Neuroplasticity,also known as brain plasticity,refers to the brain tissue's ability to be repaired to reorganized and to create new connections among the nerve cells.It implies that the location of a given function in the brain (for example,certain area in the motor cortex) can displace to another area of the cortex.This transfer ability can be accomplished by sensory motor feedback training.In the case of cerebral palsy (CP) and stroke,neuroplasticity relates to unaffected nerve cells and new synaptogenesis process taking over the functions of damaged nerve cells and their connections.The aim of this overview is to explain how does neuroplasticity work and how intensive sensory motor feedback training can reorganize nerve cells.Although neurorehabilitation offers a series of therapies from the psychological to occupational,speech,teaching or re-training patients on mobility skills,this overview focuses on physical rehabilitation using a comprehensive feedback system to accelerate brain recovery.

STUDY DESIGN: Randomized controlled single-blinded clinical trial. PURPOSE: To evaluate the efficacy of Schroth therapy on thoracic curve angle, pain, and self-perceived body image (SPBI) of the back in Scheuermann's patients in comparison with the efficacy of classic anti-gravitation exercises. OVERVIEW OF LITERATURE: Scheuermann disease is the most common cause of hyperkyphosis of the thoracic and thoracolumbar spine during adolescence. However, very few studies evaluated the effect of exercises on the progression of kyphosis in Scheuermann patients. Schroth three-dimensional exercise therapy was found in several studies to be effective in the treatment of adolescent scoliosis; however, we found no randomized controlled trials that evaluated the efficacy of this method in Scheuermann patients. METHODS: A total of 50 young adults (males and females) with Scheuermann's disease were randomly divided into either the experimental group (Schroth therapy treatment, n=25) or the control group (classic anti-gravitation exercises, n=25). Participants in both the groups were provided a course of individual treatment sessions during few weeks, with one appointment per week. They were required to perform the exercises daily throughout the study period (12 months) and fill their performance in a research log. We evaluated the thoracic Cobb angle (main outcome measure), pain, SPBI, flexion of the shoulder (supine), flexion of the shoulder (standing), kyphotic deformity measured using inclinometer, and L5 kyphosis apex line (L5-KAL) as well as administered the Scoliosis Research Society-22 Questionnaire for the participants before the treatment, after 6 months, and 1 year postoperatively. These results were then compared. RESULTS: In the mixed analysis of variance, the main effect of time was significant in the thoracic kyphosis (F [1]=5.72, p=0.02), and in the L5-KAL (F [1]=5.76, p=0.02). The main effect of time on the kyphotic deformity, measured using an inclinometer, did not reach the significance level; however, it showed the tendency (F [1]=2.80, p=0.07). In the group-by-time interaction, a significant difference was found in the thoracic kyphosis (F [1]=4.91, p=0.03) and in the kyphotic deformity, measured using an inclinometer (F [1]=4.05, p=0.02). Thus, the Schroth therapy group showed significantly greater improvement than the classic anti-gravitation exercises group. CONCLUSIONS: The present findings indicate that back exercises in general, and Schroth therapy in particular, is an effective treatment for preventing and significantly improving the thoracic Cobb angle and symptomatic representation in Scheuermann's patients.
Adolescent ; Body Image ; Congenital Abnormalities ; Exercise ; Exercise Therapy ; Humans ; Kyphosis ; Methods ; Physical Therapy Modalities ; Posture ; Quality of Life ; Randomized Controlled Trials as Topic ; Scheuermann Disease ; Scoliosis ; Shoulder ; Spine ; Young Adult

Methods: In the cross-sectional segment, 150 initial lateral X-rays of patients with Scheuermann’s disease and postural kyphosis were analyzed, and 80 additional X-rays were analyzed in the follow-up segment. The data taken from the X-rays of the whole spinal column included the thoracic kyphosis angle, the C7 plumb line, and the L5-KAL. Clinical data included a numerical rating scale of self-perceived body image, pain, and a Scoliosis Research Society-22 questionnaire (SRS-22). Results: Significant positive associations were observed in a cross-sectional study between the L5-KAL and thoracic kyphosis, lumbar lordosis, C7 line, and self-perceived body image. In the follow-up nested study, in a mixed analysis of variance, the main effect of time was significant for the L5-KAL, kyphotic deformity and SRS-22, which indicated a change in these parameters after treatment of Scheuermann’s disease patients. Significant positive associations were observed between the changes in L5-KAL and the changes in thoracic kyphosis. Conclusions Our evidence suggests that the L5-KAL can serve as an indicator of the thoracic curve change in Scheuermann’s disease and postural kyphosis patients and should be considered in clinical practice.