| Cerebral Palsy (CP) is an umbrella term which most | | | | plausible mechanism of remediation through the use |
| commonly refers to subcortical brain damage before | | | | of a dynamic brace which gives some level of |
| the age of 2 years old. The most common | | | | support, but also challenges the individual to make |
| presentation involves initial flaccidity followed by | | | | attempts to support an upright posture. Compression |
| spasticity of the muscles of wrist and ankle flexors, | | | | braces as well as Elastic tension braces, such as |
| and shoulder and hip adductors. | | | | Spinecor, provide a model for a neuromuscular |
| Agonistic/antagonistic muscle imbalances result in a | | | | rehabilitation brace for the use in Cerebral Palsy. |
| significantly higher prevalence of thoracolumbar | | | | Functional Map Expansion offers another mechanism |
| scoliosis in CP. Attempts at surgical and non-surgical | | | | of neuroplasticity which can be exploited in treating |
| management have failed to exploit the opportunity | | | | the causes of neuromuscular scoliosis. Through |
| to utilized postural therapy as a means towards | | | | passive repetitive activation of ascending pathways, |
| neurorehabilitaiton. Neuroplastic changes have been | | | | healthy areas of the brain can expand and replace |
| reported following courses of sensorimotor | | | | areas which have lost function. This is similar to cross |
| stimulations. Treatment of neuromuscular scoliosis | | | | model adoption which involves the phenomenon of |
| through the use of assisted corrective movement, | | | | competing sensory perceptions, such as the |
| constraint induced movement therapy, | | | | competing senses of vestibular and somatosensory |
| somatosensory and vestibulospinal activations, may | | | | function. Vestibular activation of extensor tone may |
| successfully remediate neuronal functional losses | | | | serve to replace gravitational activation of flaccid |
| associated with CP. | | | | muscle spindles and golgi tendon organ dysfunction. |
| Neuroplasticity is considered to be fractionated in | | | | Activation of intact brain regions during postural |
| four categories, Compensatory Masquerade, | | | | realignment may provide a portal to exploit |
| Functional Map Enlargement, Cross Model | | | | Homologous Region Adoption. This may occur in |
| Reassignment, and Homologous Region Adoption. | | | | adjacent or opposing regions of the brain. The |
| In the case of Compensatory Masquerade, brain | | | | concept of multimodal sensory stimulation during |
| injured individuals may experience remediation of a | | | | attempted postural correction has been utilized in |
| specific skill through compensatory neuronal | | | | neurorehabilitation associated with balance disorders, |
| reorganization of non-injured brain regions. Changes in | | | | and may serve as a model of therapy in the CP |
| neurological organization are driven by changes in | | | | population. |
| demand, in other words, when treating neuromuscular | | | | In my experience, postural retraining using corrective |
| scoliosis in CP, if a supportive brace is utilized without | | | | movement mobilization, vestibular activation and the |
| putting additional demands on the musculoskeletal | | | | flexible spinecor brace is a promising approach to |
| system, no remediation could be expected. However, | | | | neurological remediation following brain injury in |
| the concept of Compensatory Masquerade is a | | | | conditions of Cerebral Palsy. |