Neurac® Therapy

Restore movement. Relieve pain. Enhance performance.

Neurac Therapy is a research-supported approach to rehabilitation and everyday life performance training. It targets the root causes of pain and dysfunction by aiming at restoring proper neuromuscular control — through precise suspension exercises with vibration and gradual pain-free progressions.

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The "Neurac" name is short for neuromuscular activation, and coins that the approach specifically targets the nervous system's control of the motor system.  

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Neurac Therapy is the clinical application of the Neurac® Method for patients with neuromusculoskeletal pain, dysfunction, or performance limitations. It uses standardized suspension-based exercise tests to assess and treat, while re-testing performance in a relevant functional task to support or challenge the clinical hypotheses.

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Neurac Therapy is delivered by licensed healthcare practitioners—such as physical therapists, chiropractors, physicians, and equivalent regulated professions—who have completed Redcord’s structured Neurac education program consisting of three progressive courses taught by certified instructors.

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​​​​Within Neurac Therapy, clinical hypotheses are explored directly during task performance by temporarily influencing how the task is performed. This approach is called Perform Pluss (Perform+).
 

Perform+ refers to a therapist-led strategy in which task conditions are intentionally modified in order to observe immediate improvement in movement quality and symptoms. The goal is to test, support, or weaken a working clinical hypothesis.

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Perform+ refers to changes that temporarily support or facilitate task performance.

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The therapist may guide Perform+ through manual contact, verbal instruction, or changes to the body–environment interaction, such as external support, altered stance, or modified load. Most often specific kinetic chain activation is manipulted and immediate changes in functional task performance inform further assessment and treatment decisions. 

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A functional task is a movement activity that replicates what the patient reports having difficulty performing in daily activities or sport-specific contexts and is therefore meaningful to the patient (Zarzycki et al., 2022). Examples include reaching onto a shelf, putting on a shoe while standing, lifting an object, walking, running, or changing direction.

During functional tasks, movement quality reflects how effectively the body’s stability and mobility systems interact to meet task demands. According to the combined stability–mobility systems model, effective movement depends on coordinated interaction between stabilizing and mobilizing subsystems, and changes in task conditions can immediately alter this interaction (Hoffman et al., 2013).

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​​​​The therapist deliberately manipulates task conditions—through manual contact, verbal instruction, or changes to the body–environment interaction—to test clinical hypotheses.

Manual contact, verbal instruction, or external items may be used to alter task performance, with immediate changes guiding further assessment and treatment.

A functional task is a movement activity that replicates what the patient reports having difficulty performing in their daily activities or sport-specific context, and is therefore meaningful to the patient (Zarzycki et al., 2022). 

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For example: reaching on a shelf, putting on a shoe while standing, lifting a frying pan, walking, running, or cutting.

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In functional tasks, movement quality reflects how effectively the stability and mobility systems interact to meet task demands (Hoffman et al., 2013).

• Perform+ temporarily improves that interaction. 

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According to the combined stability and mobility systems model, movement quality depends on effective interaction between stabilizing and mobilizing subsystems, and altered task conditions can immediately change this interaction (Hoffman et al., 2013).

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How Perform+ is used in Neurac Therapy

1. Select a functional task
Choose a specific task the patient reports difficulty performing in daily life or sport (e.g. bending down to pick up an object).

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2. Observe baseline performance (CASSS)
Assess Control, Amount of movement, Speed, Symmetry, and Symptoms during the task to establish a reference.

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3. Apply Perform+ (facilitation)
Temporarily facilitate the task by adjusting task conditions—through manual contact, verbal instruction, or changes to the body–environment interaction—and repeat the same task.

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4. Choose Neurac tests, treat, and re-test the task
Use the observed CASSS responses to select relevant suspension-based test/exercise(s) (e.g. Supine Pelvic Lift, Prone Bridge). After treatment, re-test the original functional task to support or challenge the clinical hypothesis.

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Immediate changes in task performance help guide exercise selection and progression within Neurac Therapy.

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Clinical example
A patient reports pain when bending down to pick up a paper. The clinician observes reduced control (e.g., jerky movement or deviant load transfer), limited range of motion, and pain during the task. 

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With Perform+, the clinician temporarily improves trunk–pelvis support (e.g., manual abdominal pressure, a simple cue, or an external constraint) and repeats the same task. If pain decreases, control improves (e.g., improved force-steadyness), and the patient reaches further with less hesitation, this supports the hypothesis that task performance is sensitive to trunk–pelvis strategy.

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The the findings guide the next step in Neurac Therapy—often progressing into standardized suspension-based tests such as Supine Pelvic Lift and Prone Bridge, followed by immediate re-testing of the functional task

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The clinical example elaborated
The abstracted example above are elaborated into a more practical or concrete one, including: 

• The functional task

• The hypothesis

• Perform+ variants (manual, verbal, environmental)

• Perform– variants (safe challenge)

• Exactly what outcomes to look for (CASSS + simple measures)

• And how this translates into Neurac testing (Supine Pelvic Lift / Prone Bridge)

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Example: Using Perform+ during a functional task

Functional task
Standing forward bend to pick up a paper from the floor.

This task is selected because it replicates a daily activity the patient reports difficulty performing (cf., "History").
 

Step 1: Observe baseline task performance

The patient performs the task two to three times. The therapist observes baseline performance using the CASSS factors (Control, Amount, Speed, Symmetry, Symptoms) [Zarzycki et al., 2022]:

• Control: movement smoothness, coordination, guarding, segmental “buckling”, or abnormal pelvis-hip or scapulo-humeral rythm.

• Amount: how far the patient can bend (for example fingertip-to-floor distance in centimeters)

• Speed: ease and continuity of movement, hesitation, stop–start behavior, or  number of seconds to perform the task.

• Symmetry: weight shift, hip shift, trunk rotation, or one-sided avoidance (pick with right and left hand).

• Symptoms: pain (rated on a 0–10 Numeric Rating Scale), fear (dreadful face), or discomfort (moaning, stating)

Simple outcome measures (sufficient for clinical decision-making) [cf. CASSS]:

• Brief movement control description (smooth / hesitant / segmented) [C]

• Fingertip-to-floor distance or reach distance (A)

• Seconds taken to perform the task (S)

• Presence or absence of side-to-side asymmetry (S)

• Pain score (0–10) [S]

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Step 2: Form a working hypothesis

Rather than attributing findings to isolated muscle “activation,” the hypothesis is framed in terms of movement strategy and load transfer:

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Hypothesis:
The patient’s symptoms and movement quality during the floor pick-up are influenced by insufficient control and force transfer between the trunk and pelvis under load. If trunk–pelvis support is temporarily improved applying fascilitation measures, task performance should improve immediately, as reflected by changes in Control, Amount, Speed, Symmetry, and Symptoms. Reverse effects should be registered appling inhibation measures. 

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Step 3: Apply Perform+ (facilitation)

Perform+ (A): Manual abdominal support
The therapist provides gentle, broad support at the lower abdomen or pelvis (similar to a light brace), and the patient repeats the task.

What this tests:
Whether temporarily improving trunk–pelvis support improves task performance.

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A positive Perform+ response may include:

• Reduced pain (for example a decrease of two points or more on the pain scale)

• Smoother descent and return, with less guarding

• Increased reach toward the floor

• Less hesitation during the movement

• Reduced trunk rotation or side shift

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Perform+ (B): Instructional facilitation (no manual contact)
The therapist provides simple verbal instructions, such as:

• “Breathe out gently as you start to bend.”

• “Keep your rib cage stacked over your pelvis.”

• “Lightly brace as if preparing for a cough, without holding your breath.”

The task is then repeated.

Purpose:
To test whether a cue-led change in movement strategy improves task performance.

Perform+ (C): Change in body–environment interaction
A temporary belt, strap, or light tactile band is applied around the lower trunk or pelvis, and the task is repeated.

Purpose:
To test whether altering external task conditions improves performance without therapist contact.

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​Step 4: Translate findings into Neurac testing and treatment

If Perform+ targeting the trunk–pelvis region is clearly positive, and facilitation targeting the hips or feet is negative, the next logical step in Neurac Therapy is to select suspension-based tests and exercises that challenge trunk–pelvis force transfer.

Common examples include:

• Supine Pelvic Lift: graded testing and training of force transfer between hips, pelvis, and trunk (posterior and rotational chains dominant)

• Prone Bridge: graded testing and training of integrated trunk stability and coordination under load (anterior and rotational chains dominant)

After treatment, the original functional task (picking up the paper) is re-tested to support or challenge the clinical hypothesis and assess carry-over.
 

Clinical interpretation

Improving trunk–pelvis support changed task performance immediately, suggesting that the patient’s movement strategy and load transfer during the floor pick-up are modifiable and clinically relevant. This response is consistent with, but does not directly prove, improved neuromuscular function of the trunk–pelvis-hips kinetic chains.

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References

Zarzycki, R., Smith, C. A., Smith, S. S., & Van Dillen, L. R. (2022). Application of the 4-element movement system model to sports physical therapy and education. International Journal of Sports Physical Therapy, 17(1), 108–123. https://doi.org/10.26603/001c.30318

Hoffman, S. L., Gabel, P., & Williams, J. (2013). Expanding Panjabi’s stability model to express movement: A theoretical model. Manual Therapy, 18(3), 236–240. https://doi.org/10.1016/j.math.2012.10.005