This book is about the neuroscience of recovery from arm and hand paresis, and the development of therapeutic approaches to promote recovery.

Neurorehabilitation is a complex process involving multiple stakeholders that play a role in the delivery of various services. The understanding, the goals, and the therapeutic approaches used by these stakeholders are often different.

Different types of outcomes are emphasized by the different groups - impairments, activity, or participation. This choice will impact the nature of the intervention.

Recovery means different things.

This is one of the important points emphasized in this chapter and pretty much throughout the book.

Recovery can mean different from the perspective of research trials, clinical practice, and public health.

Current clinical practice is focused on training activities of daily living (ADL) to allow patients to gain independence and return to their life roles to the best of their ability. The authors contend that this approach encourages “compensation” and has taken the focus away from driving “true recovery”.

The issue of “true recovery” and “compensation” is an interesting topic in neurorehabilitation. Levin et al. 2009 talk about these ideas at different levels, but the JK and TC focus only on the behavioral level.

True recovery or restitution is the return to or toward pre-morbid levels of strength and motor control.

Compensation.

addressing the real underlying cause, which can - motor impairment.