How Motor Learning shapes contemporary Neurorehabilitation Practices. A critical synthesis of theoretical frameworks, clinical traditions, and neuroscientiÞc evidence from past to future.

OBJECTIVE: This study addresses the need for standardized approaches in neurorehabilitation, focusing on the assessment and modulation of Motor Learning variables through both theoretical and practical frameworks. Current clinical practice and research often lack systematic tools to capture the complexity of movement organization and patientÐtherapist interactions, limiting reproducibility and optimization of interventions. METHODS: A comprehensive checklist of core Motor Learning variables for neurorehabilitation was developed by integrating expert knowledge with AI-driven analysis, resulting in a reliable taxonomy organized in a checklist applicable to both research and clinical settings. The neurophysiological principles underlying the Italian neurorehabilitation legacy, Cognitive Multisensory Rehabilitation (CMR) and the Grimaldi Muscle Shortening Maneuver (GMSM), were examined through historical sources and expert interviews. A qualitative analysis of video-recorded CMR sessions assessed the feasibility and applicability of the aforementioned checklist. Finally, a prototype device for controlled GMSM ankle stimulation was developed to enable quantitative assessment of muscle tone modulation. Surface EMG and high-density EEG were used to evaluate peripheral and cortical responses in a single patient. RESULTS AND CONCLUSIONS: Findings indicate that the core Motor Learning variables relevant to neurorehabilitation are Practice, Task, Feedback, Environment, Therapist, and Individual. Both CMR and GMSM represent theoretically valid approaches, grounded in explicit and implicit learning processes, respectively. A combined and dialogical framework is encouraged. Standardized checklists offer a practical method for CMR data collection, while additional variables better capture therapistÐpatient guidance, an aspect still underexplored. The GMSM prototype demonstrated predictable modulation of muscle tone through Dynamic Stretch Reßex Threshold adjustments, consistent with dynamic systems models of movement. Preliminary evidence suggests cortical engagement beyond passive mobilization, supporting the translational potential of GMSM for person-centered neurorehabilitation.