Corso di Laurea in Terapia della Neuro e Psicomotricità dell'Età Evolutiva

The main aim of the Teaching is the knowledge and ability to apply the acquired knowledge to the specific professional in the field of neuromuscular pathology, with reference to the pediatric age.

The specific aims of the Teaching are:

- the knowledge of the anatomy, physiology, and semiotics of the neuromuscular system;

- the knowledge of the main pathological patterns of the peripheral nervous system in pediatric age, in particular the paralysis of the brachial plexus;

- the knowledge of the main neuromuscular diseases in pediatric age, in particular the spinal muscular atrophies, neuropathies, myopathies and dystrophies;

- the knowledge and ability to apply in the professional context of the rehabilitation evaluation and rehabilitation treatment of neuromuscular diseases, with reference to the different frameworks, the natural history of the disease, the main assessment scales and the measures used in the rehabilitation treatment.

KNOWLEDGE AND UNDERSTANDING
At the end of the course for the respective modules, the student must know:
- the biomechanical and kinesiological aspects of statics and antigravity dynamics of the trunk and the interactions with other districts
- the basic elements of general applied kinesiology and special kinesiology in the field of neuromuscular diseases
- outcome measures for the definition of the motor problem
- functional evaluation scales for the evaluation and monitoring of the neuromotor sign

ABILITY TO APPLY KNOWLEDGE AND UNDERSTANDING
At the end of the course for the respective modules, the student must be able to:
- carry out an adequate evaluation of the sign and symptom to place them in the organization global movement;
- carry out the kinesiological analysis of postural passages and gestures

- evaluate the fees adopted by the subject affected by neuromuscular pathology
- assess the need for orthoses and / or aids

- set up a therapeutic exercise project, integrated into a multidisciplinary care project

- accompany any surgical intervention

AUTONOMY IN INTELLECTUAL PRODUCTION AND CRITICAL JUDGMENT
At the end of the course the student will be able to rework the study material and identify the key concepts.

At the end of the course, the student must consciously acquire the procedures necessary for evaluation and interpretation of the clinical sign in neuromuscular pathology to plan,
independently plan and manage the individualized qualification and rehabilitation path of the aged patient evolutionary.
They must also acquire good skills in evaluating problems and related areas of intervention to report problems that are beyond his competence, in order to involve another professional with greater competence in the project and in the rehabilitation management, be it another TNPEE or other healthcare professional.

COMMUNICATION SKILLS
In order to ensure adequate habilitation and rehabilitation, at the end of the course the student will have to acquire skills and tools for efficient and effective communication:
• with the subject in developmental age who presents mainly neuromuscular problems
• with caregivers (parents, relatives, community assistants, ...)
• with the clinical nursing staff and with all the professional operators in
health or technical areas that make up the team
• with the specialist or basic pediatric medical staff who take care of the patient

• with all school or educational staff involved in the patient's life

LEARNING ABILITY
The three-year course lays the training foundations for practicing the profession. To guarantee the best rehabilitation management in the exercise of his professional activity at the end of the course, the student will have to acquire autonomous continuous learning skills in the field of functional diagnosis and neuromotor rehabilitation techniques oriented towards scientific evidence.

Furthermore, he/she must be able to implement self-evaluation strategies of their own preparation and professional practice, to guarantee the best professional performance on the patient.

Finally, he/she will have to keep himself updated on the possibilities of undertaking in-depth training in addition to the obligation of continuing medical education and any subsequent studies to improve his professional competence.

INFANTILE NEUROPSYCHIATRY VII

- Recalls of anatomy and physiology of the neuromuscular system

- Clinical semiology in developing age

- Physiology and pathology of the peripheral nervous system

- Physiology and pathology of the second motoneurone

- Introduction to the international reccomendations for the clinical-care path of the main neuromuscular diseases

NEUROLOGY II

- Skeletal muscle diseases: physiopathological principles and differential semeiotics

- Progressive muscular dystrophies

- Congenital muscular dystrophies

- Congenital myopathies

- Canalopathies and myotonies

- Metabolic myopathies

- Inflammatory and secondary myopathies

- Disorders of the neuromuscular junction: myasthenia gravis

- Congenital mygenie

NEUROPSYCHOMOTORIE SCIENCES IX

- Sign semeiotics in neuromuscular pathology;

- Special Kinesiology;

- The rehabilitation project and therapeutic strategies in the rehabilitation treatment of patients with: Sensory motor neuropathies; Myotonic dystrophies; dystrophinopathies; Spinal muscular atrophy; Pompe disease; Congenital muscular dystrophies; Congenital myopathies;

 - Tools of functional rehabilitation: rehabilitation, aids, orthoses

NEUROPSYCHOMOTORIE SCIENCES X

- Neuromuscular Semeiotic: from observation to reading the sign;

- Rehabilitation assessment in neuromuscular diseases: muscle examination, joint examination, time trials, functional assessment scales;

 - Rehabilitation assessment of people with DMD in the various stages of the disease; the indications of the international guidelines, national and of the Ministerial Council on neuromuscular diseases of the Ministry of Health; The North Star Rating Scale, Hammersmith Expanded, EK and the Seating Clinic Evaluation Card.

The SMA rehabilitation assessment in different forms: the indications of the international and national guidelines. The Chop Intend Evaluation Scales, Hammersmith, Hammersmith Expanded, Upper Limb Module, EK and the Seating Clinic Evaluation Card. Charcot Marie Tooth: proposal for a functional evaluation form.

rehabilitation assessment Congenital muscular dystrophies and congenital myopathies: the indications of the international guidelines. Glycogenosis 2 in different forms: the indications of the International Guidelines. The GSGC Evaluation Scale.

The child neuropsychiatry and neurology modules are divided into 24 hours of teaching each, while the neuropsychomotor sciences module is divided into 12 hours of teaching.

The lectures are supported by presentations (ppt) with graphic and video supports. The interaction between teacher and student will be facilitated by the discussion of clinical cases.

We inform students that, in compliance with this University’s recommendations, educational activities may be subject to variations in the event of any health emergency or other kind of emergency.
Specifically, educational activities could be carried out online, through multimedia platforms, and, if possible, in small groups in lecture halls

The final test consists of a written test and an oral test which will be carried out on the same day in the presence of all the teachers of the integrated course.

The written test will last 180 minutes (3 hours) and will consist of a set of 60 written questions (multiple choice with a single correct answer, or short open-ended questions):

- 30 related to the program of the CHILD NEUROPSYCHIATRY VII module

- 30 related to the program of the NEUROLOGY II module

- 15 related to the program of the NEUROPSYCHOMOTOR SCIENCES IX module

Determination of the score of the written test:

- each correct answer (multiple choice or open) is worth 1 point for the CHILD NEUROPSYCHIATRY VII and NEUROLOGY II modules and 2 points for the NEUROPSYCHOMOTOR SCIENCES IX module

- incorrect or missing answers are worth 0 points

- the final score (expressed in thirtieths) is calculated as the weighted average of the scores of the individual modules

Failure to achieve a passing grade at the end of the written test even in just one module will result in failure to pass the test of the integrated course and the need to take the exam again or, at the student's choice, the single module.

We inform students that, in compliance with this University’s recommendations, assessment procedures may be subject to variations in the event of any health emergency or other kind of emergency. Oral and written exams might be conducted through multimedia platforms.

Trattato di medicina fisica e riabilitazione, G.N. Valobra e altri, Utet, 2010

Malattie neuromuscolari, appunti di clinica e riabilitazione, A.Ferrari,  ed.Ghedini  1988

Le lesioni ostetriche del plesso brachiale: percorso riabilitativo fisioterapico-chirurgico, Riabilitazione Oggi, aprile 2004, n.4

Mercuri E, Finkel RS et al. Diagnosis and management of spinal muscular atrophy: Part 1: Recommendations for diagnosis, rehabilitation, orthopedic and nutritional care. Neuromuscular Disorders 28 (2018) 103-;115.

Finkel RS, Mercuri E et al. Diagnosis and management of spinal muscular atrophy: Part 2: Pulmonary and acute care; medications, supplements and immunizations; other organ systems; and ethics. Neuromuscular Disorders 28 (2018) 197-;207.

Birnkrant DJ, Bushby K et al. Diagnosis and management of Duchenne muscular dystrophy, part 1: diagnosis, and neuromuscular,rehabilitation, endocrine, and gastrointestinal and nutritional management. Lancet Neurol 2018; 17: 251-;67.

Birnkrant DJ, Bushby K et al. Diagnosis and management of Duchenne muscular dystrophy, part 2: respiratory, cardiac, bone health, and orthopaedic management. Lancet Neurol 2018; 17: 347-;61.

Birnkrant DJ, Bushby K et al. Diagnosis and management of Duchenne muscular dystrophy, part 3: primary care, emergency management, psychosocial care, and transitions of care across the lifespan. Lancet Neurol 2018; 17: 445-;55.

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