02. Experts Corner

Webinar Q&A with Maxime Chevrier - Telehealth In Your Practice

April 14, 2021

I’d like to thank everyone who attended my webinar, it was great to see so many people from the NeuroTracker community attending. There were a lot of great questions but not enough time to cover them all, or in enough detail. Hopefully this Q&A solves that problem - I hope you find it informative! There were also some questions from personal users of NeuroTracker, look out for a dedicated webinar for this by the NeuroTracker team, coming early summer.

If you didn’t attend the webinar, you can watch the recorded version here.

Q. You talk about NeuroTrackerX, but I also see NeuroTracker mentioned without the "X". Are these 2 different versions?

Yes they are.

The original NeuroTracker commercial software has been around for 10 years. It’s a Windows based platform that can only be run from a single computer. As of April 2021, the original software is no longer supported.

The name NeuroTrackerX refers to a major upgrade from the original software. It utilizes the latest 3D rendering software (Unity), and can be run on Windows and Mac computers (Android coming soon). Any NeuroTrackerX software license can be used on any number of computers. NeuroTrackerX also has a plethora of features that did not exist in the original software, such as advanced data analytics and custom program building. Here is an overview of NeuroTrackerX features.

5 Reasons to be Excited About NeuroTrackerX

Lastly, the name NeuroTracker still represents the company and the patented methodologies, scientific research and validation behind the commercial product. So generally speaking, NeuroTracker is now used to represent the science and technology, and NeuroTrackerX refers to the software platform.

Q. I have the original system at my clinic. Can you advice me on how best transition to NeuroTrackerX?

Yes, once I understand your needs I can advise on the specific applied and business benefits advantages you can expect with the upgrade. The NeuroTracker support team provides great on-boarding once upgraded. It’s a fairly seamless transition, so you can get up and running with it from the get-go. If you haven’t seen it, there is great testimonial interview with Katie Mitchell where she talks about her experience of upgrading her business to NeuroTrackerX.

NeuroTracker Testimonials - Katie Mitchell

Q. How many balls did the ADHD athlete start with?

This is a simple question, but a good one. I was using 3 balls (or targets) with that 14-year-old hockey player. For athletes I believe 4 targets is ideal, as it represents well the attentional distribution challenges they typically face in sports competitions. However, if the athlete’s initial baseline is lower than expected, I will adapt to 3 targets, as was the case with this client due to ADHD. In my experience, healthy athletes from the age of 14 upwards, tend to be best suited to 4 targets from the beginning of their training program.

Q. Maxime, if clients do sessions at-home, do you also do remote consultations with them, or do they still come into your office?

Yes I do still see clients in-center. Most of the time the focus is on assessments at my clinics, followed by a custom protocol from them to work on from home. The training also complements the in-clinic assessments, because I ask them to train under different conditions, for example at different times of the day, combined with remote consultations. This allows me to look into trends related to things like sleep, circadian rhythm, diet and so on, to see how those influence attentional capacities, and how best habits can be implemented.  

Typically I see clients in-center once per week, two weeks, or sometimes monthly. This is a nice balance, because obviously there are still things I can only do with clients in my clinics. However, some of my athletic clients are more restricted by COVID, so I currently don’t see them for months at a time. In these cases, we focus more on Zoom consultations where we review their training data in detail, and also work more on the sports psychology perspective. They still find this really useful, but I expect them to start coming back to my clinics regularly, once they able to.

Q. Did you do any formal pre and post neuropsychological testing with the young client with ADHD?

Yes, I’ve used a lot of different tools over the years and also work with specialists in neuropsychological assessments. With this client I used the IVA-CPT assessment focused on visual and auditory attention. For young clients with attention issues, this gives useful metrics that have been found to be reliable for detecting the benefits of NeuroTracker training. This makes it’s particularly useful for showing parents the progress their child is making.

Q. Can you talk about the best technique to improve score. It is instructions? Or is it learning to track all the balls?

Very interesting question. There are essentially two answers.

The first refers to the NeuroTracker principle called ‘consolidation’. The consolidation phase is a rapid learning response to initial NeuroTracker training. This has been shown in many NeuroTracker studies to occur over the first 15-30 sessions, which will yield much faster improvement than subsequent training due to typical neuroplastic responses.

During this phase, clients simply need to perform the basic task – keeping their gaze towards the center of the screen (i.e. on the visual pivot), and distributing their visual attention across their targets using their peripheral vision. Past this there are really no techniques involved, for example you can’t tell someone to use a particular task-based strategy to improve their scores.

In fact, this is one of the key advantages to NeuroTracker, in that changes in scores have negligible influence from technique or strategy-related effects. Unlike most other forms of cognitive training, changes in brain function are well represented by changes in NeuroTracker scores. An analogy might be how much someone can bench press. If they end up lifting twice as much as they could before, you’re quite confident it’s strength-related, and not down to things like how they hold the bar. So, as long as a client focused on the session and following the basic technique during consolidation, they are likely to get optimal benefits.

The second answer relates to post-consolidation, when there is sufficient learning and increase in attentional capacities to progress to more advanced forms of dual-task training. Unlike performing just NeuroTracker, the rate at which improvement occurs is sensitive to both the individual’s cognitive status, and the complexity of the task added. For example, we can look at a simple dual-task, like standing instead of sitting while performing NeuroTracker. If it’s introduced too early, or with a client who is just not cognitively ready, there will likely be a significant drop in both NeuroTracker scores and session on session improvement rates thereafter.

NeuroTrackerX provides preset protocols that can be assigned to end users relative to different populations. These are based on are scientifically validated learning methodologies, and so they’re definitely a great place to start. Here's a video covering what learning progression through dual-tasks can look like.

That said, I find that this is an area where a coach or clinician’s expertise is also very valuable. Personally speaking, I will make an informed judgement based on each individual’s progress, and what I’ve learned about them, to decide when to introduce dual-tasks, and when to step up the complexity. I’ll then adapt the program accordingly, based around ongoing observations, client feedback, and session’s results. This is where the NeuroTracker data is particularly useful, because if the dual-task complexity is progressed correctly, you will see nice learning curve responses, and vice versa.

Q. Do you use NeuroTracker to monitor recovery?

Absolutely, it’s my go-to tool that I use for all kinds of injury and rehabilitation that I do with clients. As I mentioned in a recent blog, cognitive assessment has been shown to be very relevant for physical injuries with a lot of new research demonstrating the interrelationship between brain and body. There is a NeuroTracker blog by an expert in sports medicine and rehab which explores this topic.

3 Reasons Why the Brain Rules Everything in Sports

The greatest value for me is assessing return-to-play readiness. If for example an athlete returns to training or competition too soon, there are high-risks of reinjury or simply underperforming. On the flip side, if too late, it can hinder their career or they may lose their position on a team.

The key advantage here is that NeuroTracker requires the integration of many high-level cognitive capacities, and it tests individuals at their threshold cognitive capacities. This makes it’s a uniquely valuable reference point for safe assessment of performance readiness. Dual-tasks also allow specific sports abilities, such as motor-skill based drills, to be assessed at attentional threshold to probe for hidden weaknesses. There is a study which actually shows NeuroTracker to be a predictor of injury risk using this methodology.

Q. What is "Open Training"?

So as an Administrator on the NeuroTrackerX platform you can actually build and save your own custom training programs, and then immediately assign to any user. It's a really powerful tool, and as I mentioned in the webinar it's a great time saver, especially when managing a lot of clients. However, it’s also good to allow users to have some freedom to choose their own sessions, according to changes in their personal training goals, or simply for motivational reasons.

The Open Training option allows you to offer three different sessions for a client to choose, and assign this at any points in their training program. Generally, I find this works well when clients have become familiar and comfortable with their training program, so then I assign Open Training more frequently. Or I base it on their feedback during consultations.

Overall, I really like this feature, as do my clients, because it just makes it easy to strike a nice balance between structured programs and giving clients the freedom to choose. It complements remote training very well.

Q. Hi Maxime, if I book a consultation with you, can you share with me how much you charge for remote training, compared to prices in your clinics?

In short it depends on how much remote consultation and follow-up reporting the client wants, versus the number of assessments I do in-clinic, which is quite different for say a professional athlete compared to a clinical patient. But yes, I can go through the different pricing models I use for different client scenarios, as well as make recommendations regarding your clientele, based on my experience with many different types of clients.

If you’re interested in a discounted consultation session with me to implement best telehealth practices with NeuroTrackerX in your business, your can find out more information here.

Maxime Chevrier - NeuroTrackerX Professional Consulting Services

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