Neurologic Outcomes Registry
Aggregated outcomes from patients treated for concussion, vestibular dysfunction, and autonomic dysregulation.
"Directed treatment. Measured recovery. Durable results."
Constraint-Directed Recovery Rate (CDRR): Completed episodes achieving clinically meaningful symptom improvement, functional recovery, and durable stability at follow-up.
Registry Aim
The Pittsford Performance Care Neurologic Outcomes Registry evaluates whether treatment delivered through the Care Track Model — directed at the identified Constraint Profile — produces clinically meaningful and durable improvement in symptom burden and functional capacity.
Each episode of care identifies the neurologic systems contributing to dysfunction at initial clinical exam. Treatment is directed at those systems and outcomes are measured using validated clinical instruments.
Pittsford Performance Care · Pittsford & Rochester, NY
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.
Registry Population
Cohort characteristics for interpreting outcomes. All data are aggregated and de-identified.
All data are aggregated and de-identified.
Care Track Model
The registry logic — from domain identification to durable outcome.
The Constraint Profile is the full set of neurologic systems identified at initial clinical exam as contributing to dysfunction. Treatment directed at these systems — rather than at symptoms alone — is the core principle of the Care Track Model.
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.
- 1Classify the Constraint ProfileEvaluate the neurologic systems — vestibular, oculomotor, cervicogenic, autonomic, brainstem, or cerebellar — contributing to dysfunction at initial clinical exam.
- 2Deliver Targeted TreatmentDirect therapeutic interventions specifically at the identified constraint systems, not at symptom clusters alone.
- 3Measure Outcomes with Validated InstrumentsTrack symptom burden and functional status using standardized questionnaires at intake and discharge.
- 4Confirm Durability of RecoveryConduct 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.
Constraint Profile Distribution
Constraint Profile reflects the neurologic systems identified as contributing to dysfunction at initial clinical exam.
Denominator: 162 classified episodes. Legacy episodes without constraint classification are excluded.
Symptom Burden Outcomes
Distinguishing "any improvement" from "clinically meaningful change" (CMC) by domain.
Post-Concussion
0 completed episodes
Functional Recovery
Functional recovery reflects a patient's ability to return to normal daily activities.
Functional recovery data will appear as registry enrollment grows.
Durability at Follow-Up
Whether improvements persist after discharge — the third criterion of the CDRR.
Durability metrics require completed follow-up data.
Treatment Exposure
These metrics provide context for care delivery — visit count and resolution time.
Treatment exposure metrics will appear as registry enrollment grows.
Registry Methodology
"The registry measures real clinical outcomes using validated instruments and standardized episode structure."
Frequently Asked Questions
What is the Neurologic Outcomes Registry?
The Pittsford Performance Care Neurologic Outcomes Registry is a prospective clinical registry that tracks outcomes for patients treated for post-concussion syndrome, vestibular dysfunction, and autonomic dysregulation. It records symptom burden, functional recovery, and durability of improvement using validated clinical instruments.
What is the Care Track Model?
The Care Track Model is a structured clinical framework that classifies the neurologic systems contributing to dysfunction at initial clinical exam — the Constraint Profile — directs treatment at those systems, measures outcomes with validated instruments, and confirms durability of improvement at follow-up. The registry is designed to test whether this constraint-directed approach produces better outcomes.
How are concussion outcomes measured?
Post-concussion outcomes are measured using the Rivermead Post-Concussion Questionnaire (RPQ), a validated 16-item scale administered at intake and discharge. Functional recovery status and durability at follow-up are also recorded. The SF-36 is used across all domains to measure functional health status.
What does clinically meaningful change mean?
Clinically meaningful change refers to a reduction in validated symptom scores that exceeds the established minimal clinically important difference (MCID) for each instrument. For the RPQ, this is a defined threshold of symptom score reduction. Achieving clinically meaningful change means the improvement is large enough to be noticeable and significant to the patient, not just statistically detectable.
What is the Constraint-Directed Recovery Rate?
The Constraint-Directed Recovery Rate (CDRR) is the registry's primary outcome metric. It is the proportion of completed episodes in which the patient achieved clinically meaningful symptom improvement, functional recovery marker, and durable stability at follow-up. It is the registry's answer to the question: does treatment directed at the identified Constraint Profile produce durable, meaningful recovery?
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.
Clinical Note
Outcomes reported here represent aggregated registry data. Individual results vary depending on neurologic presentation, duration of symptoms before treatment, and other clinical factors. All data are de-identified. This registry is maintained for quality improvement and research purposes and does not constitute a clinical trial or systematic review.
For the full outcome registry including musculoskeletal cases, visit the PPC Outcome Registry.