How deep is your recovery? Rethinking true motor recovery versus compensation in neurorehabilitation.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος:	How deep is your recovery? Rethinking true motor recovery versus compensation in neurorehabilitation.
Συγγραφείς:	Caronni A; Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano.; Department of Biomedical Sciences for Health, University of Milan., Amadei M; Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano., Rota V; Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano., Picardi M; Department of Neurorehabilitation Sciences, Casa di Cura Igea, Milan, Italy.
Πηγή:	International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation [Int J Rehabil Res] 2026 Jun 01; Vol. 49 (2), pp. 71-80. Date of Electronic Publication: 2026 Apr 27.
Τύπος έκδοσης:	Journal Article; Review
Γλώσσα:	English
Στοιχεία περιοδικού:	Publisher: Lippincott Williams & Wilkins Country of Publication: England NLM ID: 7805421 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1473-5660 (Electronic) Linking ISSN: 03425282 NLM ISO Abbreviation: Int J Rehabil Res Subsets: MEDLINE
Imprint Name(s):	Publication: London : Lippincott Williams & Wilkins Original Publication: Rheinstetten, Schindele.
Ιατρικοί όροι (MeSH):	Recovery of Function/physiology , Neurological Rehabilitation, Neuronal Plasticity/physiology ; Humans ; Stroke Rehabilitation
Περίληψη:	Attempts to make a sharp distinction between ‘true’ recovery and compensation create ambiguity about the nature of motor improvement in neurological rehabilitation. This paper proposes a new framework to resolve this dichotomy: a stratified model where recovery is not a binary concept but is instead defined by its depth across the motor system’s multiple layers, from neurons to task performance. Our model frames the motor system as a hierarchy of causally linked strata, ranging from inner physiological layers (e.g. synaptic plasticity) to outer behavioural ones (e.g. task accomplishment). This framework allows motor improvement to be defined as a phenomenon that can occur at different layers, manifesting as a compensation–recovery gradient that propagates from inner-to-outer strata. The model’s central thesis is that the key question is not whether recovery is ‘true’, but how deep it is. We posit that a deeper recovery – one in which improvements in behavioural performance are underpinned by positive changes in inner physiological strata – constitutes a more complete and desirable clinical outcome. When comparing treatments with equivalent behavioural outcomes, those that also result in recovery in deeper physiological strata are superior and should be preferred. Therefore, this model directs neurorehabilitation research and practice toward interventions that also maximise recovery depth rather than focussing solely on behavioural outcomes. Assessing and demonstrating recovery depth requires that clinical psychometrics are complemented by quantitative metrics from instrumented movement analysis and neurophysiology, which can directly probe the inner, physiological strata of the motor system. (Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc.)
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Contributed Indexing:	Keywords: assessment; improvement; motor recovery; motor system; neurorehabilitation; restoration
Entry Date(s):	Date Created: 20260325 Date Completed: 20260713 Latest Revision: 20260813
Update Code:	20261012
PubMed Central ID:	PMC13124266
DOI:	10.1097/MRR.0000000000000701
PMID:	41877523
Βάση Δεδομένων:	MEDLINE

Περιγραφή
ISSN:	1473-5660
DOI:	10.1097/MRR.0000000000000701