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

Permanent "perceptual-motor, proximo-distal, circumscribed" rehabilitation    

In rehabilitation, neuroplasticity, i.e. the brain's ability to restructure itself and create new neurons, is dependent on age, the extent of the lesions, the degree of complexity of the structure involved,
but also and above all on the environmental conditionsthat are 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.

Hence the need to maintain "permanent re-educational 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:

Helps to avoid or minimize the appearance of unwanted motor balances
that appear gradually "to the benefit of the most solicited motor skills"

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

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

"Perceptual-motor" rehabilitation

From birth and throughout life, thebrain feeds on what it "perceives"

- in response to stimuli that inform him about the state of the different segments of the body in action

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

and elaborates by trial and error "opportunistic motor strategies"

"Proximo-Distal" rehabilitation  

Fundamental role of the Proximo-Distal Organization of Motor Skills 

Mechanically, our motor skills are gradually built from the spine
and the trunk "Proximal" to the extremities of the "Distal" limbs

When rehabilitating, it is important to keep in mind:

That the quality of the motor skills of each joint depends on the
quality of the motor skills of the joints that underlie it

"Circumscribed" rehabilitation

The motor skills resulting from the information-action circuit originate in awareness 

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

Thepatient must be placed in a "circumscribed" working environment which delimits and channels the movement in a very precise
way because it determines theconditions for the development of the motor diagram
to be internalized. It is essential to stimulate the activity of a part
of the body in a clear and unequivocal way, by "systematically integrating" it into the patient's overall motor pattern