Similarly, some practice-related interventions may seem to retard or slow performance gains when present, seen, for example when tasks are ordered randomly. We now understand that some practice-related techniques such as drills and frequent feedback can have a performance-enhancing effect that boosts performance while available. The learning–performance distinction 1, 2 has relevance to physical therapy in that the concern is with the achievement of a sustainable or relatively permanent change in the capability for responding (learning) in contrast to a short-lasting temporary change (performance). Furthermore, we distinguish performance from learning. Throughout this special interest article, we use the terms skill acquisition and learning, synonymously. The science of motor learning itself continues to evolve, providing new insights into the optimization of skill learning and its application to the complex process of neurorehabilitation. Before the revolution in neuroscience, researchers in the field of motor learning had established a number of behavioral variables important for skill acquisition, chief among them-practice. In fact, this insight has heightened the relevance of the science of motor learning to physical therapist practice. Neuroscientific evidence over the past few decades, revealing the inherent plasticity of the brain (neuroplasticity) that allows new learning, adaptation, and compensation at multiple levels of the system from early development well into old age, has had profound implications for rehabilitation and recovery. Three overlapping essential elements-skill acquisition, impairment mitigation, and motivational enhancements-are integrated. 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. We describe a principle-based intervention for neurorehabilitation termed the Accelerated Skill Acquisition Program that we developed. For neurorehabilitation, these insights have tremendous relevance for the therapist–patient interactions and relationships. 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. ![]() ![]() ![]() 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. 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. 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.
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