A minimally invasive transpiriformis approach versus the conventional posterolateral approach in total hip arthroplasty for elderly femoral neck fractures: perioperative blood loss and early functiona

Stroke recovery involves multiple neurobiological mechanisms, including reversal of diaschisis, reorganization of surviving pathways, and formation of new synapses via neuroplasticity []. There are two forms of plasticity that are essential to this process: Hebbian plasticity, which involves activity-dependent strengthening or weakening of synapses via long-term potentiation (LTP) and depression, and homeostatic plasticity, which maintains overall network stability. Together, they support functional reorganization following injury []. Task-specific, repetitive rehabilitation leverages Hebbian plasticity by reinforcing active neural pathways through repeated use, while homeostatic mechanisms ensure network stability during this reorganization process. Intensive, task-specific rehabilitation harnesses these mechanisms to promote experience-dependent plasticity and restore motor function []. According to animal and human studies, repetitive, goal-directed practice consistently improves motor performance after stroke []. However, despite these benefits, conventional rehabilitation alone is often insufficient for achieving optimal recovery, with outcomes widely varying across individuals. This has led to the development of adjunctive approaches, including robotic technology, pharmacological agents, noninvasive brain stimulation (NIBS), and stem cell-based therapies. Although these strategies aim to enhance neuroplasticity, their clinical efficacy remains inconsistent. Moreover, the criteria for selecting appropriate patients for a specific treatment are often unclear. In this review, we outline the biological foundation of poststroke plasticity and examine how conventional and emerging rehabilitation strategies can be used to optimize stroke recovery.