Trauma and rehabilitation: Edited by Nick WardUnderstanding sensorimotor adaptation and learning for rehabilitationBastian, Amy JAuthor Information Kennedy Krieger Institute, Department of Neuroscience, Neurology, and Physical Medicine and Rehabilitation, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA Correspondence to Dr Amy J. Bastian, PhD, PT, Kennedy Krieger Institute and Departments of Neuroscience, Neurology, and Physical Medicine and Rehabilitation, The Johns Hopkins School of Medicine, Baltimore, MD 21205, USA Current Opinion in Neurology: December 2008 - Volume 21 - Issue 6 - p 628-633 doi: 10.1097/WCO.0b013e328315a293 Buy Metrics Abstract Purpose of review Understanding the behavioral mechanisms of sensorimotor adaptation and learning is essential for designing rational rehabilitation interventions. Recent findings Adaptation is the trial-and-error process of adjusting movement to new demands and is now thought to be more than a simple error cancellation process. Instead, it may calibrate the brain's prediction of how the body will move and takes into account costs associated with the new task demand. Damage of the cerebellum systematically disrupts adaptation, but damage to other brain regions often does not. Adapting to perturbations driven by a device like a robot or a treadmill leads to only partial generalization to unconstrained ‘real-world’ movements. Repeated adaptation can lead to learning a new motor calibration, but process of consolidation of this type of learning is less understood in patients. Summary Adaptation is inherently important for rehabilitation by making movement flexible, but can also be used to ascertain whether some patients can generate a more normal motor pattern. Repeated adaptation can lead to learning of a new, more permanent motor calibration. Though less understood, this type of learning is likely to be an important method for making long-term improvements in patients' movement patterns. © 2008 Lippincott Williams & Wilkins, Inc.