Or how to (re)program the Brain by the Body and its Environment?

Permanent "perceptual-motor, proximodistal, circumscribed" rehabilitation    

In rehabilitation, neuroplasticity, i.e. the brain's ability to restructure itself and create new neurons, depends on factors such as age, the extent of the lesions, the complexity of the structure involved,
and above all, the environmental conditionst imposed on the patient.

After an accident resulting in a deficiency of the central nervous system, the ability to restructure
and create neural circuits that cause patterns of motor behavior usually remains intact.

Consequently, the environment applied to the patient will play a decisive role in the creation 
and development of the specific motor balances in the making of each person.

This is why it is essential to keep the patient in a state of "permanent (re)habilitative stimulation"

This implies that rehabilitation sessions alone are not enough:

The patient must be made aware of:

- That he is the architect of his motor evolution, that he can have a real hold on his motor skills

- Encouraging them to step out of their comfort zones safely and confidently

- By providing them with simple and concrete advice that they can apply on a daily basis

- By putting the patient in the conditions to be able to carry out the desired motor diagram

Which must be constantly identified:

The conditions necessary for the accomplishment of each motor function to be recovered.

Advantage:

This approach prevents or minimizes the development of undesired motor balances
that arise progressively "to favor the most solicited motor function"

For example : the phenomena of "segmental motor symmetry" and "spasticity".

These balances are closely linked to the "reciprocal innervation principle"

"Perceptual-motor" rehabilitation

From birth and throughout life, the brain thrives on what it "perceives"

- in response to stimuli providing information about the state of different body segments in action

- according to the constraints imposed by the environment which will have a decisive impact
   on the psychomotor recovery of each individual

Through trial and error, the brain develops "opportunistic motor strategies"

"Proximodistal" rehabilitation  

The Fundamental Role of Proximodistal Motor Organization 

Mechanically, our motor function progressively develops from the spine
and torso ("Proximal") to the extremities of the limbs ("Distal") 

During rehabilitation, it is crucial to remember:

That the quality of the motor function of each joint depends
on the quality of the motor function of the joints that support it

"Circumscribed" rehabilitation

Motor function resulting from the information-action circuit originates from awareness of : 

- the direction of the resistance applied
- the visual, tactile and auditory stimuli used
- the positioning of the body and body segments in action

The patient must be placed in a "circumscribed" working environment 
that precisely defines and channels the movement, as this determines the conditions
for creating the motor pattern to be internalized. 

Stimulating a specific body area clearly and unambiguously is essential,
systematically "integrating it" into the patient's overall motor pattern.