https://www.headstrongrehab.com/blog daily 0.75 2026-01-02 https://www.headstrongrehab.com/blog/what-is-functional-neurological-disorder monthly 0.5 2026-01-02 https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/78e5a87c-9529-4ffa-8c51-24f665b89728/unsplash-image-Jt9syHEhrPE.jpg Blog - What is Functional Neurological Disorder? You may have never even heard of Functional Neurological Disorder (hereafter FND), but it’s one of the most common outpatient neurological diagnoses [1]! As we learn more and more about how the brain adapts itself to our actions and our environment, we are also learning about maladaptive behaviors of the brain: when the brain changes ways in which we don’t want. Symptoms can include weakness, tremor, pain, dystonia, and many more. Read more below to learn about FND. Laying the foundation: what is neuroplasticity? To understand FND, it’s important to understand neuroplasticity. Neuroplasticity are physical changes to the brain. When we learn something new, be it a new dance move, how to knit, or multiplication tables, our brain makes the motor pathways between our muscles and different brain areas much more efficient; maybe what was once a single lane road becomes a super highway. Further, the brain develops its own motor recipes to quickly recruit and coordinate all of the relevant parts of our body at once. Motor patterns are a lot like cooking recipes. To make or bake delicious food, you need both ingredients and the sequence of combining them into something delicious. A recipe for bread may include a handful of simple ingredients such as flour, yeast, salt, and water, but the sequence of arranging them into bread can be very complicated (how to tell when you’re done kneading the bread, how long to let the bread rise, baking temperature, and the agonizing wait for it to cool before slicing). https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/072788bc-198a-4976-9008-574d0d78f7ee/nihms-1594587-f0001.jpg Blog - What is Functional Neurological Disorder? FND physical exam: clinical tests & measures FND used to be considered a diagnosis of exclusion; we know now that FND has effective tests and measures (aside from imaging) that can further confirm a diagnosis, and are tests we often perform here at Headstrong. Symptoms of FND have a few things in common: they are entrainable, distractible, and variable. The variability of symptoms can be surmised largely though the patient’s own observations. Is the FND “on” all the time? Do symptoms wax and wane? Are there triggers the individual has already identified? Distractability refers to alteration of the symptom with distraction. For example, a positive Hoover’s sign reveals that measured strength of one muscle changes if contracting the opposing muscle groups on the opposite side at the same time, such as left hip flexion weakness that improves with simultaneous right hip extension. See corresponding image from Espay et al. (2018) for visualization of the Hoover’s sign [5]. Tests that assess for entrainability of symptoms include the response of tremor speed when watching or performing a task at a different speed, meaning that the tremor can be “trained” to operate at a different frequency. Clinicians identified the whack-a-mole sign [6], where suppression of unwanted movements such as tremor creates movements elsewhere, e.g suppressing tremor in one limb creates movement in trunk instead. There are a variety of other “clinical pearls” that can lead to a diagnosis of FND including differentiation between FND and other motor symptoms such as dystonia. For example, dystonia that does not respond to a sensory trick is more likely to be caused by FND. Treatment for FND Even after a diagnosis is made, true for most conditions, part of pursuing treatment includes elucidating the cause of the diagnosis—for example, if someone experienced a head injury due to a fall, physical therapy may both the injury as well as the patient’s increased fall risk. Causes of FND are harder to pin down; in almost half of all cases of FND, the cause is idiopathic—we just don’t know! Some risk factors may include prior physical or emotional trauma, a preceding injury, or even recent illness with a virus like the common cold or COVID-19. What do we know is that external factors like environment, stress, diet, sleep regulation, and more can impact symptoms, regardless of cause. If the brain has learned to do something incorrectly, we can use principles of motor learning and neuroplasticity to help teach the brain the correct way to perform the affected tasks. Current best practices use the OPTIMAL (Optimizing Performance through Intrinsic Motivation and Attention for Learning) theory of motor learning developed by Wulf & Lewthwaite [7]. In the OPTIMAL theory, the authors suggest that an individual’s attention may influence performance. When treating FND at Headstrong, we use this theory of motor learning to influence performance by redirecting attention away from the self (“interoception”), and towards an external focus. A good example would be focusing on kicking a ball to a particular target, rather than focusing on how the leg itself is or isn’t moving under our conscious control. https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/8b0826b2-d3d5-4fdb-811e-c3989c6240ff/101724-4612+RE.jpg Blog - What is Functional Neurological Disorder? Step 2: Practice during conditions where symptoms are lessened We take advantage of the fact that FND symptoms are distractible during treatment. People living with FND often endorse that hyperfocus on their symptoms can often make their symptoms worse. Can we redirect the brain’s energy away from how the body is performing—this so-called interoception—and instead make it focus on something else, reducing symptoms? As part of the OPTIMAL theory of motor learning, many rehabilitation protocols call for activities with a high degree of external focus—drawing attention away from the body, and placing that attention on the task performance itself. Some more examples include: When walking, focus on kicking a ball instead of swinging the leg. To restore altered balance, keep a pen laser focused on a target while performing a balance challenge. When picking up an object, focus on timing the movement with breathing, to the beat of a song. FND is not exclusive in its response to external focus! People with Parkinson’s often benefit from sound cueing when taking steps, walking to the beat of a metronome, or a visual cue e.g as is provided by a U-Step walker laser, to reduce the impact of bradykinesia on their walking ability. One of the tenets of neuroplasticity includes repetition of practice: if you use it, you improve it [8]. When symptoms are lessened, it’s all about repetition, repetition, repetition! Here at Headstrong we emphasize repeated performance of the modified activity to help re-train the brain, encouraging the original, tried-and-true, recipe for movement before FND changed the recipe. Eventually, these aids are no longer needed as the brain learns more and more through repeated practice the favored way of performing a task. https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/b03f525c-c154-4a02-bb63-c5866953a867/fMRI_FND.jpg Blog - What is Functional Neurological Disorder? Interestingly, via these studies, researchers are learning more about both FND, as well as the functions of the brain. Some of these studies may reveal certain brain areas, including the thalamus, may play a larger role in the body than previously realized [3]. Additionally, other chronic conditions such as fibromyalgia and chronic pain disorders demonstrate similar brain changes to those seen in FND [3]; however, the question remains: are these brain changes a consequence of FND, or do these brain changes cause FND? Unfortunately, many of these studies use smaller sample sizes, reducing applicability to a broader population, and at times have conflicting results. Many of these studies do not consider other co-existing conditions such as anxiety and depression. As more of these studies coalesce, with improved stratification between patient groups based on factors like age, symptomology, and severity of FND, we may come closer to definitive imaging techniques to diagnose FND, similar to how we diagnose someone with a stroke. As research continues onward, so too will diagnostics and treatment! https://www.headstrongrehab.com/blog/evidence-based-exercise-for-parkinsons monthly 0.5 2025-07-18 https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/fb65663a-f019-40a2-8de6-ed2c011979e8/unsplash-image-74bVjQjHHOA.jpg Blog - Evidence-Based Exercise for Parkinson’s But what if I don’t like those options? Fear not! In a recent Cochrane review (read: some of the best evidence available), the authors conclude that all forms of exercise assessed produce similar changes in walking ability, strength, and quality of life—meaning, the mode of exercise matters less [8]—what’s important is that you exercise in a way that you can stick to! Part of the role of a physical therapist is to help determine what type of exercise will not only help with what matters to the patient, but what type of exercise the patient enjoys! The best exercise program is one you’ll do! https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/9d0a8d3a-83e4-4b44-9cf4-25a09f9885c8/MPF_youtube.png Blog - Evidence-Based Exercise for Parkinson’s LSVT BIG and PWR! Moves Structured exercise programs have been designed specifically for people with Parkinson’s, including LSVT Big & Loud, and PWR! Moves and have demonstrated efficacy in improving gait, balance, ability to reach, and overall quality of life, especially for the full, 4-day-per-week LSVT protocol [6]. These programs also hone in on whole body, intentional movements at a high intensity. Clinicians such as physical therapists can become LSVT or PWR! Moves certified to implement official structured exercise for people with Parkinson’s; however, some participants may find the frequency of performance difficult from both a time and cost perspective, but many free, online resources including those through the Michigan Parkinson’s Foundation offer PWR! Moves videos to follow along from the comfort of home! https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/ae4f24e7-a0dd-4a3b-827d-54449a8e9173/unsplash-image-gRWPsHqsFZ4.jpg Blog - Evidence-Based Exercise for Parkinson’s - Exercise may affect neuroplasticity. In many neurological conditions, exercise has been shown to help neuroplasticity occur, including Parkinson’s [2]. Neuroplasticity refers to changes that occur in the brain as we interact with the world, physically and mentally. During high intensity exercise, neuroplastic effects can include increased excitation in movement areas of the brain, changes to the volume of grey matter in the brain, release of a neuroplastic factor: the brain-derived neurotrophic factor, and even improved dopamine transmission [2]. Neuroplasticity can enhance the body’s efficiency at performing tasks, maintaining balance, learning new skills, and more, and is critical to promote for those with a neurological condition like Parkinson’s. https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/c8786098-278a-4efb-b97c-622f378962a3/mark-hang-fung-so-nYtpiW06Lbg-unsplash.jpg Blog - Evidence-Based Exercise for Parkinson’s Tai Chi One of the principal motor impairments in Parkinson’s is bradykinesia. Usually, the basal ganglia participates in excitation or inhibition of movement in order to fit the task at hand; in essence, the basal ganglia helps fine-tune movement commands sent out by our frontal lobe (specifically, from the pre-central gyrus which houses our motor cortex). In Parkinson’s, there is a deficit of dopamine which helps the basal ganglia do its job — specifically, inhibition of movement becomes uninhibited, making movements slower, with less range of motion. Tai Chi is a mode of exercise emphasizing control of whole-body, sustained movements, incorporating strength and balance, rotation, performing high amplitude intentional movement that helps overcome the bradykinesia and maintain mobility. Tai Chi is incredibly well studied; in a recent 3.5-year study, people with Parkinson’s performing Tai Chi delayed disease progression (as measured by the UPDRS) as well as need for medication [3]! In this study, the participants performed two, 60-minute Tai Chi sessions weekly [3]. Further, many Tai Chi classes are performed in groups, a great place to meet new people! https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/3b5ae328-234c-459c-987b-c13a7eb9aec4/unsplash-image-P2aYOmAs5eM.jpg Blog - Evidence-Based Exercise for Parkinson’s Rock Steady Boxing High intensity training has been shown to facilitate neuroplasticity, the positive changes in the brain that help maintain and grow strength, balance, mobility, and more. It doesn’t get more high intensity than boxing! Rock Steady Boxing is a non-contact program incorporating high intensity training via powerful, intentional movements that, like with Tai Chi, help “override” (or “punch through, as I like to say) bradykinesia resulting from a dopamine deficit in the basal ganglia. In a large-scale survey of Rock Steady participants, measures of quality of life were all improved, including improvements in their social life [4]. While it’s important to measure the physical affects of exercise, it’s also important to assess how a mode of exercise impacts quality of life: a catch-all term describing overall life satisfaction and ability to thrive. https://www.headstrongrehab.com/blog/why-start-strength-training monthly 0.5 2025-08-04 https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/0e70aac6-c4f6-43b9-8b9e-f7ff87f1727b/101724-4921+RE.jpg Blog - Why You Should Be Strength Training - #5 Variety is the spice of life! There are many ways to get started, including: Free weights (dumbbells, barbells) - an adjustable dumbbell set for home use can take you far! Group classes at your local fitness center and/or Crossfit box Weight machines at the gym - you don't have to use free weights! Bodyweight exercises at the gym or at home - they're super effective! [14] If you don't know where to start, a skilled physical therapist, chiropractor, or trainer can help get you started on a customized exercise program. https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/cce42a19-e6c6-4273-9703-00606d75575b/JAMA_exercise.png Blog - Why You Should Be Strength Training - 80% of adults do not get sufficient exercise[1]. When thinking about improving our health, many of us resolve to begin a new exercise program. Here at Headstrong, we firmly believe in the power of strength training for your health and longevity -- read below for our six top reasons why YOU should try lifting weights! #1 We lose strength as we age! In the absence of exercise, every decade after we reach 30 years of age, we lose 10% of our strength [2,3], along with a reduction in bone density [3] and overall power, one's ability to use their muscles rapidly (e.g to stand up from a seated position, or catch oneself after a loss of balance). As we get older, we may be at risk for sarcopenia, a progressive loss of strength and muscle affecting 10% or more of older adults [4]. Sarcopenia is associated with complications including longer recovery times and cognitive impairment [4]. An alarming fact? Leg strength is a top predictor for losing independence [5]. https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/58748eba-0c8b-4932-9302-61f6e18e7970/deadlift_clinic_photo.jpg Blog - Why You Should Be Strength Training #2 Little time investment, big return, at any age! Few forms of exercise offer so much benefit for so little time. Most guidelines recommend strength training twice per week, for at least 30 minutes[1]. For older adults in particular, the benefits can be profound: In a study of older adults aged 90 and greater, high intensity strength training improved strength and walking speed [6]. Strength training as part of a regular exercise program can reduce risk for falls [7]! #3 Manage pain Strengthening your muscles can help manage your pain: Exercise, including strength training, can help manage knee pain from osteoarthritis [8]; Any exercise, including strength training, is the most effective way to manage chronic low back pain [9]! Wheelchair users are more likely to have shoulder pain [10], with up to 30-70% of users reporting shoulder pain! A shoulder strengthening program, including the STOMPS protocol, can help wheelchair users reduce pain and improve function [11]. #4 Cardioprotective Benefits We don't often think of the benefits to our heart by strength training, but strength can help our heart health! A massive study of over 28,000 women found that 82 minutes per week of strength training exercise can actually have a cardio-protective effect; women who regularly strength trained (regardless of their aerobic exercise habits) had a lower incidence of cardiovascular disease overtime [12]! In a recent systematic review, researchers suggest 60 minutes per week of strength training reduced all-cause mortality by 27% [13]. https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/6eaffbbd-e3a0-4b32-92e4-6b92d8048cbe/Jess_squat_celebration_2.jpg Blog - Why You Should Be Strength Training - #6 It’s FUN! When exploring different modes of exercise, the best program is the one you’ll do. Many people find strength training to be fun, and it’s a mode of exercise easy to perform in classes, in a group, or with an accountability buddy. As a personal anecdote, lifting weights was one of the first ways Headstrong’s PT, Jess, discovered a love for exercise, eventually leading to a pursuit of powerlifting and competition (in the picture accompanying this text, Jess had just squatted 400-lb for the first time on the competitive platform!). She not only discovered her inner and outer strength, now she helps others do the same in her clinic and as a coach with Barbell Barkada. https://www.headstrongrehab.com/blog/walking-post-stroke monthly 0.5 2025-08-04 https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/99b194a7-49f9-4a01-83ea-d072f07fae0c/101724-5440+RE.jpg Blog - Walking Post-Stroke - #5 Prompt rehabilitation When we should start rehabilitation after a stroke, and what interventions to perform, is a hot topic in stroke rehabilitation. Various "windows of recovery" have been established, citing the first 3-6 months [7], or even year, after a stroke provide the most promise for recovery, and there is some recent physiological evidence to support such a window [8]. While the adage "it's better late than never" rings true for virtually all aspects of rehabilitation, we are learning that physical rehab should ideally begin in the days after stroke to optimize recovery. There are risks to starting rehab too early: in a Cochrane review, very early mobilization (<24 hours of stroke) may not improve outcomes enough to warrant the risk [9]; however, after 24 hours, the consensus is clear. In a recent systematic review, Miranda et al. (2023) found that, excepting the first 24 hours, early mobilization after stroke can improve functional outcomes [10]. In an observational study, individuals post-stroke had better functional outcomes with earlier, more intense therapies [11]. While prompt rehabilitation seems to improve outcomes, improvements in function can be made even if it's been a number of years since the stroke. In a large clinical practice guideline, Hornby et al. (2020) unearthed improvements in walking function for participants performing high intensity training, even after the "golden window" of stroke recovery has passed [12]. While we don't have all the answers yet, research in this area is constantly being done to improve patient outcomes! Stay tuned for more on "high intensity gait training" and other high quality interventions to promote recovery across a wide variety of neurological populations, from acute to chronic! https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/ea075b7c-6790-4285-937f-439a57c747be/functionalareas_brain.jpeg Blog - Walking Post-Stroke - Factors that predict recovery: #1 where it occurred Strokes happen in a variety of areas of the brain; however, the usual suspect is the Middle Cerebral Artery (MCA), which can impact the frontal, parietal, and temporal lobes. In an MCA stroke, your brain's ability to generate a signal to tell the muscles what to do can be impaired. If the muscles do not receive a signal from the brain, they can become weakened or develop spasticity. A common condition after an MCA stroke is hemiparesis, or a one-sided weakness of the body. If a stroke occurs in the cerebellum or brain stem, a condition called ataxia can occur, where the brain's decisions about how to move the limbs is not fact-checked by the cerebellum, resulting in jerky, dis-coordinated movement. Additionally, thalamic strokes can affect strength and walking ability, as many motor pathways originating in the brain pass through the thalamus on the way to the spinal cord. Factors that predict recovery: #2 Age While strokes can happen at any age, it is thought that our brain's neuroplasticity may change with age [1]. Neuroplasticity is the brain's ability to change and restructure itself. The more you practice, the more resources your brain devotes to: motor pathways, which are the superhighways transmitting information from the brain to the muscles, and motor plans, kind of like driving directions, for swinging the paddle. With lots of practice, swinging a paddle is just like driving to your favorite coffee shop, able to be performed with less thought and with increasing levels of skill, adaptable to road bumps along the way. Certain factors work to increase neuroplasticity, including exercising at high intensities. https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/f28b203b-ce84-4428-9e80-a597ba1158c9/101724-5246+RE.jpg Blog - Walking Post-Stroke - Factors that predict recovery: #3: Stroke Severity Medical & healthcare professionals use a variety of tests and measures very soon after a stroke occurs to classify the severity of the stroke. One primary measure is the National Institute of Health Stroke Scale (NIHSS), which assesses areas of functioning including consciousness, weakness, perception, speech, and vision, among others [2]. NIHSS scores are like golf scores--the lower the better. The score range is 0-42, where 0 means limited, if any involvement, and 42 is maximal involvement. A score of 25 or higher indicates a "severe" stroke. NIHSS has primarily been used to predict discharge destination after a stay in the hospital, or a stay at an inpatient rehabilitation facility; individuals with severity scores of 14 or greater are more likely to be discharged to a long-term care facility rather than home [3]. Factors that predict recovery: #4 Early intervention & assessment If an individual experiences an ischemic stroke, which occurs as a result of a blood vessel blockage in the brain, brainstem, or spinal cord, there are medical ways to break up the blockage. A physician may prescribe use of a medication called the Tissue Plasminogen Activatior (tPA), aka the "clot buster", within the first few hours of stroke. This medication can break up the clot, allowing blood to flow once more in affected areas of the brain, which for some may improve recovery [4]; however, use of tPA has been shown to increase risk for other conditions, including bleeding of the brain [4]. Assessment early on is also important; many physical assessments performed by physical therapists can be predictive of future outcomes, especially within the first 72 hours of the stroke. Independence with sitting balance and leg strength 72 hours after stroke are both top predictors of future walking ability [5]. Diving deeper into sitting balance, a score of 42/56 or higher on the Function in Sitting Test (FIST), a physical test involving maintaining sitting balance during a variety of reaching and other physical challenges, is a predictor of discharge disposition after inpatient rehabilitation [6]. Additionally, the Functional Independence Measure (FIM) scores that assess how well someone can position themselves in bed, sit or stand, and walk, are also highly predictive of future outcomes. In a meta-analysis, Thorpe et al. (2018) state "For every 1-point increase on the Functional Independence Measure (FIM), a patient is approximately 1.08 times more likely to be discharged home than to institutionalized care" [3]. https://www.headstrongrehab.com/blog/what-is-vertigo-bppv monthly 0.5 2025-07-18 https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/9a8ae51c-3175-4120-9608-6c9dc6802af6/vestib_anatomy.jpeg Blog - Vertigo Deep Dive: BPPV - BPPV is one of the most common types of vertigo. BPPV is actually an acronym that stands for: Benign, meaning BPPV is not life-threatening; Paroxysmal, meaning, transient. The symptoms come and go rapidly; Positional, because this vertigo is triggered by changes in head position; Vertigo, as patients experience dizziness/spinning symptoms. What is it? BPPV is a type of vertigo caused by a dysfunction of the vestibular system, located on either side of your head next to the hearing apparatus. People with BPPV commonly report strong dizziness symptoms when lying back in a dentist’s chair, getting their hair cleaned at the salon, or when rolling over in bed; in a study, patients who indicated "YES" on the Dizziness Handicap Inventory for rolling over in bed and getting out of bed were highly likely to have a BPPV diagnosis[1]. Vestibular Anatomy The study of BPPV helps us further understand vestibular anatomy and why we see the symptoms we do. It is important to understand the main purpose of the vestibular system: detect motion of the head, and communicate that information to the brain. To accomplish this, the highly specialized vestibular system deep within your inner ear consists of two otolith organs (utricle, saccule) and three semicircular canals, pictured in Figure 1, on each side of your head. For BPPV, let’s hone in on those semicircular canals and their function. The semi-circular canals are filled with a thick, viscous fluid, and at the entrance of each canal is the ampulla, which is home to a special detector called the cupula. Think of the cupula like a bell that rings whenever the fluid in the canal pushes against it, telling the brain the 411. https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/a3f613e0-a9e9-45a9-ab31-9cbb0b9b8865/canals_orientation.png Blog - Vertigo Deep Dive: BPPV - So, how do the canals detect movement? Think about what happens when you turn a jar of honey upside-down to sweeten your tea: the bottle moves first, and the slower fluid eventually catches up. When you turn your head to the left, the canals (and the cupula) move with your head, faster than the thick fluid moves. The movement of the cupula through the thick fluid deflects it in the opposite direction of movement, ringing that bell. Think about what happens to your hair as you swim laps in the pool--the force of the water pushes your hair in the opposite direction of your movement. The deflection of the cupula sends a nerve impulse to the brain to tell it what happened! But, just like the honey, the fluid does move. Once that fluid starts moving leftward, it deflects the cupula in the opposite direction. Each of the three canals (horizontal, anterior, and posterior) are oriented 90 degrees from each other, allowing them to detect motion in all possible planes. The posterior and anterior canals are vertically aligned and positioned 45 degrees from midline (see diagram). The posterior and anterior canal of opposite sides, as well as both left and right horizontal canals, are co-planar, meaning they are oriented in the same plane. This is a useful redundancy in case the system on one side is working less optimally than the other, as is the case with vestibular hypofunction. https://www.headstrongrehab.com/blog/tag/strength+training monthly 0.5 https://www.headstrongrehab.com/blog/tag/treatment monthly 0.5 https://www.headstrongrehab.com/blog/tag/chronic+pain monthly 0.5 https://www.headstrongrehab.com/blog/tag/dizziness monthly 0.5 https://www.headstrongrehab.com/blog/tag/exercise monthly 0.5 https://www.headstrongrehab.com/blog/tag/Parkinson%27s+Disease monthly 0.5 https://www.headstrongrehab.com/blog/tag/BPPV monthly 0.5 https://www.headstrongrehab.com/blog/tag/gait+training monthly 0.5 https://www.headstrongrehab.com/blog/tag/stroke monthly 0.5 https://www.headstrongrehab.com/blog/tag/high+intensity+exercise monthly 0.5 https://www.headstrongrehab.com/blog/tag/vestibular monthly 0.5 https://www.headstrongrehab.com/blog/tag/cardiovascular+health monthly 0.5 https://www.headstrongrehab.com/blog/tag/vertigo monthly 0.5 https://www.headstrongrehab.com/blog/tag/functional+neurological+disorder monthly 0.5 https://www.headstrongrehab.com/blog/tag/FND monthly 0.5 https://www.headstrongrehab.com/blog/tag/sarcopenia monthly 0.5 https://www.headstrongrehab.com/home daily 1.0 2026-01-12 https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/e4036fac-46b7-4095-9d99-9825786bfda0/101724-4427+RE.jpg https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/9fefeea9-52d2-49db-abf2-d6214b4c5c95/101724-4745+RE.jpg https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/02f6226a-a8e7-46e8-a1a6-41840ea2b34e/101724-5252+RE.jpg https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/0775af44-2c41-416f-9d34-67f66fcf79c9/IMG_5203.jpg https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/49e3daa3-90e5-43f4-9402-20eae1dbb40c/101724-5091+RE.jpg https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/6c40a1ee-6846-4ca1-94ea-baf582dd8afa/101724-4697+RE.jpg https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/7ca89e78-ac56-47c6-9e5b-aa99dec1f923/101724-5394+RE.jpg https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/50e2ca7d-0f89-485a-96cb-c16a22a47748/FND_laser.png https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/57ef9d98-086f-4219-9bb8-cc1f79ee0dc9/101724-4571+RE.jpg https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/8f285b0a-0e5f-4ed6-87d4-316e270b1867/101724-5769+RE.jpg https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/3b154633-0a60-49dc-9cd8-b32449cb1f99/101724-5181+RE.jpg https://www.headstrongrehab.com/about daily 0.75 2026-01-06 https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/8f6fe8eb-b02e-4c75-be98-b786304ccb25/101724-4318+RE.jpg https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/a3fd542d-65df-41c1-afbb-fde78059aa24/101724-4849+RE.jpg https://www.headstrongrehab.com/404-page daily 0.75 2025-06-24 https://images.squarespace-cdn.com/content/v1/685ab6ec11bd4b650892cee5/1750775542060-YP43HD7N6SW49R3P5XOH/404.png https://www.headstrongrehab.com/faq daily 0.75 2026-01-06