Our movement originates from the interaction between the brain, nerves, and muscles. When there are interruptions or communication problems, movement disorders such as gait difficulties and motor blocks occur.
Movement in the Human Body: How Does it Work?
The activity of our brain is based on the movement of neurons; from birth, we acquire information that leads us to develop a cognition on which movements are based, which over time become automatic. Just the thought of being able to lift an arm, open a hand, and close it, involves 15% of our brain’s effort. Our brain is an almost perfect machine, where each area has a specific function. If a patient is particularly slow or uncoordinated, there may be something at the brain level that is not functioning: something in the interaction between the brain, nerves, and muscles is not going as it should. Multiple areas are involved in movement, including:
- the premotor area: which serves to anticipate movements
- the visuospatial area: which tells us “how big we are,” how much space we have around us, and whether we can make a certain movement in that space
How Neurorehabilitation is Changing
The task of the rehabilitor until now has been to try to understand how to use the compensatory areas of the damaged areas in order to bring about an improvement in the quality of life of patients. Normally, motor areas are used for movement, but in Parkinson’s patients, voluntary areas are used to compensate for their damage, resulting in a significant effort on the part of the patient, who claims to “walk as if he had rocks on his feet.”
Indeed, the compensatory areas are only a way to bypass movement disorders and are not sufficient to restore the right autonomy to patients, so studies have been conducted to find a way to act directly on movement areas.
Up to 20 years ago, it was believed that the command of our body was entirely in the brain, the central nervous system. If a problem arose centrally, it was thought that there could be no improvement other than by surgically acting directly on it. However, today it has been possible to observe that the peripheral brain system, if stimulated in a certain way, is able to send an impulse to the brain capable of activating some areas involved in movement, generating an improvement in motor disorders that lasts from 3 to 5 days.
Years of Study to Find a Neurorehabilitation Therapy
At the beginning, there was an observational phase because it was necessary to implement something different. By reconstructing the mapping of the brain and peripheries, studying the phenomena on the motor areas of our patient, analyzing which peripheries no longer moved, it was possible to observe that some motor areas were completely stationary. This happens because the brain, having little energy, prefers to conserve it for more vital movements, such as heartbeats and breathing, almost completely abandoning the extremities (hands and feet). The research was very empirical; various stimuli were tried and various hypotheses were elaborated. For example, it was considered whether pain could reactivate the inactive motor areas of the brain. However, over time it was observed that painful stimulation actually caused a retraction, so the brain could not store this information.
The Stimulus that Reactivates the Motor Areas
After various attempts, the right stimulus was identified, also through observation using a CT scan, which managed to reach the brain and reactivate the areas involved in movement: the premotor area, the visuospatial area, and the basal ganglia. Furthermore, this stimulation in two points of the feet, delivered by the Gondola medical device, not only rekindles the areas but the brain is able to acquire the information and maintain it for a few days (from 2 to 5 days). This is not obviously a cure, but a therapy to be added to others: medication, rehabilitation, and possibly DBS.
Gondola has not defeated Parkinson’s disease but has significantly improved the quality of life of Parkinson’s patients.
Some of our patients (Parkinson’s patients) who have been using the Gondola device for more than 8 years continue to use it with excellent results, demonstrating that over time no addiction is created. Moreover, 95% of patients who have been using the device for at least 3 years have not had to increase their drug therapy, keeping it stable.
Stroke and Gondola Treatment
The therapy with Gondola is also proving beneficial for stabilized stroke patients. Following a stroke episode, the patient is diagnosed with 6 months of recovery, that is, a period during which, thanks to good rehabilitation, he can recover the motor skills damaged by the ischemic episode. After these months, the patient is defined as “stabilized” and must mainly focus on maintaining the improvements achieved during the rehabilitation period.
Gondola is proving effective in improving movement in stabilized patients who have suffered an ischemic event for more than 6 months, improving their walking speed and reducing spasticity.
