PREFRONTAL CORTICAL REORGANIZATION DURING THERAPEUTIC GAIT IN ADOLESCENT IDIOPATHIC SCOLIOSIS
IRSSD &ScoSym2026, Novi-Sad, Sırbistan, 18 - 21 Haziran 2026, (Yayınlanmadı)
- Yayın Türü: Bildiri / Yayınlanmadı
- Basıldığı Şehir: Novi-Sad
- Basıldığı Ülke: Sırbistan
- Akdeniz Üniversitesi Adresli: Evet
Özet
PREFRONTAL CORTICAL REORGANIZATION DURING THERAPEUTIC GAIT IN ADOLESCENT IDIOPATHIC SCOLIOSIS
Authors: Tombak Kadriye1, SUZEN Esra2, SIMSEK Buket2, COLAK Omer Halil2, OZEN Institution: ¹Akdeniz University Faculty of Health Sciences, Antalya, TURKEY
2 Akdeniz University, NeuroscienceLab, Faculty of Engineering, Department of Electrical and Electronics Engineering, Antalya, TURKEY
INTRODUCTION Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity affecting 0.5–5% of the adolescent population and is associated with postural instability and motor control impairments. Recent evidence suggests that AIS involves neurophysiological reorganization within the central nervous system. The prefrontal cortex (PFC) plays a crucial role in planning gait strategies and integrating sensory information for postural control. This study aims to quantitatively evaluate PFC activity during Schroth walking in adolescents with AIS using functional near-infrared spectroscopy (fNIRS) to provide insights into neuroplastic adaptation mechanisms.
METHODS In this cross-sectional study, 15 adolescents with AIS and 16 healthy controls participated. Cortical activity was recorded using a portable fNIRS system (22 channels covering BA 9, 10, 11, 46) while participants performed "Schroth walking" on a 12m straight path under therapeutic cues (elongation, derotation, and rhythmic breathing). Raw data were processed using HOMER3 and converted to oxygenated (HbO) and deoxygenated hemoglobin (HbR) concentrations via the modified Beer-Lambert law. Differences in HbO concentrations between groups were analyzed using Independent Samples t-test (α=0.05).
RESULTS A statistically significant difference in HbO was found in channel 12 (left medial superior frontal gyrus; BA9/10) between the AIS and control groups (p < 0.05). In the AIS group, an increase in HbO levels was observed in the left medial superior frontal gyrus, right dorsolateral PFC (DLPFC), and anterior cingulate cortex (channels 7, 11, 17, 19). Conversely, a decreasing trend in HbO was identified around the left DLPFC (channel 6). No significant differences were found in the remaining channels.
DISCUSSION AND CONCLUSION The findings indicate a lateralized and compensatory reorganization of frontal cortical networks in AIS patients during dynamic postural tasks. The significant HbO increase in the left medial SFG suggests that gait in AIS requires enhanced cognitive-motor integration and internal monitoring to maintain stability. This topographic pattern reflects a shift in functional load distribution to maintain postural control. These results support fNIRS as a sensitive tool for monitoring neurophysiological responses during rehabilitation. Further longitudinal studies are needed to determine if these immediate neurocortical adaptations transition into long-term neuroplastic changes following Schroth-based interventions.