Understanding sensorimotor adaptation and learning for rehabilitation

PURPOSE OF REVIEW: Understanding the behavioral mechanisms of sensorimotor adaptation and learning is essential for designing rational rehabilitation interventions. RECENT FINDINGS: Adaptation is the trial-and-error process of adjusting movement to new demands and is now thought to be more than a simple error cancellation process. Instead, it may calibrate the brain's prediction of how the body will move and takes into account costs associated with the new task demand. Damage of the cerebellum systematically disrupts adaptation, but damage to other brain regions often does not. Adapting to perturbations driven by a device like a robot or a treadmill leads to only partial generalization to unconstrained 'real-world' movements. Repeated adaptation can lead to learning a new motor calibration, but process of consolidation of this type of learning is less understood in patients. SUMMARY: Adaptation is inherently important for rehabilitation by making movement flexible, but can also be used to ascertain whether some patients can generate a more normal motor pattern. Repeated adaptation can lead to learning of a new, more permanent motor calibration. Though less understood, this type of learning is likely to be an important method for making long-term improvements in patients' movement patterns.