The goal of treatment for motor impairment is not to “normalize” but to “functionalize” through facilitative modulation and enabling context

Abstract

AbstractAdaptations occurring in the central nervous system (CNS) in the presence of pathology arenotuniformly “good” for the organism when viewed in a functional context. A functional reordering of CNS priorities can be produced by allowing restructuring of the external context or through modification of neuromuscular physiology or anatomy designed to reduce the inherent restriction of functional movement in upper motor neuron syndrome. In fact, volitional control can often be “unmasked” through such interventions. Therapeutic interventions should not be directed toward “normalization” of motor patterns but should permit a functional reordering of CNS priorities that would otherwise not be possible.