**Conflict of interest**

*Therapy Approaches in Neurological Disorders*

appropriate patients.

nervous system function.

of thoracic hyper-kyphosis [11] and FHP [12–16, 78, 79] has been found in RCT's to result in improved neurophysiological measurements. Finally, clinical management and improvement of several complex neurological disorders have been documented in multiple case reports where spine correction was suggested to be the important variable which improved the patient's neurophysiological disorder [17–25]. Thus, considering the facts that biomechanics studies, randomized trials, and case reports all point to the same finding, clinically and scientifically one would need to concede that improved neurophysiology following correction of the abnormal spine towards normal values is an evidence-based and logical approach to pursue with

Similarly, the known intimate connections between afferent input (from the proprioceptive, visual and vestibular systems) and stable upright postures of the head and neck [28] and the fact that there exists a plethora of mechanoreceptors in the cervical spine soft tissues providing necessary neurophysiological input in a feed forward and feedback system provides a strong fundamental physiological basis for the concept that altered spine alignment can have a profound effect on sensorimotor control via connections to the vestibular, visual and central nervous systems [29]. Furthermore, and as explicitly stated in the introduction to this chapter, a complex network of neurophysiological connections between cervical spine mechanoreceptors and the sympathetic nervous system exists [30–32]. This information coupled with the findings of both case control investigations [34] and randomized trials [10, 11, 63, 79] provides strong clinical evidence that restoring normal sagittal plane posture and cervical spine alignment is important for a better afferentation process, improved sensorimotor control, and improved autonomic

Clinically, the astute reader should recognize the need to radiographically assess the full spine alignment, in particular the sagittal plane, to identify if a patient is a candidate and in need of true spine correction; that is, structural rehabilitation of the spine and posture. A comparison of the patient's spine and posture should be made against tested normal alignment values such as the Harrison full spine model and posture displacement models discussed herein. Furthermore, the addition of fundamental neurophysiological testing and the basic parts of sensorimotor control measurements should be considered as important assessments during patient evaluations. Once an indication for corrective care has been identified, the clinical administration of specific spine mirror image corrective exercises and extension traction methods should be employed. Previously, we have discussed the techniques, indications and contraindications, timing of, and applications for several known spine corrective methods and the clinician should be willing to add these to their armamentarium for patient care; we refer the reader to this source [35]. Adding the goal and methods of true spine correction to the clinical outcomes of patient care should not be foreign, it should not be in disregard to traditional strength and functional conditioning; it should simply be part of the basic, fundamental treatment approach for abnormalities of the human frame in the effort to

improve a variety of spine related and neurophysiological disorders.

This chapter has explored the hypothesis and evidence that restoring normal posture and spine alignment has important influences on neurophysiology, sensorimotor control and autonomic nervous system functionality. There is limited but high-quality research identifying that sagittal spine alignment restoration plays an important role in improving neurophysiology, sensorimotor control, and autonomic

**66**

**7. Conclusion**

PAO is a paid consultant to CBP; DEH teaches spine rehabilitation methods and sells products related to the treatment of spine deformities. IMM has nothing to declare.
