A different approach...

There are several key factors for the success of this treatment modality in this specific group of patients.

The combination of these factors allows motor skills that patients had not previously experienced and despite their limitations may be possible to learn. 

Main factors

Motor Learning



Motor Learning

Which could be defined as: The process of acquiring a skill by which the learner, through practice and assimilation, refines and makes automatic the desired movement". or “A set of internal processes associated with practice or experience leading to relatively permanent changes in the capability for skilled behavior”.

Motor learning describes skills that are learned through practice; these skills do not emerge because of other factors such as neural maturation, passively imposed movements, or the integration of primitive reflexes. A more detailed definition of motor learning, also from Schmidt is, “a set of processes associated with practice or experience leading to relatively permanent changes in the capability for movement.” (Schmidt, 1999)

Schmidt highlights that the Variability of Practice Improve Motor Learning and also that the term known as Optimal Learning occurs when performing Task practiced under many different conditions.
Among patients with severe disabilities, simple functional motor skills are often lacking. In typically developing children, these motor skills emerge without specific training, although many of these skills can be learned through practice.  


Is defined as the capacity of neurons and neural networks in the brain to change their connections and behavior in response to new information, sensory stimulation, development, damage, or dysfunction.

Neuroplasticity is maintained through the life and depends on experience and motor learning that serve as the basis for modern approaches to the rehabilitation of people with neurological pathologies.

There are four main mechanisms described that make it possible to obtain significant functional modifications in the brain.


  • Compensation mechanism allows newly created paths that adjoin a damaged area to respond to the demands of the body caused by the loss of function in some other area. 

  • The expansion of the functional map, in which healthy cells that surround an injured area of the brain can change their function, and even their shape, so that they perform the tasks and transfer the signals that previously resolved the damaged neurons.

  • The Cross-Reassignment Model, that allows a specific type of sensory input to replace an injured one. 

  • The Adoption of the homologous region, that allows an entire brain area to take over functions from another distant area

One or more of these neuroplastic responses allow recovery, head injuries, brain diseases or cognitive disability.


Motivation is a basic psychological process, such as memory, learning, attention or perception. Along with emotion, it is considered an activating process. It activates and moves us to carry out behaviors and explains our behavior.

Motivation is created in the brain when dopamine is released and makes its way to an area of the brain called the "nucleus accumbens," which triggers feedback that predicts whether something good or bad is about to happen. This is the origin of behavior patterns.

When we intend to promote, modify or interrupt a behavior we have to motivate so that the behavior goes in one direction. This can be done with the principles of operant conditioning using a reinforcer that motivates the desired behavior.

Despite the fact that people with some type of brain damage can show because of the injury and it’s location, that the patient loses the ability to be interested or understand what we are working for (a term known as apathy). It is important to include in our treatments different aspects that can stimulate the motivation of the patient.

Even when we work with non-verbal patients and with lower cognitive levels, it is possible to find within our treatments how to incorporate reinforcers that motivate the patient, for example, music, a specific accessory of their liking or some activity that the patient wishes to learn within our treatment objectives.

Motivation becomes a primary factor and a very useful tool for the success of our rehabilitation treatment. 


  • Children with severe disabilities and the MOVE Curriculum Foundations of a Task- Oriented Therapy Approach.
    New York: Esopus Medical; 2005.

  • Schmidt RA, Lee TD (1999) Motor control and learning, 3rd edition.
    Human Kinetics, Champaign, IL, USA

  • Krakauer JW. Motor learning: its relevance to stroke recovery and neurorehabilitation.
    Curr Opin Neurol. 2006 Feb;19(1):84-90. doi: 10.1097/01.wco.0000200544.29915.cc. PMID: 16415682. 

  • Umphred's Neurological Rehabilitation. 7th edition.
    Umphred, Darcy A., St. Louis, Mo: Elsevier/Mosby, 2013.

  • Encyclopedia Britanica:

  •  Physical Rehabilitation, 5th edition,
    Susan B. O’Sullivan, Thomas J. Schmitz, 2013

My Journey To MOVE