Motor Learning, a Key Feature of Physiotherapy, an Essential Component in (PNF-Based) Neuro-Rehabilitation after Stroke - Abstract
Introduction: The amount of strokes is gradually increasing in the world, for instance in Europe the predictions are an increase of about 27 percent within
the next 5 years. This will also increase the costs for society for therapy and rehabilitation. Hemiplegia is the main result of a stroke, hindering the people with
a stroke to execute daily activities in a satisfying way. Guidelines for physiotherapy and rehabilitation point besides general therapy to motor learning as a
main component of recommended therapy. The question arises what types of motor learning strategies should be considered. Therefore this informative paper
is providing an overview and suggestions for possible clinical use. All based upon relevant literature.
Major findings: Motor learning is a process of acquiring the capacity for skilled action, practice and functional task training needs to be part of the provided
interventions. Physiotherapist need to use a clinical reasoning approach in regard of ICF categories, activity limitations and underlying impairments. Secondly,
biomechanical components need to be considered. These components are described and translated into physiotherapy and rehabilitation approaches with the
use of over ten possible strategies. The various principles and strategies addressing motor learning are summarized and the possible effects on reorganization
of the nervous system and alterations in neural drive are indicated. Specifically the motor learning approach within the PNF-concept is signalized. Finally two
cases are described to illustrate the application of PNF-based motor learning interventions.
Conclusion: A variety of motor learning principles and strategies are based upon evidence in clinical situations. The evidence is a demonstrating neural
drive alternations. A sound clinical reasoning is required for physiotherapists. There are indications for the PNF-concept to be within the guidelines for stroke
rehabilitation.