Protocols

Many Chiropractors and Physical Therapists use differing variations of head weighting. Therefore, we do not recommend any specific methodology. We would suggest reviewing the following information:

• Clinical Studies
• Head Weighting Protocols
• Whiplash Protocols
• Physical Therapy Protocols

In consideration of the vast spectrum of people with cervical deficiencies, each patient has to be evaluated individually taking into consideration his or her physical stature.

Like any muscle strengthening program, starting with lighter weight is advisable. New patients should not wear the Halo Posture for more than five minutes.

If the patient does not complain of any immediate and sudden pain, then the patient should use it at home as directed.

Initial use for patients should not exceed 5 minutes a day for a week. The time for daily use should be increased to 10 minutes for 2-3 weeks and then 15 minutes for another 2-3 weeks. Activation of proprioceptors is encouraged by having the patient sit on a balance ball, stand, or walk while keeping their jaw-line parallel to the floor while wearing the Halo.

If your planning to use the Halo as a neck rehabilitative tool, follow the basic instructions on the package and start with no more than a couple minutes of use per day. Again, starting the patient with lighter weight is advised.

Again, only you "The Health Care Professional" can decide the best and safest course of rehabilitation for a particular patient.

If you would like to know more about the benefits of the Halo Posture, Please feel free to contact us. Our customer care specialists are available Monday-Friday 9am-5pm PST to answer your questions and take your order.

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Before getting started with the HALO:

As with all other forms of active rehabilitation, in order for patients to qualify for active rehabilitation with the Halo system, they MUST be free of acute pain with activities of daily living (ADLs).

Ideally, they should have 25% or more of normal range of motion in the cervical spine, in all directions with little or no pain during movement, BEFORE starting Halo protocols.

It goes without saying that the Halo system is contraindicated with acute disc patients, acute sprain/strain injuries and anyone whose symptoms increase whilst performing the Halo protocol.

HALO sizing:

Halo Posture and Halo Rejuvenator head weights come in various sizes and range in weight from 1 pound to 5 pounds. There are a number of factors that will determine the proper weighting for yourself and your patients.

Physical fitness, age, sex, frame size, strength, degree of dysfunction, symptoms, body awareness, balance, and coordination must all be taken into account when making your clinical decision about what size Halo to use.

That being said, below you find a general guideline:

• For children and small adults, we start with a 1 lb. or 2 lb. Halo - head weight only
• For men under 170 lbs. and most women we start with a 2 lb. Halo and a 5 lb. anterior chest weight
• For men over 180 lbs, we start with a 3 lb. Halo and either an 8 lb. or 10 lb. anterior chest weight

REMEMBER, the above chart is only a guideline. Some patients can handle more weight and for others, you may have to reduce the weight. The poorer the patient’s physical condition the longer the process of posture correction will take.

When in doubt, USE LESS WEIGHT and/or time. You can always add more weight later but if the patient becomes very sore they will not be excited to try it again.

Most common "escape" patterns:

Neck buckling with chin jutting forward - head goes further into forward head posture (MUST reduce the weight - the patient is being crushed)
Hyperextension of the lumbar spine – severe atrophy of antigravity musculature, usually with hip flexor and lumbar erector dominance (MUST cue patient into proper position).

HALO Timing:

The issue of timing is much more straightforward than sizing. The frequency of treatment needs to be enough to force an adaptation while avoiding excessive wear and tear.

Almost all patients will begin at 2 minutes per day, two to three times per week.
Treatment time is typically increased by one to two minutes per week. Some patients can handle greater increases in time and for others, you'll have to back it down.
The long-term time goal is 20 minutes per day, seven times per week (until forward head posture has been eliminated at which point the patient can shift to a maintenance schedule).
Keep in mind that we want to keep patient soreness to an absolute minimum or, better yet, avoid it altogether. Most often, the patient will work up to 10-minute Halo sessions during his/her office visits (with the cueing that is sometimes necessary to achieve the correct position) before transitioning to daily use at home.

As the patient transitions to performing active care at home, their daily training time is typically cut in half while increasing the frequency. If they were up to 10 minutes per day, 2 times per week (for a total weekly training load of 20 minutes) and we go to 5 minutes per day, 6-7 times per week (for a total weekly load of 30 to 35 minutes). With this, their weekly training load has nearly doubled while giving them the feeling that they're getting a little break.

HALO Implementation:

The Halo protocol MUST ALWAYS be performed with bare feet. Not only will barefoot contact with the ground increase proprioception but, elevated heels work against the patient by pushing the head further into a forward head posture.

Within a typical session, soft tissue work is performed first, the patient is then adjusted, as only joints that are free from subluxation (substitute any word you prefer for "subluxation" if that word upsets you - it's the concept that matters) are able to provide the necessary afferentation to the cerebellum then, the Halo protocol which follows may be employed.

Most patients will begin with standing in place. As comfort level, body awareness, balance, strength, and physical fitness increase, the patient can slowly progress up the proprioception continuum. These positions and movements drive increased proprioception to the brain and may be added PROVIDED so the patient can maintain PROPER POSTIONING AT ALL TIMES.

The Proprioception Continuum:

• Standing
• Standing on one foot
• Standing on a wobble board or inflatable balance disc
• Walking
• Walking backward

General Tips:

It is strongly recommended that in addition to having the patient fill out and update the standard neck disability index questionnaires, that doctors video record (with the patient's permission, of course) the BEFORE and AFTER postural assessment, range of motion and functional testing with all patients using the Halo system. They will, no doubt, notice that daily tasks become easier for them as their posture improves and they become stronger but, it's very powerful to show them on video just how dysfunctional they were when they started (which they may not remember in great detail).

If the patient EVER returns for a follow-up office visit complaining of soreness, simply cut the last time they used in half (and/or reduce the training weight by 1 pound). You can always go up again at another appointment.

The MOST IMPORTANT skill for doctors to develop when starting a patient on the Halo system is OBSERVATION. If the weight forces the patient to buckle, or to try and "escape" out from under it AT ANY TIME DURING THE PROCESS, the weight (and, oftentimes, the training time) will have to be reduced. That patient should also be monitored and cued THE ENTIRE TIME they are performing the protocol until they have built up a decent base level of body awareness and strength in their postural system.

Having the patient perform the Halo protocol in front of a mirror can be a tremendous aid in developing body awareness and can save the doctor a significant amount of time which would otherwise be spent monitoring the patient.

REMEMBER the key to the Halo system is CONSISTENCY OVER TIME. We are working against the unrelenting force of gravity and its effect on the human frame. Each minute spent using the Halo system builds up the body’s resistance mechanisms and moves the patient toward optimal function.
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Copyright Wellness Works Chiropractic Yoni Whitten D.C., C.C.W.P. 2014

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This new weight bag is a perfect addition for those practicing this unique, life changing technique. This product and technique helps both Spondylolisthesis and Retrolisthesis of L5 on S1, developed by the late, great Dr. Burl Pettibon.  No longer do you have to go down to the local gun shop to pick up a 25 pound bag of leaded bird shot.  This sturdy canvas bag, with easy to lift handles, is filled with 25 pounds of non-toxic carbon steel pellets, and perfectly suited for corrections done in the office and at home for patients.

Directions for both:

Spondylolisthesis of L5 on S1: This procedure can correct up to a Grade 2 spondylolisthesis.

Retrolisthesis of L5 on S1 (Confirmed with seated lateral lumbar x-ray, revealing ligament injury and instability):

1. Have patient lie supine, on a firm surface, with knees bent.
2. Place a sacral block, a foam wedge or SOT block, under the sacrum, caudal to cephalic direction, with leading edge to the  level of the sacral base( lifting sacral apex up, sacral base down) , allowing L5 to freely move.  
3. Place the 25 lbs. bag directly above level of L5 on the abdomen, below umbilicus (start with 25 lbs. and build up to 75 lbs. or 3 bags for larger patients and or difficult spondy’s) Instruct patient to allow weight to slowly flatten lumbar spine to the table surface. Start with 2 minutes and build up to 20 minutes.
4. In office: perform  following your spinal adjustment procedure, from 2- 5 minutes.  Encourage home care so you can increase time up to 20 minutes daily.  It takes 90-120 days for the sacral base to align with the vertebral body of L5.
5. After procedure, as the patient returns upright under gravity,  the spine re-aligns and” ligamentous creep” caused by the blocking will stabilize the spine longer with each application.

For further comprehensive instruction go to www.pettibonsystem.com , online courses available.