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Motor skill learning in cerebral palsy: movement, action and computer-enhanced therapy.

This chapter discusses the extent to which previous research into movement control can provide key principles on which to model therapy for individuals with severe cerebral palsy. It is suggested that the movement perspective has traditionally stressed the role of implicit knowledge of the dynamic characteristics of the body and that this provides support for the principles of biofeedback training. From a more ecological 'action' perspective, however, it is concluded that previous approaches to biofeedback have been too constrained and do not translate well to functional tasks. A variation of biofeedback training is proposed that provides real-time feedback to shape the subject's action, thereby guiding them through learning contexts that are moulded to fit the individual's capabilities. A pilot study of the efficacy of such an approach in adolescents with cerebral palsy is then presented. The potential of extending computer-enhanced therapy into speculative areas such as virtual reality is also discussed.