Motor learning in neurological rehabilitation.

Abstract

While most upper limb training interventions in neurological rehabilitation are based on established principles of motor learning and neural plasticity, recovery potential may be improved if the focus includes remediating an individual's specific motor impairment within the framework of a motor control theory. This paper reviews current theories of motor control and motor learning and describes how they can be incorporated into training programs to enhance sensorimotor recovery in patients with neurological lesions. An emphasis is placed on dynamical systems theory and the use of new technologies such as virtual, augmented and mixed reality applications for rehabilitation to facilitate learning.Implications for RehabilitationKinematic abundance allows the healthy nervous system to produce different combinations of joint rotations to perform a desired task.The structure of practice to improve the movement repertoire in rehabilitation should take into account the kinematic abundance of the system.Learning can be enhanced by varied practice with feedback about key movement elements.Virtual reality environments provide opportunities to manipulate the structure and schedule of practice and feedback.