What happens when you play a musical instrument?

When you play an instrument, your brain is required to integrate information from multiple systems simultaneously. You must process visual input from sheet music, auditory input from the sounds you hear, and proprioceptive feedback* from your hands and 铿乶gers. At the same time, you are coordinating precise motor movements while maintaining attention and timing. This level of multisensory integration activates widespread neural networks throughout the brain.

Studies using functional MRI have demonstrated increased activity in areas involved in motor control, auditory processing, memory and executive function during musical performance. The corpus callosum, the major connection between the brain’s hemispheres, has been shown to be larger in musicians, suggesting enhanced communication between the left and right sides of the brain.

Playing an instrument also promotes neuroplasticity, the brain’s ability to adapt and form new neural connections. Every time a musician practices a new skill, neural pathways are strengthened through repetition. This process is similar to how athletes develop motor patterns through training. Over time, these repeated experiences lead to measurable structural and functional changes within the nervous system.

Cognitively Speaking

From a cognitive standpoint, musical training has been associated with improvements in attention, working memory, processing speed and executive function. These bene铿乼s may extend beyond music itself, in铿倁encing performance in academic, professional and everyday tasks that require focus and mental 铿俥xibility.

Music also engages the brain’s reward system. Successful practice and performance can trigger dopamine release, reinforcing learning and motivation. This combination of challenge, repetition, sensory integration and reward creates an ideal environment for long-term brain adaptation. Whether you’re learning your 铿乺st chords on a guitar or practicing a complex piano piece, you’re doing much more than making music. You’re providing your brain with a rich neurological workout that strengthens connections, enhances cognitive function and supports lifelong brain health.

*Proprioceptive feedback is the constant stream of sensory information your muscles and joints send to your brain about your body鈥檚 position, movement and force.

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Tips for Success

Rather than trying to memorize every detail, it can be helpful to approach studying as an exercise in pattern recognition and clinical reasoning. A good strategy is to focus on common presentations and differentiating features between similar conditions. Instead of studying diseases in isolation, compare them side by side. Ask yourself what findings make one diagnosis more likely than another, what imaging characteristics are associated with each condition, and which laboratory findings help narrow the differential.

Practice questions are one of the most effective study tools because they help develop familiarity with board-style wording and reinforce key concepts. Reviewing why an answer is correct (and why the other choices are not) can be just as valuable as getting the question right.

Diagnostic Imaging

Diagnostic imaging also deserves dedicated attention. Many conditions have classic radiographic appearances that can help you quickly identify the correct answer. Connecting pathologyconceptstoimagingfindingscanstrengthenretentionandimproveconfidenceduring the exam. Most importantly, focus on consistency rather than cramming.

A structured study plan that allows regular review of major topics is often more effective than last-minute late-night sessions. Part II is less about recalling obscure facts and more about recognizing common clinical patterns and applying your knowledge efficiently. With a focused approach and consistent preparation, the exam becomes much more manageable. And it is great to also be able to use your clinic experience as real-life studying too!

Best of luck to everyone who will be taking a board exam soon! Trust that you know more than you think!

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The human hand takes up a massive amount of 鈥渞eal estate鈥� in the brain. In the motor cortex and sensory cortex, the fingers require incredibly detailed neural control and feedback. Every time we perform fine motor movements 鈥� tapping, playing piano, knitting, typing, squeezing therapy putty or coordinated finger drills 鈥� the brain activates large neural networks involving the frontal lobe, cerebellum, sensory cortex, basal ganglia and even attention centers.

In simple terms: finger movement is brain exercise.

These movements increase communication between brain cells and help stimulate neuroplasticity, which is the brain鈥檚 ability to adapt, grow and strengthen connections. Blood flow to the brain also increases during coordinated movement tasks, delivering oxygen and nutrients that support brain function. Research has shown that complex hand movements can improve processing speed, attention, reaction time and memory performance鈥揳ll functions that are often affected early in Alzheimer鈥檚 disease. This also connects strongly to one of the major themes from the Lancet report: physical inactivity and reduced cognitive stimulation are major modifiable risk factors for dementia. When the brain stops being challenged, stimulated, and engaged, neural networks become weaker over time.

Keep Moving!

Finger exercises are especially powerful because they combine movement, coordination, sensory feedback, attention and learning all at once. That combination activates multiple brain regions simultaneously, like a 鈥渇ull-body workout鈥� for the nervous system. In addition to the Lancet article, PubMed also reported an article in which the was identified as a predictor of early diagnosis and progression of Alzheimer鈥檚 dementia. The encouraging part is that brain health does not depend on one magic supplement or expensive treatment. Small daily habits matter. Moving your body, protecting cardiovascular health, staying socially engaged, learning new skills and even practicing fine motor exercises can all contribute to a healthier, more resilient brain over time. Alzheimer鈥檚 disease is complex, but the growing message from neuroscience is empowering: the brain responds to how we use it.

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Learning to Adapt.

Earlier in the chiropractic medicine program, everything felt more structured. There was usually a 鈥渞ight鈥� answer hidden somewhere in lecture slides or study guides, but clinic is different. Patients rarely present exactly like the textbook examples; sometimes they forget vital details. Sometimes their symptoms change mid-visit. Sometimes you walk into a room realizing you have to think on the fly and trust yourself more than you are used to (and thought you could). That probably has been the biggest lesson of Trimester 9 for me: learning how to adapt without freezing.

At first, that felt very intimidating. There is a certain pressure that comes with knowing patients are looking to you for answers, reassurance and direction. Even when supervisors are there to guide you, there are moments where you have to make decisions independently, organize your thoughts quickly and communicate with confidence–even if internally you are still working through the uncertainty.

Confidence Evolves.

But over time, you start noticing small wins. You remember the right orthopedic test without second-guessing yourself. You explain a condition more clearly than you could a few months ago. You begin recognizing patterns between cases. You stop panicking every time something unexpected happens because you realize clinical practice is full of unexpected moments. Confidence does not appear overnight. It builds quietly through repetition, mistakes, corrections, and experience. I think many students assume confidence comes from suddenly feeling fully prepared or from knowing exactly what to do. In reality, it often comes from surviving situations where you did not feel fully prepared, and realizing you handled them better than you thought you could.

Growth Happens.

Trimester nine has also taught me that good clinicians are not the people who know everything instantly. They are the people who can stay calm, think critically, ask better questions, and continue learning while still showing up for their patients. There are still difficult days. There are still moments when I leave clinic replaying encounters in my head and thinking about what I could have done differently. But instead of viewing that as failure, I am starting to see it as part of the process. Growth in clinic is rarely dramatic; it happens little by little. And, eventually, you look back and realize you are handling situations that once completely overwhelmed you.

There has been so much growth that has happened during my first trimester in clinic. I always remind myself, I never will know less than I do right now!

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The Solution.

Instead, the most effective strategy is to meet the patient where they are and start small. Focus on identifying one habit that feels realistic and achievable for them. Not the most important habit in your clinical mind, but the one they feel confident they can change. That initial success builds momentum, confidence and trust. Once patients see that change is possible, they become more open to layering in additional interventions over time.

It鈥檚 911爆料 Education.

Equally important is how we educate. Patient education should not feel like a lecture or a checklist, it should feel like genuine desire for the best outcome. When patients understand why a change matters in the context of their symptoms and goals, they are much more likely to engage. Keep explanations simple, relevant and tied directly to what they are experiencing.

This helps shift them from passive recipients of care to active participants in their health.

It鈥檚 911爆料 Progress.

Overall, behavior change is not about perfection, it is about progression. As health care providers, our role is to guide, not overwhelm. By prioritizing small, meaningful changes and reinforcing them through clear, personalized education, we create an environment where patients feel capable rather than defeated. And that鈥檚 where real, sustainable change begins.

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What Research Shows.

When we look at the research, the story becomes much more nuanced. Large-scale studies show that meaningful health benefits occur well below 10,000 steps per day. A 2025 analysis by Ding et al. published in 听found that significant reductions in mortality and chronic disease risk occur in the range of about 5,000 to 7,000 steps per day, with around 7,000 steps associated with a substantial reduction in mortality risk compared to extremely low activity levels. Importantly, while benefits continue beyond that, the rate of improvement begins to slow, highlighting a concept known as diminishing returns. Similarly, Paluch et al. in The Lancet (2022) demonstrated that for older adults, health benefits tend to plateau around 6,000 to 8,000 steps per day, while for younger adults the plateau is closer to 8,000 to 10,000 steps. Banach et al. (2023) in the 听further reinforced that there is a clear dose-response relationship between step count and mortality, meaning more movement is generally better, but even modest increases in daily steps can significantly reduce cardiovascular and all-cause mortality risk.

This misconception might seem harmless, but it can actually shape how people view their health in a negative way. Many people fall into an all-or-nothing mindset, thinking that if they do not hit 10,000 steps, the effort somehow doesn鈥檛 count. In reality, the biggest health improvements come from moving out of a sedentary baseline. Going from 2,000 to 5,000 steps per day has a far greater impact on overall health than going from 9,000 to 10,000. Reframing this perspective is important, especially for patients who feel discouraged by arbitrary goals that may not align with their current lifestyle or capacity.

Progression, Not Perfection.

A more practical and evidence-based approach is to focus on progression rather than perfection. For someone who is relatively sedentary, increasing daily steps by even 1,500 to 2,000 can have meaningful benefits. A general target for overall health falls around 5,000 to 7,000 steps per day, while 7,000 to 9,000 or more may provide additional benefits depending on age, baseline fitness, and health status. For individuals who already reach 10,000 steps consistently, there is no need to reduce that goal, but it is important to recognize that it is not a universal requirement for good health.

Debunking the 10,000-step myth is not meant to minimize the importance of walking鈥攊f anything, it highlights just how powerful it is. Walking supports cardiovascular health, improves metabolic function, and plays a key role in stress regulation and overall

well-being. From a functional neurology perspective, it also provides sensory input through visual flow, vestibular activation, and coordinated movement patterns that engage the cerebellum and promote hemispheric integration. In that sense, walking is not just exercise, but rather it is a foundational input for brain and body function.

Conclusion?

At the end of the day, the goal is not to chase a specific number, but to build consistency. The question is not whether you hit 10,000 steps, it is whether you are moving more than you were before. That shift in mindset creates a more sustainable and realistic approach to health, one that aligns far better with both the research and the patients we are trying to support.

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The Prefrontal Cortex: Nature鈥檚 Pathways.

When you engage in negative self-talk, your brain treats the internal, “I鈥檓 not good enough,” as a real-world threat. This activates the amygdala, which is the brain鈥檚 alarm system, and it triggers a cascade of cortisol and adrenaline. Constant negative loops can eventually weaken the prefrontal cortex (PFC), the area responsible for logic and decision-making, effectively making it harder to think your way out of a bad mood. The neural pathways for rational thought become less active while the “survival” pathways become hyper-responsive. It effectively thins the grey matter density in the PFC over time, making it harder to regulate emotions or think your way out of a bad mood.

Neuroplasticity is the Driver.

On the other hand, positive self-talk is not just “wishful thinking”. It is a functional neurochemical practice. Reframing a challenge as an opportunity stimulates the release of dopamine and serotonin. These neurotransmitters improve your mood, enhance cognitive flexibility, and allow you to see solutions that a stressed brain would otherwise miss. This process is driven by neuroplasticity, the brain’s ability to reorganize itself by forming new neural connections. The brain follows the principle that “neurons that fire together, wire together.” Every time you consciously replace a self-defeating thought with a constructive one, you are physically strengthening a new neural pathway.

Over time, these pathways become more automatic based on their frequency of use. By consistently choosing kinder, more objective language, you are sculpting a brain that is more resilient to stress and more primed for success. Your brain is a supercomputer that follows your scripts, so if you would not say it to a friend, do not say it to yourself. By shifting your internal dialogue, you are not just changing your mindset, you are also changing your neurology.

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A Common Injury

The ACL is a key ligament in the center of the knee connecting the femur (thighbone) to the tibia (shinbone). Its function is to stabilize the knee against front-to-back and rotational movements. ACL injuries are common sports injuries.

According to the , 鈥�the annual reported incidence in the United States alone is approximately 1 in 3,500 people. There are approximately 400,000 ACL reconstructions every year in the United States.鈥�

I have always lived a highly active lifestyle, and it has been part of who I am for most of my life. Going from that version of myself to someone stuck on the couch, swollen knee elevated, quad barely contracting, was humbling in a way I did not expect. The early weeks were terribly slow, full of pain, stiffness and fatigue. The mental battle of watching your muscle disappear was something I have never experienced before, and there always was underlying frustration of celebrating something as 鈥渟mall鈥� as finally bending past 90 degrees. When you are used to pushing your body hard, being advised to slow down feels unnatural.

ACL rehab is not linear, but rather full of slow wins and mental setbacks. Early on, the focus is simple but critical: to reduce swelling, restore full passive extension, regain pain-free range of motion and re-establish quadriceps activation. If you do not get knee extension back early, everything downstream becomes harder. From there, we gradually load the joint with controlled weight bearing, closed-chain strength and proprioceptive retraining. Progress was not about pushing hard as I was used to doing in the weight room. It was about doing the right things at the right time.

Perspective is Everything

As someone studying neurology and rehab, I understood motor control, arthrogenic muscle inhibition and progressive overload. But feeling my quad refuse to fire gave me a completely different respect for patients who say, 鈥淚鈥檓 trying, it just won鈥檛 work.鈥� The fear of the first unassisted step, jump and single leg balance was humbling in ways I could never utterly understand before.

There was so much vulnerability in asking for help with daily automatic tasks, and so much mental fatigue with daily exercises that feel repetitive and minor compared to where you used to be. ACL reminded me of something I always knew to be true: that perspective is everything. This process has changed how I see my patients. When someone tells me they are frustrated with slow progress, I completely believe them. When they are afraid to trust their knee again, I understand that hesitation is not weakness: it is neurologically driven protection.

A significant musculoskeletal injury is not only about the healing of tissue. It ends up being a period of identity rebuilding, a mentally challenging period. As difficult as the process has been, my experience of my own ACL reconstruction has made me a more patient and empathetic future clinician.

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PQQ is a small molecule originally discovered in bacteria, where it acts as a cofactor for enzymes involved in redox reactions, which are processes that help cells manage energy and oxidative stress. Interestingly, PQQ is also found in small amounts in foods such as kiwi, green peppers, and fermented soybeans, but typical dietary intake is very low, which is why supplements have become popular.

What the Research Says.

One of the most compelling areas of research on PQQ revolves around mitochondrial function. Mitochondria, the energy 鈥減owerhouses鈥� of our cells, naturally decline in function with age. Several animal and preliminary human studies suggest that PQQ may stimulate mitochondrial biogenesis, the process by which cells grow new mitochondria. This has led researchers to explore PQQ鈥檚 potential to support energy metabolism, especially in aging populations.

Supporting mitochondrial biogenesis is crucial because mitochondria are central to almost every aspect of cellular function. Healthy mitochondria produce ATP, the molecule that powers nearly all cellular processes, and regulates oxidative stress, inflammation, immunity and even cell survival. As mitochondrial function declines, cells become less efficient at generating energy, which can contribute to fatigue, cognitive decline and age鈥憆elated diseases. By promoting the growth of new mitochondria, compounds like PQQ may help maintain cellular vitality, enhance physical and mental performance and protect against age-related deterioration.

Contributors to Cognitive Decline.

PQQ has also been researched for its neuroprotective effects. Oxidative stress and inflammation are key contributors to cognitive decline, and PQQ exhibits antioxidant properties that help neutralize free radicals. In small human trials, supplementation has been associated with improvements in attention and memory tasks, though larger, long鈥憈erm studies are still needed to confirm these benefits. Some research also points to cardiovascular effects, such as modest improvements in markers of heart health and reductions in inflammation, again highlighting PQQ鈥檚 role in cellular protection.

PQQ is an intriguing compound with scientific backing for mitochondrial support, antioxidant effects and cognitive health. If you鈥檙e considering adding it to your supplement regimen, consult with a health care provider to make sure it aligns with your health goals!

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One of the most impactful parts of the experience was traveling to Capitol Hill, where we met directly with congresspeople and their legislative staff. Our goal was to advocate for co-sponsorship of the bill we have currently circulating Congress. Currently, Medicare only covers chiropractic spinal adjustments, excluding essential components of comprehensive care such as proper examinations, therapeutic exercise, manual therapies and imaging. As future clinicians, we know that chiropractic care is far more than an adjustment. Thorough assessment and individualized treatment plans are critical for patient safety, outcomes and long-term success.

This limitation especially affects our senior population. Chiropractic care has repeatedly shown value in pain management, mobility and quality of life, yet many older adults are denied access to the full scope of care simply because Medicare hasn鈥檛 kept up with modern practice standards. Advocacy for this bill is ultimately about patient choice, ensuring seniors can decide what conservative, non-pharmacologic care best supports their health.

While at the conference, I also had a moment I鈥檒l never forget: meeting , the pioneer of functional neurology. As a student actively pursuing my diplomate in functional neurology, I was quite starstruck. Dr. Carrick鈥檚 work has shaped an entire field and continues to influence how we understand the brain, nervous system and human performance. It was inspiring to meet someone whose contributions have so deeply impacted my educational and professional goals.

ACA Engage 2026 reinforced an important lesson: our profession only moves forward if we show up. Advocacy, leadership and involvement are responsibilities. Whether through legislative efforts, research, education, or community engagement, getting involved ensures chiropractic continues to grow, evolve and serve patients at the highest level. Our voices matter, and when we use them together, real change is possible.

If you are a student interested in attending Engage next year, or are interested in being on the E-board of SACA, please feel free to email me at christinasweiss@student.nuhs.edu!

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