S07.239: Da come mi muovo a come mi sento: multidisciplinarietà in ambito pediatrico neuromuscolare
Carraro E1, Casiraghi J1
1Centro Clinico NeMO di Milano
La costruzione dello schema corporeo, ossia l’organizzazione delle sensazioni relative al proprio corpo, esercita una funzione fondamentale per lo sviluppo e la maturazione nervosa e mentale. Il primo oggetto che il bambino percepisce è il proprio corpo che diventa ben presto il mezzo dell’azione e della conoscenza. Il corpo è il filtro attraverso cui entriamo in relazione con il mondo. Patologie che sin dai primi giorni di vita portano ad una menomazione della componente motoria, a un ritardato e/o mancato raggiungimento degli appuntamenti funzionali e ad una ridotta e/o mancata esperienza di movimento possono produrre una percezione dello schema corporeo frammentata. Il corpo non è soltanto l’interfaccia con il mondo ma anche il biglietto da visita con cui ci presentiamo agli altri. Il ruolo assunto , la posizione relazionale posseduta sono anche congruenti all’immagine che il bambino presenta agli altri. Un corpo menomato, ferito, “diverso”, che “senso del sé”, quali emozioni restituisce al bambino malato? In che modo il corpo “diversamente abile” influisce sul senso di identità del bambino? A queste domande e non solo si cercherà di dare una risposta, raccontando il modo in cui l’equipe multidisciplinare del Centro Clinico NeMO (NEuroMuscular Omnicenter) affronta le patologie neuromuscolari ad insorgenza pediatrica, malattie rare ed evolutive. La definizione di malattie neuromuscolari comprende un vasto ed eterogeneo gruppo di patologie che interessano l’unità motoria, ossia: il II motoneurone, fibra nervosa, placca neuromuscolare e fibra muscolare. La compromissione di queste strutture determina deficit di forza e/o di sensibilità, modificazioni del tono e del trofismo muscolare e talora pattern di attivazione muscolare anomala, che possono variare per entità, sede e andamento nel tempo in relazione al tipo di patologia. La descrizione del lavoro svolto illustrerà anche le proposte di intervento e racconto dei bambini attraverso il gioco e attività ludico-narrative sperimentate in reparto in relazione all’impairment muscolare e alla percezione e consapevolezza del sé corporeo, in modo particolare per bambini affetti da atrofia muscolari spinali e Distrofia di Duchenne.
S07.091: Imagine: the invariants from perception to action
Iosa M1, Antonucci GNA
1IRCCS Fondazione Santa Lucia - Roma
Imagine is the title of a famous utopist song of John Lennon and of a short poetry of Fredric Brown in which it is noted how easy it is for humans to imagine ghosts, gods, devils, spaceships, and how hard is to imagine ourselves and the world around us. In the framework of ecological psychology, Gibson suggested that the perception of the world is favored by affordances, environmental features that are not abstract physical properties, but what the environment provides or furnishes to the subject depending on current intentions and capabilities of the subject. Shepard proposed that biological evolution and individual learning allowed subject to be tuned to resonate with affordances and even that most of them could be internalized. When astronauts were tested for their capacity of catching a moving object in microgravity, they anticipated their movement according to the imagination that the object could be accelerated by gravity, despite their knowledge of the absence of gravity. These result suggested the existence of an internal model of gravity, id est a neural substrate devoted for motor imagery taking into account the gravitational field typical of Earth. Acceleration of gravity and other invariants (such as the fact that space is three dimensional, that the light usually comes from above, and so on) could be internalized for speeding up the process of perception and action. Another environmental feature is the so called golden ratio, found in human anthropometry as well as in biological and physical structures. During comfortable walking at self-selected speed it has been found that the ratio between stance (the phase of stride in which the foot is in contact with the ground) and swing (the phase in which the foot is moving forward on air) is in golden ratio. It provides a harmonic structure to human walking and minimizing the energy consumption. The same value of golden ratio was found when subjects were asked to divide a sum of money with a companion in the ultimatum game or when they should choice among visual stimuli proposed in different proportions. The case of golden ratio, an anthropometric proportion and also a rhythm of neuromotor commands, as well as a feature of pleasant harmony, represent a perfect example of the concept of resonance proposed by Shepard: an ineffable sense of connection between what is in us and something in the outer world. However, experimental data showed as these invariants are not fixed values constraining subjects behaviors, but related to a selective tuning, specific features of the environment playing a pivotal role both in perception as well as in action.
S07.240: The Locomotor Imagery
Fusco A1
1IRCCS Fondazione Don Carlo Gnocchi
The origin of the use of mental images in applications of knowledge is linked to the field of psychology, with the investigations of sir Galton in 1880. The Motor Imagery allows the study of cognitive representations by the understanding of motor cognition processes and the exploration of the relationships between consciousness and action. In general, the word “Imagery” refers to the sensorial experience in mind (auditory, visual, tactile, olfactory, gustatory, kinesthetic). MI is a condition that relates to the brain’s ability to mentally simulate an action without physically performing it. In various experimental trials, it was shown how the execution of the movement and the MI share several characteristics, as temporal correlations (functional equivalence) and similar, although not identical, neural substrates. Despite the vast field of research on MI, few trials have been conducted to study human locomotion. Although generic statements have been made between MI and real performance, in terms of response times, the results are mixed and the degree of motor simulation remains unclear. It has been argued as how biomechanical and cognitive interferences can interfere with the imagined walking times, altering the subjects’ ability to mentally simulate walking. Central and peripheral neurophysiological correlates have supported the thesis that MI should not be artificially decoupled from the action itself, but rather be placed along a continuum that extends from movement to its mental representation. With a recent expression, this association of imagination / movement has been called dynamic MI (dynamic Motor Imagery, dMI) [MacIntyre and Moran, 2010]. The dMI refers to a specific sequence of MI that is accompanied by external movements that partially mimic those mentally represented, and in particular, with the specific characteristics of movement by temporal or spatial invariance. Performing simple limb movements provides real feedback, thus offering an effective solution to one of the major limitations of MI, ie the absence of proprioceptive feedback. In this paper, I analyzed the temporal and spatial correlations for the classic MI and dMI in different locomotor conditions in a group of young healthy subjects, the possible influences of age and of a pathological condition (stroke). The main results confirmed that motor imagery is a task-dependent process, with walking being temporally closer than other locomotor conditions. Moreover, the time records of dMI are closer to the ones of actual locomotion respect to those of sMI. Despite a slight slowdown in the performance of elderly compared to young participants, the temporal and spatial accuracy was better in dMI than sMI in both groups. In patients with stroke, a spatiotemporal functional equivalence was found only for dMI, and not for sMI, in forward walking. This could be due to familiarity with this task. These results might have implications for the rehabilitative techniques based on MI.
S07.050: Music and walking: a study on gait variability in Parkinson’s Disease
De Bartolo D1, Antonucci G2, Iosa M3
1Università degli Studi di Roma-La Sapienza, 2Dipartimento di Psicologia, Università degli Studi di
Roma-La Sapienza,3Clinical Laboratory of Experimental Neurorehabilitation, Fondazione Santa Lucia,
Roma
Introduction Recently the scientific interest for the use of music tools in the rehabilitation field has been increasing more and more. Many scientific contributions reported its effective use for the treatment of neurological diseases in which the gait cycle is altered. In normal conditions, it has been noted that the stance phase (in which the foot rests on the ground) has a duration of about 38% compared to that of the entire gait cycle. In Parkinson’s Disease (PD) gait rhythm is impaired, fluidity and sequencing of movement, the stride-to-stride regulation of double support and gait cycle duration may both be affected. After the first promising results, many studies on PD have focused on the use of acoustic stimuli to enhance the connection between rhythmical auditory perception and motor behavior, or with the aim to reduce reliance on medication. Despite the scientific evidence on the rehabilitation function of music, there are no studies that can clarify how music produces changes in motor behavior. So, the aim of this study is to investigate how different musical genres can affect gait parameters in patients with Parkinson’s Disease also compared with healthy young and elderly subjects. Materials and methods For this study we enrolled 20 patients with PD (72.5 ± 9.2 years; 14 M, 6 F) and a control group of 40 subjects divided among 20 healthy young adults (YA) (32.3 ± 5.9 years; M = 8; F = 12) and 20 other elderly adults (EA) (72.1 ± 5.6 years; M = 8; F = 12). The gait parameters were recorded through the use of a wearable sensor (G-walk, BTS Italia). All subjects, individually tested, walked a straight 18-meter corridor at comfortable speed, wearing the sensor and a wireless Bluetooth headset. The experimental conditions of the study were a total of 14: two of normal walking (with no music) and twelve with different music tracks lasting 40s each (Chopin, Beethoven, The Beatles, Queen; Survivor, Metallica). The data obtained by the inertial sensor were processed with the IBM SPSS statistical software. An ANOVA test with repeated measures (rm) was performed between the various conditions. Results and Conclusions Post hoc analyses reported that music influenced all the gait parameters measured. Particularly we found a specific difference for the music*group effect for the step length (<0.001). How could we expect, the PP group reported a lower speed level that goes up for music with a faster pace (The Beatles, Survivor, Queen). The reported positive effect of music on the gait parameters has an important application especially for the PP group. As stated in literature about elderly and PD patients, it must be accounted that physiologically they need to maintain a certain level of comfort during walking, for this reason the effects found are small. In conclusion, we state that music produces a positive effect on gait parameters usually affected in PD.