The first part of this chapter discussed some of the basic
principles of motor learning derived from laboratory
studies in healthy subjects. Neurorehabilitation is based
on the assumption that these motor learning principles
can be applied to motor recovery after injury, and that
training can lead to permanent improvements in motor
function in patients with motor deficits (Krakauer,
2006). Several key issues must be addressed in the development
of rehabilitation interventions based on motor
learning principles. First, it is still unclear whether and
to what extent motor learning mechanisms themselves
may be impaired in patients. Second, the goals of rehabilitation
should be clarified with respect to recovery of
impairment versus functional compensation, as learning
may make differential contributions to these two processes.
Third, it is necessary to consider which type(s)
of motor learning are most relevant to patients. Finally,
it needs to be appreciated that recovery is not synonymous
with motor learning; endogenous processes triggered by
ischemia can themselves lead to recovery (Murphy and
Corbett, 2009). The interaction between learning and
spontaneous biological recovery is only beginning to be
investigated (Biernaskie et al., 2004; Carmichael, 2010).