Motor learning principles for neurorehabilitation

Tomoko Kitago, John Krakauer

Research output: Contribution to journalArticle

Abstract

Neurorehabilitation is based on the assumption that motor learning contributes to motor recovery after injury. However, little is known about how learning itself is affected by brain injury, how learning mechanisms interact with spontaneous biological recovery, and how best to incorporate learning principles into rehabilitation training protocols. Here we distinguish between two types of motor learning, adaptation and skill acquisition, and discuss how they relate to neurorehabilitation. Functional recovery can occur through resolution of impairment (reacquisition of premorbid movement patterns) and through compensation (use of alternative movements or effectors to accomplish the same goal); both these forms of recovery respond to training protocols. The emphasis in current neurorehabilitation practice is on the rapid establishment of independence in activities of daily living through compensatory strategies, rather than on the reduction of impairment. Animal models, however, show that after focal ischemic damage there is a brief, approximately 3-4-week, window of heightened plasticity, which in combination with training protocols leads to large gains in motor function. Analogously, almost all recovery from impairment in humans occurs in the first 3 months after stroke, which suggests that targeting impairment in this time-window with intense motor learning protocols could lead to gains in function that are comparable in terms of effect size to those seen in animal models.

Original languageEnglish (US)
Pages (from-to)93-103
Number of pages11
JournalHandbook of Clinical Neurology
Volume110
DOIs
StatePublished - 2013
Externally publishedYes

Fingerprint

Learning
Animal Models
Activities of Daily Living
Brain Injuries
Neurological Rehabilitation
Rehabilitation
Stroke
Wounds and Injuries

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Motor learning principles for neurorehabilitation. / Kitago, Tomoko; Krakauer, John.

In: Handbook of Clinical Neurology, Vol. 110, 2013, p. 93-103.

Research output: Contribution to journalArticle

@article{4d37354d66f6473ba7c2da6fa62ff23c,
title = "Motor learning principles for neurorehabilitation",
abstract = "Neurorehabilitation is based on the assumption that motor learning contributes to motor recovery after injury. However, little is known about how learning itself is affected by brain injury, how learning mechanisms interact with spontaneous biological recovery, and how best to incorporate learning principles into rehabilitation training protocols. Here we distinguish between two types of motor learning, adaptation and skill acquisition, and discuss how they relate to neurorehabilitation. Functional recovery can occur through resolution of impairment (reacquisition of premorbid movement patterns) and through compensation (use of alternative movements or effectors to accomplish the same goal); both these forms of recovery respond to training protocols. The emphasis in current neurorehabilitation practice is on the rapid establishment of independence in activities of daily living through compensatory strategies, rather than on the reduction of impairment. Animal models, however, show that after focal ischemic damage there is a brief, approximately 3-4-week, window of heightened plasticity, which in combination with training protocols leads to large gains in motor function. Analogously, almost all recovery from impairment in humans occurs in the first 3 months after stroke, which suggests that targeting impairment in this time-window with intense motor learning protocols could lead to gains in function that are comparable in terms of effect size to those seen in animal models.",
author = "Tomoko Kitago and John Krakauer",
year = "2013",
doi = "10.1016/B978-0-444-52901-5.00008-3",
language = "English (US)",
volume = "110",
pages = "93--103",
journal = "Handbook of Clinical Neurology",
issn = "0072-9752",
publisher = "Elsevier",

}

TY - JOUR

T1 - Motor learning principles for neurorehabilitation

AU - Kitago, Tomoko

AU - Krakauer, John

PY - 2013

Y1 - 2013

N2 - Neurorehabilitation is based on the assumption that motor learning contributes to motor recovery after injury. However, little is known about how learning itself is affected by brain injury, how learning mechanisms interact with spontaneous biological recovery, and how best to incorporate learning principles into rehabilitation training protocols. Here we distinguish between two types of motor learning, adaptation and skill acquisition, and discuss how they relate to neurorehabilitation. Functional recovery can occur through resolution of impairment (reacquisition of premorbid movement patterns) and through compensation (use of alternative movements or effectors to accomplish the same goal); both these forms of recovery respond to training protocols. The emphasis in current neurorehabilitation practice is on the rapid establishment of independence in activities of daily living through compensatory strategies, rather than on the reduction of impairment. Animal models, however, show that after focal ischemic damage there is a brief, approximately 3-4-week, window of heightened plasticity, which in combination with training protocols leads to large gains in motor function. Analogously, almost all recovery from impairment in humans occurs in the first 3 months after stroke, which suggests that targeting impairment in this time-window with intense motor learning protocols could lead to gains in function that are comparable in terms of effect size to those seen in animal models.

AB - Neurorehabilitation is based on the assumption that motor learning contributes to motor recovery after injury. However, little is known about how learning itself is affected by brain injury, how learning mechanisms interact with spontaneous biological recovery, and how best to incorporate learning principles into rehabilitation training protocols. Here we distinguish between two types of motor learning, adaptation and skill acquisition, and discuss how they relate to neurorehabilitation. Functional recovery can occur through resolution of impairment (reacquisition of premorbid movement patterns) and through compensation (use of alternative movements or effectors to accomplish the same goal); both these forms of recovery respond to training protocols. The emphasis in current neurorehabilitation practice is on the rapid establishment of independence in activities of daily living through compensatory strategies, rather than on the reduction of impairment. Animal models, however, show that after focal ischemic damage there is a brief, approximately 3-4-week, window of heightened plasticity, which in combination with training protocols leads to large gains in motor function. Analogously, almost all recovery from impairment in humans occurs in the first 3 months after stroke, which suggests that targeting impairment in this time-window with intense motor learning protocols could lead to gains in function that are comparable in terms of effect size to those seen in animal models.

UR - http://www.scopus.com/inward/record.url?scp=84872331621&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84872331621&partnerID=8YFLogxK

U2 - 10.1016/B978-0-444-52901-5.00008-3

DO - 10.1016/B978-0-444-52901-5.00008-3

M3 - Article

VL - 110

SP - 93

EP - 103

JO - Handbook of Clinical Neurology

JF - Handbook of Clinical Neurology

SN - 0072-9752

ER -