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Functional cranial release treatment (FCR) - newly renamed as Functional Cranial Neurology (FCN) is a non-surgical neurological treatment produced by Dr. John Lieurance. FCR is classified as chiropractic procedure1. that involves the usage of three basic techniques which includes, endonasal balloon inflation, eye movement exercises, and gentle muscle manipulation techniques. FCR is designed to improve neurological function and restore normal oxygen and blood flow with in the brain region by correcting the position of the cranium bones2. This cranium bone structure consists of eight bones located in the scalp which are ethmoid, sphenoid, frontal, occipital, the two parietal, and the two temporal bones3. The maintenance of the cranium bones in the right structure is very critical for health and well-being as the misalignments of this structure could exert excess pressure on the brain, causes headaches, and raises the possibility of the occurrence related health problems such as sinus, dizziness and prospectively alters the skeletal alignment of other body parts such as the neck and lower back2.

Etymology
The etymology of functional cranial release treatment was drowned from its primary influence on cranial bones with in the brain area. The term (release) comes from its primary goal of releasing restrictions of connective tissues in between to promote better blood circulation and oxygenation around the brain and central nervous system2.

History, development and conceptual basis
Cranial bones mobility approach was first bought to the attention of the medical field by a physician named William Sutherland in the 19th Century4. Sutherland proposed five essential elements known as the primary perspiratory mechanism that explains fundamental human body actions which are the inheritance of brain and spinal cord mobility, cerebral-spinal fluid fluctuation, intracranial and spinal membranes motility, skull bones mobility and involuntary and sacral movement that occur between the ilia2. Many types of cranial manipulation therapies have emerged based on Dr. William work such as craniosacral therapy (CST), cranial osteopathy, neuro cranial restructuring (NCR) and functional cranial release treatment (FCR). These therapies share similar actions represented in applying rhythmic movements in order to release pressure to facilitate blood and oxygen movement. Functional cranial release treatment was developed recently by Dr. John Lieurance who was also influenced by Dr. Westin Price’s work concerning environmental factors affecting the cranial structural organization. In addition, Dr. John was encouraged to seek further research and worked on cranium chiropractic techniques development after observing good results related to endonasal balloon therapy which reportedly improved breathing and vision5.

Cranial bones structural change and mobility
The possible movability of cranium bones is still highly questioned with the medical field. Theories concerned with reasons behind cranium mobility was highlighted through modern studies such as the evolutionary theory of facial structures collapses. This theory argues that the human brain gets smaller over time. Nowadays, humans scalp structure shows congestion and lack of space for wisdom teeth’s to fit within the skull resulting in teeth crowding and alterations in the facial structure which in turn leads to limited ionization and oxygenation of the brain6. Research in to this kind of movement produced mixed findings, Several studies argued in favor of potential cranium mobility for example, Heifetz and Weiss (1981) documented an expansion of the head bones due to inner cranial pressure in comatose patient sample using strain gauge tool7. Moreover, Oleski and Smith (2002) reported significant changes of cranial bones after therapeutic manipulation8.

Assessments prior to functional cranial release treatment
The diagnosis of cranial misalignment is assessed based on the acquired physical and neurological, psychological conditions. In addition, a serious of non-invasive neurological testes is done to evaluated the brain and nervous system state such as, balance and eye movement testes9.

Functional cranial release treatment methodology
FCR treatment methods are by far non-invasive and gentle in nature as it is done with minimum discomfort and do not take long time. In fact, patients statements reveled fast symptoms relief from the first session. In addition, patients have also reported feelings of relaxation, clarity, and balance5. There are three main methods used in FCR treatment.

The first FCR technique involve endonasal balloon adjustment
This technique is used to organize and modify the interior cranial bones into alignment. Before the procedure, certain palpation and neurological tests are done to establish the location of restriction (subluxation). The procedure involves inserting a small balloon into a specific location in the nasal cavity and slowly inflating it. This produces pressure that realigns the spheroid bone into a proper position hence reinstating to the nervous system its correct cranial-sacral rhythm and neural tone 10. The fact that there is a specific location where a small cot is positioned makes this procedure relatively quick. This procedure is the most direct acting part of the FCR therapy.

The second FCR technique involve a set of eye exercises
This technique includes several eye rotations that promote an individual to create new pathways within the nervous systems and improve the health of their brain, just as much as the entire nervous system9.

The third FCR technique involve neuro-musculoskeletal work
This technique includes stretching and pending of certain areas of the body such as head, legs and hands flipping in order to release muscle tightness and stimulate the peripheral nervous system2. Some therapists supplement FCR with spinal adjustments and Sacro-optical technique only as required1.as well as teaching patients some gentle head massaging methods11.

Functional cranial release treatment goals and areas
FCR treatment can be used to treat various pathologies including both physical and physiological conditions.

Physical conditions treated with FCR
FCR Influence the physical health through balancing the brain and nervous system in a way that allows the body to heal itself .FCR manages the source of symptoms rather than simply removing the symptoms which may occur again. Many related conditions were treated using this technique that range from sever ones such as fibromyalgia, Meniere’s, traumatic brain injury, chronic pain, migraines and storke to less severe ones such as vertigo, sinuses, sleep apnea or even snoring. In addition, FCR reportedly increases the body ability to fight infections9,releases neck pain, correct dental misalignments and have improved to a large extent the state of some neurological disorders such as Parkinson’s, multiple scleroses and Alzheimer’s2.

Psychological conditions treated with FCR
FCR influence on psychological health is mediated by restoring brain health12 due to the fact that the state of the brain is very critical in determining the psychological state as every part is responsible for certain neurological, cognitive, social or behavior aspect. Therefore, healthy brain lead to better psychological health represented. For example, in better memory, thinking, perception, and healthy balanced respond to stress9. FCR treatment has revealed good results in treating different types of stress, panic attacks, anxiety, and emotional instability as reported from patients5.

Functional cranial release treatment safety and risks
FCR is generally safe if performed by a well-trained doctor. However, not all patients are suitable for the treatment. Thus, prior screening questions and testing are necessary. Furthermore, the experience of the endonasal balloon adjustment is temporarily uncomfortable as before the release within the brain area occurs, a large amounts of pressure accumulate in the nose. However, it takes less than ten seconds for the discomfort to recede after the adjustment is done. The adjustment process is done gradually starting with mild pressure2.

Scientific reception and criticism
It has been shown that cranial manipulation based therapies could relieve tension and stress symptoms. Nevertheless, much of the available scientific evidence are not in line with the claims that cranial manipulation based therapies can be used to treat cancer and other probable diseases. Some researchers have carried out a systematic assessment of randomized craniosacral therapy clinical trials and established that the cranial manipulation based therapies are not based on clinical trials. Overall, evidence that seems to support the efficiency and effectiveness of FCR are scares and do not demonstrate any biological mechanisms that are plausible. Attributed to the lack of proper, well-designed randomized regulated trails, the procedure is featured with pseudoscience, and may arguably be right to be considered charlatanism13