The NeuroGym® approach to physical therapy for individuals with neurological injuries/conditions was developed through a synthesis of research findings in human motor learning and motor control, biomechanics, physiology of exercise, and rehabilitation medicine. Historically, one of the most widely used approaches to physical rehabilitation in neurologic populations has been the Neurodevelopmental (NDT) or Bobath approach that was based on a reflex-hierarchical theory. More recently, research in the movement sciences relating to how motor skills are acquired, how such skills are 'represented' in the brain and how motor skill learning can be enhanced, has resulted in a number of current models of human motor control (e.g. neural networks, coordinative structures or synergies, action plans or motor programs). Despite differences between these various models, one commonality is that the individual is viewed as an active participant in the learning process.

At the same time as movement scientists have been enhancing our knowledge about how motor skills are acquired, researchers studying brain plasticity have also been providing increasing evidence that the brain is capable of much greater recovery following damage than had been previously thought - even many years post-acute. While these advances in theoretical research in both movement science and brain plasticity were and continue to be significant, the implications of these findings have been slower to impact on clinical practice.

The NeuroGym® concept was developed as a practical implementation of research findings relating to such important rehabilitation issues as motor skill learning, brain plasticity and muscle physiology. To be most successful in achieving this aim, new therapeutic techniques and tools were developed to help better enable the motor re-learning process. For example, highly interactive and speed-sensitive EMG and Balance Biofeedback systems were created to allow for more intensive and effective motor retraining. These unique tools and techniques were designed to be equally as effective for an individual with extremely limited motor control (such as following brain or spinal cord injury), as for a child who wishes to improve 'clumsy' motor abilities or for an athlete recovering from knee or ankle injury.

The clinical efficacy of an active, motor learning-based approach to neurological physical rehabilitation, even in individuals many years post-acute, is accumulating rapidly. The interested reader is directed to the list of peer-reviewed journal references provided below. A number of researchers are examining not only the clinical use of emerging data from the movement sciences (e.g. Langhammer, B. & Stanghelle, JK, 2000), but also the evidence base (or lack of evidence) of traditional approaches to neurorehabilitation (e.g. Lennon, S., 2001).

Sample Articles/Letters of Relevance to a Movement Learning Approach

Bohannon, R.W., Integrating movement science and physical therapy, Letter to the Editor, Phys. Ther., 71, 344, 1991.

Carr J.H. and Shepherd R.A., A motor learning model for rehabilitation, in Movement Science: Foundations for Physical Therapy in Rehabilitation. Aspen Publishers, Rockville, MD, 1087, 31.

Edwards, S. Neurological Physiotherapy, 2^nd Edition; A Problem-Solving Approach. Churchill Livingston, 2001.

Horak, F. Assumptions underlying motor control for neurologic rehabilitation. In: Lister MJ ed. Contemporary management of motor control problems. Alexandria, VA. Foundations for Physical Therapy, 1991, 11-27.

Langhammer, B. & Stanghelle, JK. Bobath or Motor Relearning Progamme? A comparison of two different approaches of physiotherapy in stroke rehabilitation: a randomized controlled study. Clinical Rehabilitation, 2000, 14: 361-369.

Lennon, S. Gait Re-education based on the Bobath Concept in two patients with hemiplgia Following Stroke. Physical Therapy 2001, 81(2): 924-935.

Mulder, T. The Learning of Motor Control Following Brain Damage: Experimental and Clinical Studies. Swets North America, Berwyn, PA 1985.

Nativ, A. Kinesiological Issues in Motor Retraining Following Brain Trauma. Critical Reviews in Physical and Rehabilitation Medicine, 1993, 5(3): 227-246.