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Indirect Motor Pathways

Indirect Motor Pathways

The indirect motor or extrapyramidal pathways originate in the brainstem, the lower portion of the brain that connects it to the spinal cord. They consist of several distinct tracts, each with specialized functions. The four main tracts of the indirect motor pathways are the vestibulospinal tract, the reticulospinal tract, the tectospinal tract, and the rubrospinal tract.
The vestibulospinal tract originates in the vestibular nuclei of the brainstem. The vestibular system detects changes in...

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Updated: May 15, 2026

Structured Motor Rehabilitation After Selective Nerve Transfers

Structured Motor Rehabilitation After Selective Nerve Transfers

Published on: August 15, 2019

Motor learning principles for neurorehabilitation.

Tomoko Kitago¹, John W Krakauer

¹Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA. tk2229@columbia.edu

Handbook of Clinical Neurology

|January 15, 2013

Summary

Neurorehabilitation leverages motor learning for recovery after brain injury. Intense motor learning protocols during the early post-stroke window can significantly improve motor function by targeting impairment.

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Last Updated: May 15, 2026

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Area of Science:

Neuroscience
Motor Control
Rehabilitation Science

Background:

Neurorehabilitation assumes motor learning aids motor recovery post-injury.
Mechanisms of motor learning post-brain injury and their interaction with spontaneous recovery are poorly understood.
Current neurorehabilitation prioritizes compensatory strategies over impairment reduction.

Purpose of the Study:

To differentiate between adaptation and skill acquisition in motor learning.
To explore the relationship between these motor learning types and neurorehabilitation.
To investigate optimal incorporation of motor learning principles into rehabilitation.

Main Methods:

Distinction between adaptation and skill acquisition motor learning types.
Analysis of functional recovery through impairment resolution and compensation.
Review of animal models and human stroke recovery data.

Main Results:

Functional recovery can be achieved via impairment resolution or compensation, both responsive to training.
Animal models show a 3-4 week window of heightened plasticity post-ischemic damage, enhanced by training.
Most human motor impairment recovery post-stroke occurs within the first 3 months.

Conclusions:

Targeting impairment with intensive motor learning protocols within the first 3 months post-stroke may yield significant functional gains.
Understanding motor learning nuances is crucial for optimizing neurorehabilitation strategies.
Intensive training during critical plasticity windows could maximize functional recovery outcomes.