PRIME™ (Postural Restoration Integrative Multidisciplinary Engagement) Program
Our passion for multi-disciplinary engagement and treatment led to the development of our PRIME program to help us maximize outcomes for people who were struggling to manage complex or confusing issues that were not helped with traditional PT or even non-integrated PRI® (Postural Restoration) treatments.
Our PRIME program utilizes the science of Postural Restoration® in an integrated, multi-disciplinary way that coordinates care from multiple disciplines in a seamless program to maximize the effectiveness of a Postural Restoration based program.
Through this program we have helped patients from across the globe set up and progress through a successful program for rehabilitation or human performance.
Can You Relate to These People?
- There’s got to be more going on as to why I feel the way I do, yet nobody seems to know what’s wrong with me.”
- “I feel I am married to my PT/Chiro/Massage therapist. I need to see them to feel good but I wish I could manage it on my own.”
- “I am working hard on my therapy and seeing such small results. I know its helping but it’s got to be easier than this!”
- “Despite all of this treatment I’m still just not getting any better.”
- “This PRI stuff works, I just can’t get it to stick with this patient.”
We’ve Been There Too!
We understand that people who have long-standing physical issues often struggle to get better with traditional care models. We’ve had our patients ask all those questions and more, and we’ve asked them ourselves.
This is WHY We created the PRIME program. We needed answers to address those specific things.
Our PRIME team has developed the knowledge, and has the experience and tools to address issues related to these complex problems. Once all the causes are addressed in a cohesive manner you will finally have a path to actually get better and back to living your best life!
What Do I Get When I Come to PRIME?
- A dedicated CASE MANAGER who will guide you through your entire visit. This person will coordinate all aspects of your care, communicate with your local providers, and help answer any questions you have.
- A TEAM of experts in various fields ready and willing to work together to help YOU.
- The TOOLS (orthotics and activities) you need to get your body functioning at its maximal effectiveness 24 hours a day! (Yes even when you are sleeping!)
- A PLAN to progress your exercises and activities after you leave Nebraska.
- Follow-up COMMUNICATION including telehealth services (if needed) to help you with and hurdles you may hit in your recovery
Lets Get started!
Learn more about the process of PRIME Below
How do I apply?
If you want to apply to engage with our PRIME team, whether in person, or through an online consultation, the first step is to submit our PRIME application. This is a comprehensive packet that gives us information from multiple perspectives to assist us in determining the best way we can help you. We ask for specific pictures of your teeth and feet as well as a recent eye exam and refraction.
Triage
Once your application is completed, our team will review your paperwork and determine what the best options to assist you are. Typically, we will be able to determine if you are a candidate for PRIME or online consultation services within a week of receiving your complete application. If we need more information from you, we will be in contact with you. Even if we don’t feel you are a candidate to come to Lincoln for PRIME we will offer you suggestions and recommendations of where to start.
Coming to PRIME
If you are accepted to come to PRIME, you will be contacted by our staff. They will discuss with you how our program will help you, which tools and professionals you will need to see, and what the estimated costs will be. If you wish to proceed, we will schedule a time for you to come to Lincoln, NE. Since we see limited numbers of patients each PRIME week, we typically schedule out 1-3 months after you are accepted. Once we have a date set up, you will then receive an itinerary outlining your time in Lincoln and you can start to plan your trip.
If you are doing an online session with our staff, that will be scheduled as soon as possible following the triage process.
PRIME WEEK
WELCOME TO LINCOLN!!!
Day 1 (Monday)
,Monday is the busiest day of the week for PRIME. This is the day we will develop the orthotics and tools you need to allow your body into a neutral state and to be able to finally move forward in your program. For specific information on each piece of the program, click the buttons below.
Step 1: Dental Impressions: The first appointment is getting impressions of your top and bottom teeth at the dental office. To ensure we can deliver your dental orthotic as soon as possible, we need to get these impressions as soon as possible. This will most likely be your first appointment
Step 2: Physical Therapy Assessment: Your physical therapist will do a thorough Postural Restoration(R) assessment to determine your specific limitations and integration needs including dental influence, footwear, and visual influence on your body. We will determine what you need to get your body neutral at this appointment. A large issue will be determining the proper shoe for you at this session.
Step 3: Vision assessment: Once we know what it takes to get your body in a neutral state, you will be seen with a Physical Therapist and our Optometrist to determine a visual prescription for you for either full time use or training. This prescription will assist you in staying neutral with upright activity.
Step 4 Physical Therapy treatment: In the afternoon you will have a physical therapy session to start learning what exercises and activities you will need to do to integrate the use of your new orthotics.
Step 5: Dental bite registration: Now that you have the tools needed to get your body in a neutral state the dental team meets us at the Hruska Clinic to do one more impression of how your teeth “fit” when you are neutral.
Day 2 (Tuesday)
On Tuesday the emphasis is placed on the Physical Therapy aspect of the program. You will most likely have 2 sessions of PT this day to go over general concepts, goals of activities to master along with instruction and performance of specific techniques to assist you in retraining your bodies postural patterns into a more neutral state. These activities could include lying-down breathing activities, standing glute strengthening, visual/perceptual training, or head and neck “postural” exercises all with a Postural Restoration(R) basis behind them.
Depending on your specific visual prescription or glasses needs you may actually be able to pick up your glasses this day. We have a local optical lab that can make a pair of glasses, in many cases, in about 24 hours. If this is not possible for your particular needs, you will continue to use trial frames so you can utilize the new glasses prescription when performing Physical Therapy activities.
Day 3 (Wednesday)
Today is the day that you will get your oral (occlusal) orthotic delivered at the dentist’s office! The vast majority of our patients will either get a MOOO device or MMOO device (see more below for specific information about these devices).
Typically, you will have one session of Physical Therapy in the morning prior to getting your appliance to continue to work on the activities and goals set yesterday.
In the early afternoon one of our PTs will meet you at the dental office when the oral orthotic is delivered to ensure the calibration is done in the best manner to keep your body neutral. The appointment can take 30-60 minutes to ensure everything is correct.
Following the appointment at the dental office, you will have another PT session at the Hruska Clinic to go over how to integrate this new orthotic with your exercises and daily life.
If it is determined you need custom PRI orthotics, today is usually the day those impressions will be done. This is the only piece that we cannot have fabricated for you before you leave PRIME. If you need these custom orthotics they will be mailed directly to you after you leave PRIME.
Day 4 (Thursday)
We want to ensure that your occlusal orthotic (MOOO or MMOO) works for you at night, we strongly suggest you stay until Thursday so you can spend a night sleeping with your orthotic in. If there are things that need to be adjusted, our dental team is available to adjust your appliance before you leave Lincoln.
You will have one last session with your PT/case manager to discuss how to integrate these tools and activities into your daily life, answer any additional questions, review exercises, including taking videos of the technique if you’d like, or whatever else needs to be done so you feel comfortable with your program before leaving Lincoln.
Follow-Up
Whether you were referred by a therapist, or we help you find a local therapist to connect with when you get back home, we will send them information on what transpired during your PRIME week and what our plans and goals are.
Part of your follow-up as a PRIME patient is a follow-up virtual visit set up at your convenience with your PRIME PT to answer questions and guide progression once you get home. This is part of your clinical management fee so is no extra cost to you. If this platform is helpful, additional virtual visits can be done at a discounted rate for our PRIME patients. This is a great way to ensure you are progressing and improving as you get back home and reintegrate with your normal life. Our therapists are all available via e-mail whenever you have questions.
Occasionally return trips to Lincoln are recommended if your vision or dental appliances need to be readjusted or updated as you get better. This is not always the case, but sometimes that will be our recommendation. Communication with your physical therapist will help with making these decisions.
The number one reason patients do not improve with our program is if they do not continue to follow-through with their activities or stay in communication with their therapist. To facilitate improvements in your progression we recommend the following:
1) Communicate good AND bad steps with your therapist who can guide you and assist in adjusting your activities or routines so you can improve faster.
2) Do not add additional variables by participating in other therapy programs, or utilizing other orthotics without discussing with their PRIME manager.
3) Do not change your glasses or dental appliances without discussing with the PRIME manager.
If other things are added or changed, our ability to determine what is a potential issue and how to help will be severely limited. Please contact your therapist if you are seeking or considering other treatment options to see if they will be good adjunct treatments or harmful to your progress.