CORTICO-SUBCORTICAL RELAY THEORY VERSUS CONVENTIONAL METHODS IN REHABILITATION MEDICINE


PURPOSE: This study compares a new protocol, the Cortico-subcortical Relay approach, in rehabilitation with the traditional concepts. The Cortico-subcortical Relay study identifies the neurological lesion but with a focus on pathway damage. Therapy involves deploying substitution pathways. Pathways are critically analysed to determine if their stimulation or inhibition is beneficial. Integrating the right pathway with proper stimulation methods is the key.

RELEVANCE: The Cortico-subcortical approach is specific to the individual patient in contrast to the general approach in traditional therapy. It is more correctly the designer approach in therapeutics. The difference in outcomes is highly significant both in the degree of recovery and the quickness of response. Although greater expertise is necessary to employ this approach, there are sufficient reasons to change from the older approach the new Cortico-subcortical concept globally.

DESCRIPTION: Cases are both neurological and orthopedic. Orthopedic appliances used cater to the stimulus approach rather than the conventional supportive aim alone. Thus it is a more neuro-orthopedic angle with dynamic orthoses. It has been analysed from the neuro-anatomical perspective with future rehabilitation methodology in mind. Various cases are presented to support the above theory.

OBSERVATIONS: The immediate response and the quick and effective results indicate that the affected pathway has been targeted correctly and the bypass or parallel pathway found is effective in bringing about functional recovery. CONCLUSIONS: Thus the
cortico-subcortical relay theory proves its efficacy in rehabilitation mangement by showing that no two patients are identical, even with similar lesions and therefore use of identical therapeutic techniques is outdated and ineffective. Thus a tailor-made approach is more suitable to bring about the desired results.The use of neuroanatomical pathways repeatedly in mangement the author owes to Alf Brodal.


This above study and clinical application of the same is the future horizon, India in the World. A number of short-term and year long courses in this direction have already proved the efficacy and popularity in India and abroad and thus the place if India in the scientific world.

A book on this subject titled “CSR Circle-a designor approach in musculoskeletal dysfunction” based on Cortico-subcortical relay studies – a neuroanatomical approach by Dr. Nandu Chhabria, P.T., Honorary Director Rehab Sciences, Sir H.N. Hospital and Research Centre, Mumbai India, paves a way for quality care a step ahead..