adjust them within an hour of their lives. Because you know, also being a doula. I just love that we have that in common. Even though the most awesome births can be traumatic on mommy and baby, there's a lot going on. There's a lot of stretching of body tissues and things like that. So things can be pushed out of alignment in mommy and babies. So there are some really wonderful gentle chiropractic techniques out there that you can use right on newborns. So as a chiropractor, you also incorporate essential oils with your care a.
The Essential Oil Revolution
"dr debbie" Discussed on The Essential Oil Revolution
"She's fully certified through the center of aromatherapy research and education. Debbie, welcome to this show. How are you doing today? Well, thank you so much. I'm doing great. How about yourself? I am doing great. Well, I want to dive into so many different topics today. You're also a doula, which I was a dualist for many years as well. You're a chiropractor, which I've utmost respect for the field of chiropracty, but I feel like it's also a field that a lot of people have a lot of misunderstandings around. So I want to dive into all that, but first, I want to start with the center for aromatherapy research and education, which you hold a full certification through. It's also known as care, which I hear referred to as care a lot. Give us a little bit of background into that institution or that would you call it a school? It's a certification process, and yes, it can be thought of as a school. It's a training center for people who are interested in learning more in depth information about the use of essential oils and really what makes them work. It's a great system where you can go and be trained in 5 mainly 5 topics. You learn the history of anointing and laying on of hands through the reading about essential oils in the Bible. And even though the Bible isn't about essential oils, there's a lot of great references in the Bible because it was so much a part of that part of the world's lifestyle. You also learn about the kids. There's like over 200 recipes. 600 references in different forms of thatch and fashion, yes. So that's really interesting. A lot of people don't know that. And you learn chemistry, the chemistry of essential oils and what really makes them work down to a molecular level. You learn how to use the oils as an emotional tool to help you.
The Essential Oil Revolution
"dr debbie" Discussed on The Essential Oil Revolution
"Your mouth and seeing how it refreshes that mouth odor. Nutmegs also great to add volume to your hair and for boosting sexual stamina. So many wonderful things in nutmeg plus it just smells heavenly. So give nutmeg a try if you don't have it in your stache, put it on your wish list and enjoy some nutmeg essential oil this time of year. Now let's pull a recipe out of our DIY dug out the segment on our show where we read recipes that have been submitted by you are amazing listeners. Today's recipe comes from Michelle deveining and it is called the crisp restless leg calmer. To make the crisp restless leg calmer and you'll need coconut oil, three drops pan away, three drops copaiba and three drops frankincense, rub on your legs for a calming effect for legs that have trouble being still. Thank you for your recipe, Michelle, we always appreciate hearing from you. Our listeners, if you have your own recipe, you'd like to submit to our dugout simply email us at DIY at revolution oils podcast dot com. Support for our show comes from liquid eye V I always have a big tall glass of water with one stick of liquid IV mixed in by my side in the morning during workouts or just because I love the flavor and the way it makes me feel..
The Essential Oil Revolution
"dr debbie" Discussed on The Essential Oil Revolution
"Favorite essential oils of all time, how it relates to the pineal gland. And so many other wonderful things that essential oils can provide to us. Our guest today, doctor Debbie koharski, has been using essential oils for many, many years and has been healing patients on so many different levels in her chiropractic practice. If you need a boost in a reminder today that your body is meant to be healthy, then this is the episode for you. You'll hear that interview in a moment, but first allow me to share my favorite oil of the past week. This week, as the weather transitioned to colder and colder, I've been having a hard time getting warm to the core. You know that feeling where you just can't seem to warm up no matter how many sweaters you put on. So I broke out my nutmeg essential oil mixed it with some coconut oil and then warmed it up between my hands and then I rubbed it on my lower back kind of the middle to low back range that is where your kidneys and some adrenal glands live, so getting that nutmeg over the adrenal glands over the kidneys is such a nourishing thing that you can do to get your body warmed up and prepared for winter. Other things you might not know about nutmeg essential oil is that it is wonderful for mental stress. If you've been battling the blues, get some nutmeg going in your diffuser. It can also be surprisingly useful for some women with strong menstrual cramps. I'd recommend rubbing it on the lower abdomen and then layering it on top with a warm heat pack. It's also great for mouth odor. So if you ever feel like a peppermint bomb dropped into your mouth, it's just too overwhelming. Try mixing some nutmeg with some coconut oil, swishing it around.
Animal Radio
"dr debbie" Discussed on Animal Radio
"Especially medical related but yeah there's you know this is a whole new realm of veterinary medicine nowadays so graduating veterinarians. Now he can have classes in just specifically reptiles Laboratory species animals like mice and rats So there's a whole lot of specialization that you can get nowadays for me when i came through school Had to learn a lot of this in continuing education on the job but the the now graduating veterinarians are so specialized. It's really amazing. There's so much to know okay. So if you want to talk to dr debbie about your lizards what do they call hemi penis penis or hemi say they only knows inside my dodge durango but now i can see the correlation between the two. Because that's one powerful engine if you wanna talk to her about your dogs or cats any animals that you have from the free animal radio app for iphone and android blackberry and laurie. News is just about ten minutes less than ten minutes away. What do you have coming up all right so then serious now. Drug problems in one of a big animal industry in this country. And it's really shocking. You won't believe the drug that we're talking about okay. That leaves my mind going there okay. That's on the way in just a couple of minutes right here on animal. Animal radio stick around well. This healthy serving of animal radio is brought to you by red barn. of course. your dog's favorite treat company now in the cable business with the i five ingredients featuring real animal protein. This meal is sure to satisfy your dogs carnivore cravings because your dog loves meat and no red barn loves your dog visit red barn dot com and use the promo code animal radio for ten percent of your purchase. That's red barn. Dot com with promo code animal radio.
Animal Radio
"dr debbie" Discussed on Animal Radio
"Fixed the good stuff get more animal radio with the free animal. Radio app for iphone and android. Your dog loves meat. That's why they'll love the new line of red baron dry dog food. The first five ingredients in each red barn recipe are meat fish or poultry sure to satisfy your dogs carnivore cravings. The added functional ingredients. Make red barn. Dry dog foods. The perfectly balanced meal for your best friend available in land ocean and sky recipes. Your dog loves meat. We love your dog head to red barn dot com to use the promo animal radio for ten percent off your bag celebrating the connection with our pets. This is animal radio featuring veterinarian. Dr debbie white groomer. Joey villani news director. Lorie brooks and now from the red barn studios. Here are your hosts. How rooms and judy francis. If you're listening now which you are. I can guarantee you're listening our you not hearing me say you're listening now. You probably have a pet. You might have a dog. You might have a cat. You might have fish. He might have horses. But you probably don't have a beaver. probably not. yeah they are they're exotic. I don't think it's actually legal to own beavers. No i don't think so. It's a wild animal. But there are wildlife rehabilitators. Yes and in a few minutes. We're going to talk to the mother of justin bieber who justin bieber roommate chest in beaver. Apparently she Is rehabbing a beaver. Among other things. I don't laugh. I mean i don't know what this all about Certainly name is adorable. I lied. I'm not here to judge but i am here to listen and find out. What just in beaver is all about. And we'll have justin bieber zone in the bomb and just a few minutes. I can't even imagine what would it be. Run around free in the house. Go to the store you come back in your kitchen table would be on. The league's would be gone. I'm gonna stick to my cat. My cat is low maintenance. I am a guy. They don't really chew too much. Stop up now. They're not big chewers usually so she's on the way in just a few minutes and we're also going to do a check of the news with lorie brooks. What are you working on for this hour. you know. I was admiring your empathy skills. How when you're talking about. You're just here to listen and stuff and have you ever thought as an animal lover that you are different from other people you know like you feel so much because your heart just aches for these little crazy is that just me. No it's not just you know there are others too but the amazing thing is that scientists have now discovered what it is physiological thing in our human bodies that causes this animal craziness. Animal love empathy. What makes us animal lovers. So i'll share this with you. Because i think it's pretty amazing okay. I cannot wait to find out why. I love animals so much. Dr debbie is ready to take your calls so as joey villani. If you have any questions for our dogfather call right now from the free animal radio app for iphone android and blackberry. They make me say that. Actually i get ten cents. Every time i say that. Have a dollar now. We're going to line to well. Hi how are you doing. I'm good how are you very good. What's going on in your world. Oh well i've just got a big cat that seems to have dandruff. not all the time. But from time to time it seems to be clicked a little bit by the top of her tail You know where it comes from her body in that area She's a siamese cat and she weighs almost eighteen pounds. Holy moly a couple of years. But she's not fat she's just A big cat. Gator shadows wow exercise and everything. But she's just a big test. I took her in and When i first got her new said she's not a fat cat. she's just a big cat. This is the way some of them are. Sometimes you know a little When i first got her they some something on her. I can't even remember what it was and that it did work. It was very greasy and it just were self off and it didn't really work. I was wondering if there's something. I can use on her colt that might help it. Okay perhaps now. There's a couple of things. I wanna ask you. Does she seems itchy scratchy. She have hair loss in any of the areas on her body. She doesn't scott says she doesn't have any hair loss and i've kind of pulled up her and check check. She doesn't have any dry. Spots are dry under there. It's weird to sing. It's kinda like a flaky When i brush her. And i'd take the air off the brush. You can see a little spot of hair She's an indoor cat. And i'm wondering if maybe it's just a dry skin that she's got well. The first thing is when you tell me that you have a siamese that's eighteen pounds. My bs radar is going on and she's in good weight because there are not many. Siamese which are fine boned lean cast is generally. What the breeds hype is so i would just partial. I think maybe half. Siamese yeah well we do see especially in the hindquarter area right over the rump. We do see a problem where overweight cats will commonly get dry skin in that area. And they'll have a lot of flaky nece in part of it is because they're a little bit to round. I'm kind of like a weeble. They can't turn around. And groom that spot very well so that can definitely play one factor in things but when we look at what are all the causes of what makes a cat. We have flaky skin. Well we look at things like parasites so perhaps your veterinarian did treat with a topical parasite product. That'd be one of the simplest things that i would always start with us to make sure we're doing really good flea control because there's also other types of parasites you can't see like might that can cause Flaky nece as well as itching and so forth. So making sure that you've had your cat she's an indoor cat all the time understand. Yeah but they're still. I feel give her the three things Later that he's not An aggressive cat in any way but.
Animal Radio
"dr debbie" Discussed on Animal Radio
"From celebrating the connection with our pets. This is animal radio featuring veterinarian. Dr debbie white groomer. Joey villani news director. Lorie brooks and now from the red barn studios. Here are your hosts powell abrahams and judy francis thanks. I enjoyed talking to you on this show. That's my favorite part of the show and in fact we're going to go to the phones in just a couple of minutes. If you have questions for dr debbie or giovanni or you just want to say hello from the free animal. Radio app for iphone android blackberry..
Animal Radio
"dr debbie" Discussed on Animal Radio
"Celebrating the connection with our pets. This is animal radio featuring veterinarian. Dr debbie white groomer joy. Villani news director. Lorie brooks and now from the red barn studios. Here are your host. Hal abrahams and francis. All we have a big show for you today. A very serious topic. Dr debbie i want you to be honest with me. Have you ever contemplated suicide you know. I can't say i ever have in my professional life at all But there's been some really dark time. Some really difficult things from employees issues business issues too.
ANPT Balance and Falls Special Interest Group
"dr debbie" Discussed on ANPT Balance and Falls Special Interest Group
"You know somebody's balanced. Somebody's balanced skills. Ms balanced capability or ability and also probably their fall risk. But if i have somebody using those throughout the day on. I don't know that it's telling me. Is this person challenging themselves or are they not how difficult is balanced. How much of an issue is balancing their like we can just say compared to all the other people their age and their gender with their condition their ability falls hear on about curve. Same with doing therapy. We can look at somebody and weaken the other sweating. They looked fearful. You know they're screaming whatever measuring when he used for their working too hard or they look forward. Maybe not working hard enough but we have more fine tuned than that to say. I need to make this task harder. Or they're not getting their money's worth out a museum and we're just working fear not actually training an edison. I think those are different measures than the measures the systems that are commercialized currently I love it. And so and the the focus that you have to to try to create something in that gap is rom. But the other pista about would be What's going on quarterly or in the nervous system heavy thought at all about cooking in that. Row miami while we're sensors like we just need to wear this No i understand that but at least in in being able to measure it in in clinic And there are some noninvasive and it's really really intriguing in my brain is not big enough to go both directions at the same time. I know that there are definitely people whose brains are that big. A lot of people would say that makes you a good scientist is at your your circumscribing year. Study or not trying to do too much at one time. But i but. I mean they're intriguing in you know in reading those those studies in talking to people who do those kinds of studies But i have not stopped to figure out how you would put the two together. Because i haven't really figured out this side of things yet you need to add a neuroscientist your land so that sounds like a really worthwhile stop. And i'm so excited about the the underway now recruiting live participants again Validation in stroke. What other populations have you done allegation on are you looking to validate on So the ten point scale. We did do a study in a group of older adults. Fifty and older who sung it was a range of. I don't feel balanced challenged through. I kind kinda worry about my balance. But nobody with a history of falls and i i have not published that one mostly because we then shortly thereafter switch to the seven point scale I have gone back to to publish the results on the ten point scale right one of the problems with measures as you refine it. Then you're like oh man our that our exactly and then. A lot of the initial work was with college students so got it so unhealthy younger younger population. So i've not. There are no other more circumscribed groups of people that i've worked with yet. I have anybody who would like to use it Especially the newer version If anybody who emails. I send it in their welcome so i had people. On in parkinson's clinics use it had people in general fall in and older adult clinics. Use it Something units but not. That's great and in fact it was. is it laura. Tany louder. I think is her name. That does neuro spark Educational i think she attended your presentation. i think that you did that. Csm for years ago as a as part of the bound false sig Presentation product And she loved it and she must have approached you after you emailed it to her cassettes. As you're saying that it's really sparked my memory to say like that's what she was talking which sagana emailed her and she's like could use it. Yeah and i just love this measure. That's great yes. So i'm i'm thrilled. The people using it because really i firmly believe that than in the practice of pt. You should be really dosing. Your interventions appropriately under working people. We shouldn't be over. Working people will have intentional reasons for choosing the doses the activities the interventions that we choose. And if you can't measure it in some meaningful way than you're not choosing your destroying things at somebody in your probably some of the time but not all times well said well said and when you talk about someone's balance We do have some measures right. Even have our course set from the neuro academy but they don't really get at the stability and none of them purport to measure the intensity of the intervention. They are very very clear about what they're measuring in it's it's fall risk or it's a certain type of balance ability or it's the underlying hardware underlying physiology. That goes into balance of the health of those systems. I mean the very very clear about what they are measuring. It's just that none of them are really measuring the intensity of what. You're what you're doing and it's hard to say you know. There are so many studies that say high intensity this produces these kinds of better results or lower intensity this or you know for stretching this dosage often for this amount of time. produces better results. But we can't say that about balance activity. Yeah i love that. I in fact i think it was just In the last couple of days again catching up on my csm presentations and The presentation that tambi but actually was presenting she. She talked about her next steps in her. Research you know looking at. We need to make dose response curves and if if you can train somebody and be less aggressive and put them through less discomfort and they get the same effect right then. That's what you wanna do but right now What you're saying is we have no idea what. The intensity is that they're experiencing and that's patient specific. So you're you've us a a first step a very important for step two to now pay a lot of things that confound that people over report people that under report You know fewer outside gains than than pain perhaps but but there's definitely a whole psychology behind the scale but right and so it boy that brings up another recent presentation and it was katherine lang talking about you know. We know that you'll have this this curve right. And there's the people that under reported the people over report the people that are reporting really accurately. But but you don't know who you've got in front of you so doesn't fix all problems but if someone's an under reporter at is there any evidence that talks about like at least they'll consistently under report and.
ANPT Balance and Falls Special Interest Group
"dr debbie" Discussed on ANPT Balance and Falls Special Interest Group
"Dole tasking. That sort of thing so that study that was supposed to have been finished by now is just restarting this week. Another covid casualty delay. i do love so you know. Stroke is close to my heart and You mentioned including people that phages so kudos to you. I think that's so important and i still see studies. Where feta's that gives people out of them. Were there any adaptations you needed to do to the scale to make it official friendly no because we designed it intentionally upfront. In that it's color coded it has numbers and it has words and what an deci will be perfectly honest about. I've tried to read you. Know psychometric studies and properties. And i have not figured out how to validate isn't the right word. But assess the use people what we noticed that people use one of those modalities at the time so the folks with Asia on tend to look at the colors or they look at the color and they point to that square. The students by large tend to use the word so instead of giving number. They'll come back with you. Know i feel blah blah not just quote you that definition and other people use the numbers so i think because it had different modalities to access it. We haven't really had an issue. With people. With efficient i will say people with severe receptive of phase of the few people who we are not sure they actually understood. The concept of it up front page has not been an issue as far as we can tell you right okay. now that's that's wonderful. And then are there any exclusion criteria or. I guess i should say what. What are your inclusion exclusion criteria for the populations. You're testing out this. This measure so for the strokes. The stroke study that we're doing right now. It's really just anybody would. It's chronic anybody more than six months past their stroke. Who on self identifies as having balanced difficulties or feels like they're limiting their activities because we fear of falling on or because of poor balance they. I mean the usual restrictions orthopedic or or cardiovascular issues that make the type of exercise unsafe Those types of things but nothing. I'm the cognitive ram including even The the the degree of asia So i think we sort of self limit there. Because of somebody's receptive officials severe enough that they can't understand our study than they also can't understand our consent and sort landed just not equipped to to go that step beyond wonderful That i mean that makes sense and so your data collection will start. I'm hearing different predictions of fall into winter but It's looking like there will be a light at the end of the tunnel. We are beginning. Are data collection again tomorrow. Congratulations that's good news. And what's what's your end that you still need an an and we're people go. If they want to participate. I think they will. We had quite a few people so with the first call out for people who are interested in coming in I think most of the people were not allowed to not ask him about the vaccination but most of them volunteered that they are vaccinated It's a really stringent. I'm on the university committee for You know kobe. Human subjects research approvals. And it's were stringent than any of the clinical settings around but we we're looking for about twelve more folks and we've got ten on to come in and be screened in the next couple of days. Oh good oh nipple hit. I think we'll hit that in. And is it a one time visit or is it no we we have to evaluation visits upfront at the end. And it's ten intervention sessions. I okay but ten out of twelve already at least hopefully screen. So that's good good step so with that It looks like in the next year we might see a new publication. And i love that. It'll be a validation on stroke on but the next step is What what else do you have in your pipeline are. What's the next study that you wanna start once you finish this one. So the as far as the scale we mostly used it with Reactive so we've done reactive testing before and after our interventions so we're looking at both I would. I would love to find kinetics that identify balance difficulty and not just balanced performance. Because i think that hover somebody sways or how quickly they step or any of those. Things has more to do with their balance ability or their performance the balanced task than it does with difficult task was in the first place once. They're really strict instructions about stand there and do not sway. Do not move. So i would. I would love to be able to find a way. And i've talked with some of the engineers about some little bit higher level modeling. that's beyond my immediate ability and things to look at because the world of of wearable sensors make some of those measures if you could create the mathematical model to go with the measures are easy. So that's sorry no that's okay so I'm just chewing on the idea of wearables which is such a hot topic And it and it definitely opens up the ability to assess and more real environments to right. If it's not a million dollar cents or that you're afraid to let leave your clinic. Yes but the other thing. I i was in a recent conversation with of the weinstein. So the The the university of southern california motor behavior neuro rehabilitation lab and they were talking about h. reflects and and and and we're ables but specific to the wearables And what the data is that. They collect how it's converted And one that's really telling you versus what somebody has decided to say. It means exact on which kind of blew my mind is like. That's a whole 'nother tier. I had never even considered. I just believed that. I was very naive. And my belief of these sensors so when you talk about wearables and one of them is the. Apd 'em right which is a very expensive but has some has some pedigree with horrid being part of the development that company Even that sensor right where let you can buy the whole suite of if you're early wealthy and you put them on you know ankles and waste and each wrist and i think there's one at the chest and it that's a lot to get a person aware right so it starts to become like well it's not gonna be just running around and putting this on so have you talked at all about. Are you looking at like. What are the best options out there to try to have something. So at this point. I think that I'm not convinced that any of the commercial systems at this point have the variables that i'm necessarily looking for. I think they they are on their way. They have been. They are getting to.
Academy of Neurologic Physical Therapy Podcast
"dr debbie" Discussed on Academy of Neurologic Physical Therapy Podcast
"Tasking. That sort of thing so that study that was supposed to have been finished by now is just restarting this week. Another covid casualty delay I do love so you know. Stroke is close to my heart and You mentioned including people that phages so kudos to you. I think that's so important. And i still see studies where fatal something that gives people out of them. Were there any adaptations you needed to do to the scale to make it official friendly no because we designed it intentionally upfront in that it's color coded. It has numbers and it has words and what an deci will be perfectly honest about. I've tried to read you. Know psychometric studies and properties. And i have not figured out how to validate isn't the right word. But assess the use people what we notices that people use one of those modalities at the time so the folks with Asia on tend to look at the colors or they look at the color and they point to that square. The students by large tend to use the word so instead of giving number. They'll come back with you. Know i feel blah blah not just quote you that definition and other people use the numbers so i think because it had different modalities to access it. We haven't really had an issue with people Say people with severe receptive of phase of the few people who we. We're not sure they actually understood. The concept of it up front page has not been an issue as far as we can tell you right okay. now that's that's wonderful. And then are there any exclusion criteria or. I guess i should say what. What are your inclusion exclusion criteria for the populations. You're testing out this. This measure so for the strokes on the stroke. Study that we're doing right now. It's really just anybody would. It's chronic anybody more than six months past their stroke. Who on self identifies as having balanced difficulties or feels like they're limiting their activities because we fear of falling on or because of poor balance they. I mean the usual restrictions orthopedic or or cardiovascular issues that make the type of exercise unsafe Those types of things but nothing. I'm the cognitive ram including even The the the degree of asia So i think we sort of self limit there. Because of somebody's receptive officials severe enough that they can't understand our study than they also can't understand our consent and sort landed just not equipped to to go that step beyond wonderful That i mean that makes sense and so your data collection will start. I'm hearing different predictions of fall into winter but It's looking like there will be a light at the end of the tunnel. We are beginning. Are data collection again tomorrow. Congratulations that's good. News and What's what's your end that you still need an an and we're people go. If they want to participate. I think they will. We had quite a few people so with the first call out for people who are interested in coming in I think most of the people were not allowed to not ask him about the vaccination but most of the volunteered that they are vaccinated It's a really stringent. I'm on the university committee for You know kobe. Human subjects research approvals. And it's were stringent than any of the clinical settings around but we we're looking for about twelve more folks and we've got ten on to come in and be screened in the next couple of days. Oh good oh leg nipple hit. I think we'll hit that in. And is it a one time visit or is it though we we have to evaluation visits upfront at the end. And it's ten intervention sessions. I okay but ten out of twelve already at least hopefully screen. So that's good good step so with that It looks like in the next year we might see a new publication. And i love that. It'll be a validation on stroke on but the next step is What what else do you have in your pipeline are. What's the next study that you wanna start once you finish this one. So the as far as the scale we mostly used it with Reactive so we've done reactive testing before and after our interventions so we're looking at both i would i would love to find kinetics that Identify balance difficulty and not just balanced performance. Because i think that hover somebody sways or how quickly they step or any of those. Things has more to do with their balance ability or their performance the balanced task than it does with difficult task was in the first place once. They're really strict instructions about stand there and do not sway. Do not move. So i would. I would love to be able to find a way. And i've talked with some of the engineers about some little bit higher level modeling. that's beyond my immediate ability and things to look at because the world of of wearable sensors make some of those measures if you could create the mathematical model to go with the measures are easy. So that's sorry. No that's okay so I'm just chew on the idea of wearables which is such a hot topic And it and it definitely opens up the ability to assess and more real environments to right. If it's not a million dollar cents or that you're afraid to let leave your clinic. Yes but the other thing. I i was in a recent conversation with of the weinstein. So the the the university of southern california motor behavior neuro rehabilitation lab and they were talking about h. reflects and and and and and we're ables but specific to the wearables And what the data is that. They collect how it's converted And one that's really telling you versus what somebody has decided to say. It means exact on which kind of blew my mind is like. That's a whole 'nother tier. I had never even considered. I just believed that. I was very naive. And my belief of these sensors so when you talk about wearables and one of them is the. Apd 'em right which is a very expensive but has some has some pedigree with horrid being part of the development that company Even that sensor right we've let you can buy the whole suite of if you're early wealthy and you put them on you know ankles and waste and each wrist and i think there's one at the chest and it that's a lot to get a person aware right so it starts to become like well it's not gonna be just running around and putting this on so have you talked at all about. Are you looking at like. What are the best options out there to try to have something. So at this point. I think that I'm not convinced that any of the commercial systems at this point have the variables that i'm necessarily looking for. I think they they are on their way. They have been. They are getting to.
Academy of Neurologic Physical Therapy Podcast
"dr debbie" Discussed on Academy of Neurologic Physical Therapy Podcast
"Or track You know as people develop the as what do their what those are self perception do. Because i i would bet that people don't realize that they're hitting those apa's yes which can be measured right there. There's ways to measure that of course in the lab it's harder in the clinic But really interesting and And i just love this conversation of i never. I never thought there were api as you develop in reactive bounce. I love that So so this might be a nice time to Pause for a second because you've given us lots to chew on and just go through some of the basics right for people listening in I think a lot of the balance terms get used generally and a lot of times that that means they get used incorrectly right. So the specificity of gets lost and you are a balance expert and i just loved to use some of this time to talk about differentiating some of those commonly used balanced terms. Herb so i am. I have my advisor extent. Wants the traditional keeping your center of mass over your base support. He or somebody during my dissertation defense said you know what a tree stump in can keep it center mass over. Its based in support. But it's not very useful so when most people say they they mean keeping your center of mass within your base of support but even just normal walking. We don't do that. We're constantly moving our center of mass and then rearranging our base of support to fit our new center of mass location. And so i tend to talk more about stability and he is a pretty standard maybe more engineering based definition so it's the ability of the system to return to its previous state. So if i'm walking along and somebody pushes me or slips me or or pulls the floor out from under me my ability to go back to walking in that controlled normal way is stability or the converse. If i can't you know if i fall or Eight stumbles steps or can't get back to that normal walking vets instability. So it's it's the ability of that system to come back to its its baseline Which i think is a lot more useful when we're looking at human movement and the things that people need to do every day It's another piece that we think a lot about in our lab is in. You would know you very familiar with this in working with with stroke and stroke research but people who are really active putting themselves in harm's way more so there may be more likely to fall but there are some more active and they're sedentary and therefore they're challenging themselves and arguably maintain their balance and all the subsystems involved in in balanced control healthier people rarely fall off sofas so if somebody spends all day sitting on a sofa there not as likely to fall until they have to move while some of my stroke population can fall out of a chair at rest. Well yes other. But in general yes. I completely agree so There is definitely a sweet spot in the active enough to not be sedentary maintaining all the systems that you need and not so active that you're that you're putting yourself in too much risk which you know is a different point for every person right. Yes yes so so balance. If i heard you correctly is not such helpful term. It's funny because it's one that we make sure to teach and pt school and we all know it. But i think it's fine to say the realm of balance as long as people understand that includes an awful lot of different things and that there are more specific concepts that you need to think about when you're gonna start doing assessments and intervention design. Very nice and then are there any other Terms that you think it misused or would i think people. Maybe don't think i actually i take that back. People thinking more about proactive versus reactive. I think that once you do balanced training in on a clinic clinical setting often enough for long enough. They become a little bit more intuitive. I know that with my students. We really have to to sit in. Have them work through things physically or mentally. You know what's reactive. Throw a ball cheer responding. But you still have all those pasta adjustments ahead of time. You have time to to call up a motor peremet whole nine yards. It's it's a proactive activity. It's not reactive. yeah. I love that. Because i've had i've had students and even you know license collisions where they just start to say save. There's activity in it. It's reactive like okay. You had to respond to where through bond. You didn't know how to time but you saw it before you had to respond to it and therefore it's still and you have interest of respond. yes yes. Beautifully stated yeah still so with that. I wanna go back to to take another flight if you will out of the stability measure. Because i think as you define those terms it really added to just what a important and helpful tool. This is clinicians With that how did you go about validating this and then what are your next steps using it or your next steps and research so in that we have on since the paper that that you asked me about. We've modified after having just a lot of different people look at the ten point scale and we've changed it to a seven point scale and we and we have found that that is easier for people to use we unfortunately were in the middle of a really big Balanced training study with individuals with stroke. And we've been exactly you're now that data collection has been on hold so we've been using the new seven point scale for that. Study at part of the point of that study was to really look at the use of the scale in different types of balance training in this population who sometimes have phases sometimes have difficulty with.
ANPT Balance and Falls Special Interest Group
"dr debbie" Discussed on ANPT Balance and Falls Special Interest Group
"Or track You know as people develop the as what do their what those are self perception do. Because i i would bet that people don't realize that they're hitting those apa's yes which can be measured right there. There's ways to measure that of course in the lab it's harder in the clinic But really interesting and And i just love this conversation of i never. I never thought there were api as you develop in reactive bounce. I love that So so this might be a nice time to Pause for a second because you've given us lots to chew on and just go through some of the basics right for people listening in I think a lot of the balance terms get used generally and a lot of times that that means they get used incorrectly right. So the specificity of gets lost and you are a balance expert and i just loved to use some of this time to talk about differentiating. Some of those commonly used balanced terms. Serve so i am. I have my advisor extent. Wants the traditional keeping your center of mass over your base support. He or somebody during my dissertation defense said you know what a tree stump in can keep it. Center mass over its base in support. But it's not very useful so when most people say balanced they mean keeping your center of mass within your base of support but even just normal walking. We don't do that. We're constantly moving our center of mass and then rearranging our base of support to fit our new center of mass location. And so i tend to talk more about stability and he is a pretty standard maybe more engineering based definition so it's the ability of the system to return to its previous state. So if i'm walking along and somebody pushes me or slips me or or pulls the floor out from under me my ability to go back to walking in that controlled normal way is stability or the converse. If i can't you know if i fall or Eight stumbles steps or can't get back to that normal walking vets instability. So it's it's the ability of that system to come back to its its baseline Which i think is a lot more useful when we're looking at human movement and the things that people need to do every day It's another piece that we think a lot about in our lab is in. You would know you very familiar with this in working with with stroke and stroke research but people who are really active putting themselves in harm's way more so there may be more likely to fall but there are some more active and they're sedentary and therefore they're challenging themselves and arguably maintain their balance and all the subsystems involved in in balanced control healthier people rarely fall off sofas so if somebody spends all day sitting on a sofa there not as likely to fall until they have to move while some of my stroke population can fall out of a chair at rest. Well yes other. But in general yes. I completely agree so There is definitely a sweet spot in the active enough to not be sedentary maintaining all the systems that you need and not so active that you're that you're putting yourself in too much risk which you know is a different point for every person right. Yes yes so so balance. If i heard you correctly is not such helpful term. It's funny because it's one that we make sure to teach and pt school and we all know it. But i think it's fine to say the realm of balance as long as people understand that includes an awful lot of different things and that there are more specific concepts that you need to think about when you're going to start doing assessments and intervention design. Very nice and then are there any other Terms that you think it misused or would i think people. Maybe don't think i actually i take that back. People thinking more about proactive versus reactive. I think that once you do balanced training in on a clinic clinical setting often enough for long enough. They become a little bit more intuitive. I know that with my students. We really have to to sit in. Have them work through things physically or mentally. what's reactive. Throw a ball cheer responding. But you still have all those pasta adjustments ahead of time. You have time to to call up a Peremet whole nine yards. It's it's a proactive reactive. Yeah i love that. Because i've had i've had students and even you know license collisions where they just start to say save. There's activity in it. It's reactive like okay. You had to respond to where through bond. You didn't know how to time but you saw it before you had to respond to it and therefore still and you have interest in respond. Yes yes beautifully stated. Yeah still so with that. I wanna go back to to take another flight if you will out of the stability measure. Because i think as you define those terms it really added to just what a important and helpful tool. This is clinicians With that how did you go about validating this and then what are your next steps using it Or your next steps and research so in that we have on since the paper that that you asked me about. We've modified after having just a lot of different people get the ten point scale and we've changed it to a seven point scale and we have found that that is easier for people to use. We unfortunately were in the middle of a really big Balanced training study with individuals with stroke. And we've been exactly you're now that data collection has been on hold so we've been using the new seven point scale for that. Study at part of the point of that study was to really look at the use of the scale in different types of balance training in this population who sometimes have phases sometimes have difficulty with.
Academy of Neurologic Physical Therapy Podcast
"dr debbie" Discussed on Academy of Neurologic Physical Therapy Podcast
"And in looking at that. It occurred to me that there is no way to measure. How difficult is this balance task for this person. You can measure. How fast is the floor moving. Or how much did. I use to nudge them. You can measure if it's proactive. You can measure. How far forward did they lean on. How quickly but that's measuring the performance. That's not measuring how hard the task was so. I did a lot of research in the really. There was nobody measuring intensity for balance training. If you go to dose and exercise program you need to have the frequency the intensity type in the time that intensity portion is easy for weight since easy aerobics. Easy for stretching. It's easy for most of the other. Modalities that we administer but it's not motor. Learning is another example where it's not easy to dose the intensity level. But it isn't didn't so i worked with students at a colleague to just brainstorm ideas for how we might measure this and we came up with something that sort of a modified of the visual analog scale. The scale urban graded both and i in doing a lot of reading decided that i believe that this balance intensity is a lot like pain that it is individual to the person that we can't look at from the outside and say this is this heart for this person or this hard. Just you can't look at somebody and say they're experiencing this much pain because everybody perceives pain differently there just too many systems that going to balance that we've had students where we set up a bunch of different tasks symbol twenty students come through some really welcome slack line but can't stand on a bosa ball to save their life and vice versa and just different people their experiences the bodies they different things are challenging to different people that that's really great and at one of the things that Trying to go through and and catch up on my csm presentations because there's some amazing presentations This really resonates with me because One of the speakers was lou national and he talks about a lot of times what we call reactive balance people kind of anticipate unless you're really good at mixing it up and so you might be scoring reactive balanced but really it's an a. as And i wonder if your scale would help get at that. I don't know i. I completely agree though because even with Mechanical perturbations joe. Pryatta somebody whether it's eight participations standing provision trauma perturbations certainly it. It's well established that once the person is done at once or twice or three times. They changed their their set ahead of time so that they can respond more easily or so. The probation doesn't push them outside of their limits to begin on. And that's that's establish and i i think it the reverse of that is a little bit true civil. We do pretty intense gaming with difficult services and Video games that really requiring a lot of cognitive skill a lot of Stepping reaching all at the same time. If somebody reaches that's proactive. But now if the floor moves in unexpected way there's a reactive component to that activities. I think you get a little bit of both home in what we tend to call a proactive activity. But i don't know that that are scale would be able to distinguish. But i do think what it would find that as you do the task and what we have found when we apply this to reactive tasks certainly you know that people find the thing to be easier as they go. I think that is because they're able to have that set ahead of time where their their center of mass is in a better location to resist the type of perturbation. They're about to get on their basal. Supporters better set all of those kinds of things. Still so going back. Sorry i didn't mean to step on your words going back to what you said a little earlier about reactive balance being more challenging And i and i think i also heard that it's more modifiable through interventions which is exciting if you touched in someone's apa's and used your scale. And then. i went in and did reactive balance. Which would i anticipate that. They're perceived stability Rating would be different if reactive bounces indeed more challenging That i could see if i really got reactive versus if it was still an apa. Because they didn't do it. so great. And i still got the same score. I don't know. I know that You know the evidence seems to say that if you're training reactive tasks as you learn the task you begin to develop not just this more favourable set ahead of time but also if the task is slow enough for known enough you can develop. Aps to the reactive task which is not what normally happens in a reactive task. And i think that that's part of the learning. I think it's probably all adds into why the person feels less challenged and i and then go along with each other right that. If the person is more successful in recovering to that perturbation they probably felt less challenged. That's the logic of it But i don't know it would be interesting actually to look and see if you can differentiate some of those.
ANPT Balance and Falls Special Interest Group
"dr debbie" Discussed on ANPT Balance and Falls Special Interest Group
"And in looking at that. It occurred to me that there is no way to measure. How difficult is this balance task for this person. You can measure. How fast is the floor moving. Or how much force did. I use to nudge them. You can measure if it's proactive. You can measure. How far forward did they lean on. How quickly but that's measuring the performance. That's not measuring how hard the task was so. I did a lot of research in the really. There was nobody measuring intensity for balance training. If you go to dose and exercise program you need to have the frequency the intensity type in the time that intensity portion is easy for weight since easy aerobics. Easy for stretching. It's easy for most of the other. Modalities that we administer but it's not motor. Learning is another example where it's not easy to dose the intensity level. But it isn't didn't so i worked with students at a colleague to just brainstorm ideas for how we might measure this and we came up with something that sort of a modified of the visual analog scale the scale urban paraded both And i in doing a lot of reading decided that i believe that this balance intensity is a lot like pain that it is Individual to the person that we can't look at from the outside and say this is this heart for this person or this hard. Just you can't look at somebody and say they're experiencing this much pain because everybody perceives pain differently there just too many systems that going to balance that we've had students where we set up a bunch of different tasks symbol twenty students come through some really welcome slack line but can't stand on a bosa ball to save their life and vice versa and just different people their experiences the bodies they different things are challenging to different people that that's really great and at one of the things that Trying to go through and and catch up on my csm presentations because there's some amazing presentations This really resonates with me because One of the speakers was lou national and he talks about a lot of times what we call reactive balance people kind of anticipate unless you're really good at mixing it up and so you might be scoring reactive balanced but really it's an a. as And i wonder if your scale would help get at that. I don't know i. I completely agree though because even with Mechanical perturbations joe. Pryatta somebody whether it's eight participations standing provision trauma perturbations certainly it. It's well established that once the person is done at once or twice or three times. They changed their their set ahead of time so that they can respond more easily or so. The probation doesn't push them outside of their limits to begin on. And that's that's establish and i i think it the reverse of that is a little bit true civil. We do pretty intense gaming with difficult services and Video games that really requiring a lot of cognitive skill a lot of Stepping reaching all at the same time. If somebody reaches that's proactive. But now if the floor moves in unexpected way there's a reactive component to that activities. I think you get a little bit of both home in what we tend to call a proactive activity. But i don't know that that are scale would be able to distinguish. But i do think what it would find that as you do the task and what we have found when we apply this to reactive tasks certainly you know that people find the thing to be easier as they go. I think that is because they're able to have that set ahead of time where their their center of mass is in a better location to resist the type of perturbation. They're about to get on their basal. Supporters better set all of those kinds of things. Still so going back. Sorry i didn't need to step on your words going back to what you said a little earlier about reactive balance being more challenging And i and i think i also heard that it's more modifiable through interventions which is exciting if you touched in someone's apa's and used your scale. And then. i went in and did reactive balance. Which would i anticipate that. They're perceived stability Rating would be different if reactive bounces indeed more challenging That i could see if i've really got reactive versus if it was still an apa because they didn't do it. so great. And i still got the same score. I don't know. I know that you know the evidence seems to say that if you're training reactive tasks as you learn the task you begin to develop not just this more favourable set ahead of time but also if the task is slow enough for known enough you can develop aps to the reactive task which is not what normally happens in a reactive task. And i think that that's part of the learning. I think it's probably all adds into why the person feels less challenged and i and the go along with each other right that. If the person is more successful in recovering to that perturbation they probably felt less challenged. That's the logic of it But i don't know it would be interesting actually to look and see if you can differentiate some of those.