Neurologic Outcomes Registry

The Pittsford Performance Care Neurologic Outcomes Registry is a prospective clinical registry that tracks outcomes across three neurologic domains: post-concussion syndrome, vestibular dysfunction, and autonomic dysregulation. For each completed episode of care, the registry records symptom burden at intake and discharge, functional recovery status, and durability of improvement at follow-up.

The Care Track Model is a structured clinical framework that organizes neurologic rehabilitation into four sequential phases. Each episode of care in the registry follows this framework, which ensures that treatment is directed at the specific neurologic system limiting recovery rather than addressing symptoms in isolation.

1. 1
   Identify the Primary Constraint

   Evaluate the neurologic system — vestibular, oculomotor, cervicogenic, autonomic, brainstem, or cerebellar — acting as the primary barrier to recovery.
2. 2
   Deliver Targeted Treatment

   Direct therapeutic interventions specifically at the identified Primary Constraint system, not at symptom clusters alone.
3. 3
   Measure Outcomes with Validated Instruments

   Track symptom burden and functional status using standardized questionnaires at intake and discharge.
4. 4
   Confirm Durability of Recovery

   Conduct structured follow-up to verify that improvement is maintained after discharge.

The registry uses four validated clinical instruments to measure outcomes. Each instrument is administered at intake and at discharge, enabling a standardized pre-to-post comparison within each episode of care.

Denominator: 109 classified episodes. Legacy episodes without constraint classification are excluded.

Based on 1 episode with complete visit count and resolution data. Episodes with zero or missing values are excluded.

Recovery from neurologic conditions such as concussion, vestibular dysfunction, and autonomic dysregulation does not follow a uniform trajectory. In many cases, the limiting factor is not the severity of the initial injury but rather the specific neurologic system that is failing to adapt. The Care Track Model refers to this as the Primary Constraint.

When the Primary Constraint is correctly identified — whether vestibular, oculomotor, cervicogenic, autonomic, brainstem, or cerebellar — treatment can be directed precisely at that system. The registry exists to test whether this constraint-directed approach produces better outcomes than symptom-based treatment alone. Each episode recorded in the registry contributes to that question.

The Constraint-Directed Recovery Rate (CDRR) is the registry’s primary outcome metric: the proportion of completed episodes in which the patient achieved clinically meaningful symptom improvement, functional recovery, and durable stability at follow-up.