What are stroke survivors trying to do? They're trying to move better.
Where does better movement come from? The brain!
Is the brain learning (new brain connections) or relearning (using existing connections)?
This debate has been around for a long time. Here's the question restated: If you've had a stroke and you're learning how to move better everyday. Is that movement learning or movement relearning? Is it new stuff (new neuroplastic change) or are you reactivating a part of the brain that used to do that movement?
I've been pretty successful selling to the world that it is all about neuroplasticity-- that it's all new learning. But that's only once the plateau has been reached. You know the plateau, that first big reduction in recovery? Prior to that most recovery comes from the brain "healing" (although "coming back on line" is a better description).
So, lets review:
Prior to the plateau: Using brain that already knows the movement.
After the plateau: Using new brain to do the old movement.