Infusing motor learning research into neurorehabilitation practice: a historical perspective with case exemplar from the accelerated skill acquisition program.
: This special interest article provides a historical framework with a contemporary case example that traces the infusion of the science of motor learning into neurorehabilitation practice. The revolution in neuroscience provided the first evidence for learning-dependent neuroplasticity and presaged the role of motor learning as critical for restorative therapies after stroke. The scientific underpinnings of motor learning have continued to evolve from a dominance of cognitive or information processing perspectives to a blend with neural science and contemporary social-cognitive psychological science. Furthermore, advances in the science of behavior change have contributed insights into influences on sustainable and generalizable gains in motor skills and associated behaviors, including physical activity and other recovery-promoting habits. For neurorehabilitation, these insights have tremendous relevance for the therapist-patient interactions and relationships. We describe a principle-based intervention for neurorehabilitation termed the Accelerated Skill Acquisition Program that we developed. This approach emphasizes integration from a broad set of scientific lines of inquiry including the contemporary fields of motor learning, neuroscience, and the psychological science of behavior change. Three overlapping essential elements-skill acquisition, impairment mitigation, and motivational enhancements-are integrated.


BACKGROUND
(See Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A71) for more insights from the authors.
University of Southern California, Division of Biokinesiology and Physical Therapy (C.J.W., R.L.); Rancho Los Amigos National Rehabilitation Center Downey, CA (R.L.); Emory School of Medicine, Division of Physical Therapy Atlanta, GA (S.R.B., L.B.W.); and School of Rehabilitation Science, McMaster University, W. Hamilton, ON (L.W.).
Carolee
C
Winstein
Rebecca
R
Lewthwaite
Sarah R
SR
Blanton
Lois B
LB
Wolf
Laurie
L
Wishart
D035843:Biomedical Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology*; D009473:Neuronal Plasticity / Q000502:physiology; D026741:Physical Therapy Modalities; D011597:Psychomotor Performance / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation