This article presents a comprehensive set of guiding principles for motor therapy, at first for the domain of neurorehabilitation. The article is a narrative review and although there is value in this type of summaries, it is for me insufficiently clear what the origin is of the ten principles. With other words, what was the basis of the author for deriving these elements as the guiding principles. For instance, Lennon et al. (Lennon, S., Ramdharry, G., & Verheyden, G. (2018). Physical Management for Neurological Conditions E-Book. Elsevier Health Sciences) also present 10 key principles of physical management in neurorehabilitation. I understand the difference in scope (movement training versus physical management), but some framework for the pathway to the ten principles presented here should be proposed to the reader.
The introduction lacks a coherent flow. Paragraph 1 is clear and demonstrates the advantage of a common language (but is this the aim of this article?). The link between the next four paragraphs (neuroplasticity, theories, technology and patient) and the guiding principles is unclear to me. They seem to provide some examples of knowledge linked to the domain but their fit within the story is lacking. The last paragraph should explicitly state the aim.
I would be in favour of a sort of methods section (1) how the principles were determined and (2) how the information for each of the principles was collected.
My suggestion would be to rethink the build-up of figure 1. It seems now presented as a continuum which is actually not the case.
The presentation of each of the principles is in my opinion too exemplary. I like table 1 with definitions and examples and would therefore suggest that each of the principles would consist of:
- Definition; what is the agreed explanation and meaning of principle (and what is it perhaps not). This definition should be referenced. I’m afraid not one principle in table 1 has a reference now. Sometimes, under definition, there is actually no definition given (e.g. 7. biomechanics in table 1).
- Evidence-based practice results: this is now lacking. As a reader, we need to have confidence that what is suggested is actually of benefit. A reader now would not become convinced about such an advantage. Examples should also be specific. Now, many of the literature findings presented are vague I’m afraid.
- Examples of the principle applied in clinical practice. Again, one needs to be specific here. For instance in table 1, line 1, “Sensory priming as a warm-up exercise.” What is meant by this? This is actually the case for nearly all principles in table 1.
The discussion should start with the aim and critically reflect upon the product (the principles) and process (how the principles were derived), and what the next steps would be. A limitations section is always useful for a reader.