{"id":236,"date":"2010-02-13T23:13:47","date_gmt":"2010-02-13T23:13:47","guid":{"rendered":"http:\/\/viscontitoscoalda.com\/?p=236"},"modified":"2010-02-13T23:13:47","modified_gmt":"2010-02-13T23:13:47","slug":"236","status":"publish","type":"post","link":"https:\/\/viscontitoscoalda.com\/index.php\/2010\/02\/13\/236\/","title":{"rendered":"Fondazione Salvatore Maugeri di Montescano e Frazzitta Giuseppe"},"content":{"rendered":"

Novit\u00e0 importanti sul Morbo di Parkinson. ne \u00e8 autore un medico marsalese, il dottor Giuseppe Frazzitta.<\/a><\/strong><\/h4>\n

dal sito:
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<\/span><\/strong>http:\/\/www.marsala.it\/cronaca\/salute\/12151-il-morbo-di-parkinso-e-le-scoperte-del-dottore-giuseppe-frazzitta-marsalese.html<\/a><\/p>\n

Esiste in Montescano in provincia di Pavia, presso la Fondazione Salvatore Maugeri un Centro riabilitativo, dove vengono seguiti i pazienti affetti dalla Malattia di Parkinson.
\nUna sezione dedicata agli stessi pazienti e inoltre a coloro che soffrono di Sclerosi Multipla, Malattie Demielinizzanti Rare, Mieliti, Mielopatie, Mielolesioni, patologie Neurodegenerative.\u00a0 Il paziente riesce ad avere risposte ai suoi quesiti, incitamenti a lottare e un fattivo aiuto sul piano medico-terapeutico-riabilitativo.<\/span><\/strong><\/p>\n

Giuseppe Frazzitta, medico specialista in Neurologia e Responsabile del Laboratorio di Diagnostica e Rieducazione neuromuscolare dell\u2019IRCCS Fondazione \u201cS. Maugeri\u201d, Montescano (Pavia).\u00a0 La malattia di Parkinson \u00e8 una malattia degenerativa del sistema nervoso. E\u2019 causata dalla degenerazione delle cellule nervose di una piccola regione del cervello chiamata sostanza nera. Tali cellule producono una sostanza chiamata dopamina necessaria alla trasmissione nervosa per un buon controllo dei movimenti, in particolare quelli automatici quali la mimica facciale, i movimenti pendolari delle braccia durante la marcia, ma anche i movimenti fini come ad esempio abbottonarsi o allacciarsi le scarpe. Non si conoscono completamente le cause della malattia. Sono sicuramente implicati sia fattori esterni, quali sostanze tossiche, che una predisposizione biologica che porta alla morte della cellula nervosa.<\/span><\/strong><\/p>\n


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Sembra che | Il contatto prolungato con insetticidi, fertilizzanti e pesticidi potrebbe favorirne l\u2019insorgenza soprattutto in agricoltori esposti a grandi quantit\u00e0 di tali sostanze. Certamente sono implicate alcune sostanze stupefacenti o i traumi cranici ripetuti (si pensi al caso del pugile Mohammed Al\u00ec). Esistono inoltre rari casi di forme ereditarie ad esordio giovanile dove pi\u00f9 membri di una stessa famiglia ne sono affetti, ed alla base delle quali sono alcune mutazioni genetiche che sono state in parte identificate.<\/span><\/strong><\/p>\n

Come si formula la diagnosi? | La malattia di Parkinson si presenta con tre tipi di manifestazioni. Il tremore a riposo, prevalentemente a livello delle mani e che interessa inizialmente un solo lato. Una riduzione della velocit\u00e0 dei movimenti chiamata ipocinesia-acinesia: i movimenti del corpo diventano rallentati, il camminare risulta difficile, cos\u00ec come il vestirsi, lo scrivere, il parlare. La rigidit\u00e0: il paziente lamenta di avere le gambe rigide\/pesanti e la mobilizzazione passiva di un arto risulta difficile dando l\u2019impressione di muovere un\u201dtubo di piombo\u201d. All\u2019esordio tali segni clinici possono essere lievi e non \u00e8 raro che la malattia non sia riconosciuta prima di mesi o addirittura anni, con gravi conseguenze a carico dei pazienti. Il tremore o la ridotta motilit\u00e0 possono essere erroneamente attribuiti alla fatica, all\u2019et\u00e0 o ad uno stato depressivo. Un\u2019 anamnesi accurata e soprattutto un dettagliato esame neurologico porteranno alla diagnosi finale. Gli esami neuroradiologici (TAC, NMR, PET) oltre all\u2019anamnesi familiare, lavorativa e farmacologia sono di ausilio per escludere forme di parkinsonismo secondario a fattori vascolari, tossici, farmacologici (neurolettici ad esempio), ecc.<\/span><\/strong><\/p>\n

Come evolve la malattia di Parkinson? | L\u2019evoluzione della malattia \u00e8 molto variabile. Nella maggioranza dei casi si assiste ad un andamento lentamente progressivo. Sono possibili fluttuazioni dello stato clinico con periodi di aggravamento (magari in presenza di concomitanti patologie internistiche o infettive) seguiti da periodi di stabilizzazione. Schematicamente, si possono distinguere i seguenti stadi: Un primo stadio, detto \u201cluna di miele\u201d, dove i sintomi migliorano con il trattamento, interferendo poco con la vita normale. Un secondo stadio in cui compaiono problemi nella marcia e nelle attivit\u00e0 quotidiane, che richiedono aggiustamenti della terapia e in cui il malato rimane comunque autonomo. Un terzo stadio in cui il paziente presenta difficolt\u00e0 progressive nella marcia ed ha bisogno di aiuto perdendo man mano la sua autonomia. Con il passare del tempo possono comparire altri disturbi quali difficolt\u00e0 ad urinare, disturbi del sonno, costipazione, depressione e deficit cognitivo.<\/span><\/strong><\/p>\n

Come si tratta la malattia di Parkinson? | Il trattamento consiste nel \u201csupplire\u201d la dopamina mancante con l\u2019uso di farmaci che ne riproducono gli effetti. Essi risultano molto efficaci almeno all\u2019esordio della malattia. Dopo qualche anno pu\u00f2 comparire una sorta di \u201cfenomeno di esaurimento\u201d dell\u2019efficacia del farmaco con conseguente variazione degli effetti del trattamento. La durata del beneficio di ogni singola dose si pu\u00f2 abbreviare e possono comparire blocchi motori o movimenti involontari. Bisogna a tal punto cambiare terapia o associare pi\u00f9 farmaci. Il mantenimento di un\u2019attivit\u00e0 fisica e la riabilitazione neurologica sono essenziali per ritardare l\u2019insorgenza della forma avanzata e complicata della malattia. In particolare un adeguato trattamento Neuroriabilitativo presso centri specializzati pu\u00f2 permettere al paziente affetto da Malattia di Parkinson di mantenere il pi\u00f9 a lungo possibile la propria autonomia personale e di ridurre al minimo gli aggiustamenti farmacologici al fine di evitare le complicanze legate all\u2019uso di questi farmaci. La fisioterapia pu\u00f2 permettere la riduzione delle retrazioni muscolari, mantenere la funzionalit\u00e0 del rachide, migliorare l\u2019equilibrio negli spostamenti e il mantenimento di una deambulazione il pi\u00f9 possibile normale. L\u2019ergoterapia pu\u00f2 migliorare l\u2019autonomia nelle attivit\u00e0 del vivere quotidiano. La logopedia pu\u00f2 portare ad un miglioramento del parola. Pu\u00f2 rendersi utile un supporto psicologico sia per il paziente che per chi lo assiste. Il ruolo dell\u2019ambiente e la responsabilizzazione del malato nel seguire il trattamento risultano essenziali. Diverse associazioni possono essere d\u2019aiuto e fra queste, in Italia, l\u2019Associazione Italiana Parkinsoniani (AIP) ed Azione Parkinson (AP). Pi\u00f9 recentemente \u00e8 stata messa a punto una tecnica di stimolazione cerebrale profonda con una tecnica neurochirugica chiamata stereotassi mediante la quale sono inseriti alcuni elettrodi a livello dei nuclei della base disfunzionanti. Tale intervento \u00e8 eseguito in alcune divisioni di neurochirurgia in Italia e trova la sua indicazione prevalente in soggetti ancora relativamente giovani con malattia di vecchia data, senza compromissione cognitiva e con scarsa risposta alla terapia farmacologica.<\/span><\/strong><\/p>\n

Montescano exists in the province of Pavia, Salvatore Maugeri Foundation at a rehabilitation center, where patients are followed by Parkinson’s disease.
\nA section dedicated to the same patients and also to those who suffer from multiple sclerosis, demyelinating disease of Rare, myelitis, myelopathy, Mielolesioni, neurodegenerative diseases. The patient is able to have answers to his questions, prompting a fight and it helps the medical-therapeutic-rehabilitative.<\/em><\/p>\n

Joseph FRAZZITTA, specialist in Neurology and Head of the Laboratory of Diagnostic and neuromuscular reeducation IRCCS Fondazione “S. Maugeri, Montescano (Pavia). Parkinson’s disease is a degenerative disease of the nervous system. E ‘caused by the degeneration of nerve cells in a small region of the brain called the substantia nigra. These cells produce a substance called dopamine is necessary for nerve transmission for greater control of movements, in particular those machines whose facial expressions, movements of the arms while driving commuters, but also the fine movements such as buttoning or tying your shoes. Incompletely known causes of disease. Are certainly involved both external factors such as toxins, that a biological predisposition that leads to death of nerve cells.<\/em><\/p>\n

It seems that | Prolonged contact with pesticides, fertilizers and pesticides could lead to outbreaks particularly in farmers exposed to large amounts of these substances. Certainly some drugs are involved or repeated head injury (consider the case of boxer Muhammad Ali). There are also rare cases of hereditary juvenile-onset, where several members of one family are affected, and on the basis of what are some genetic mutations that have been partially identified.<\/em><\/p>\n

How do you make the diagnosis? | Parkinson’s disease presents with three types of events. The tremor at rest, mainly at the hands and that is focusing initially on one side only. A reduction in speed of the movement called hypokinesia-akinesia: the movements of the body become slow, walking is difficult, as the dressing, writing, speaking. Rigidity: the patient complains of his legs stiff \/ heavy and passive mobilization of a limb is difficult to give the impression of moving a “lead pipe”. These clinical signs at presentation may be mild and it is rare that the disease is recognized first by months or even years, with serious consequences borne by patients. The tremor or reduced motility may be mistakenly attributed to fatigue, age or a state of depression. A ‘thorough medical history and especially a detailed neurological examination will lead to the final diagnosis. Neuroradiological examinations (CT, NMR, PET) as well as on history, family work and pharmacology are of help to exclude forms of parkinsonism secondary to vascular factors, toxic, pharmacological (eg neuroleptics, etc.).<\/em><\/p>\n

Evolves as Parkinson’s disease? | The evolution of the disease is highly variable. In most cases there will be a slowly progressive course. Are possible fluctuations in clinical status with periods of exacerbation (even in the presence of concomitant internal pathologies or infectious) followed by periods of stabilization. Schematically, we can distinguish the following stages: a first stage, called “honeymoon”, where the symptoms improve with treatment, interfering little with normal life. A second stage in which there are problems in the march and in daily activities, requiring adjustment of therapy and in which the patient is still autonomous. A third stage in which the patient presents with progressive difficulty in walking and need help as losing its autonomy. With the passage of time may appear other problems such as difficulty urinating, sleep disturbances, constipation, depression and cognitive impairment.<\/em><\/p>\n

How is Parkinson’s disease? | The treatment is to “compensate” the missing dopamine with the use of drugs that reproduce the effects. They are very effective at least at onset of disease. After a few years may see a sort of “phenomenon of exhaustion of the drug with consequent variation of the effects of treatment. The duration of the benefit of each dose can shorten engine blocks and can appear or involuntary movements. So we must change or combine multiple drug therapy. The maintenance of physical activity and neurological rehabilitation are essential to delay the onset of advanced and complicated form of the disease. Neurorehabilitation in particular a proper treatment at specialized centers may allow the patient with Parkinson’s disease to maintain for as long as possible personal autonomy and to minimize medication adjustments to avoid complications related to use of these drugs . Physiotherapy may allow the reduction of muscle retraction, maintaining the functionality of the spine, improve balance during movement and the maintenance of a normal gait as possible. The occupational therapy can improve independence in activities of daily living. Speech therapy may lead to an improvement of the word. May be helpful psychological support for both the patient and carer. The role of the environment and the empowerment of patients to follow treatment are essential. Several associations can be helpful and of these, in Italy, the Italian Association Parkinson (AIP) and Parkinson’s Action (AP). More recently developed a technique of deep brain stimulation with a technique called stereotactic neurochirugica by which some electrodes are inserted at the level of dysfunctioning basal ganglia. This action is performed in several divisions of neurosurgery in Italy and finds its indication remains relatively prevalent in young subjects with disease of long standing, with no cognitive impairment and poor response to medication.<\/em><\/p>\n

Montescano existe dans la province de Pavie, Salvatore Maugeri Foundation \u00e0 un centre de r\u00e9\u00e9ducation, o\u00f9 les patients sont suivis par la maladie de Parkinson.
\nUne section d\u00e9di\u00e9e \u00e0 ces m\u00eames patients et aussi pour ceux qui souffrent de scl\u00e9rose en plaques, maladie d\u00e9my\u00e9linisante de Rare, my\u00e9lite, une my\u00e9lopathie Mielolesioni, les maladies neurod\u00e9g\u00e9n\u00e9ratives. Le patient est en mesure d’avoir des r\u00e9ponses \u00e0 ses questions, provoquant une bagarre et elle aide l’r\u00e9adaptation m\u00e9dico-th\u00e9rapeutiques.<\/em><\/p>\n

Joseph FRAZZITTA, sp\u00e9cialiste en neurologie et directeur du Laboratoire de diagnostic et de r\u00e9\u00e9ducation neuromusculaire IRCCS Fondazione “S. Maugeri, Montescano (Pavie). La maladie de Parkinson est une maladie d\u00e9g\u00e9n\u00e9rative du syst\u00e8me nerveux. E ‘caus\u00e9e par la d\u00e9g\u00e9n\u00e9rescence des cellules nerveuses d’une petite r\u00e9gion du cerveau appel\u00e9e substance noire. Ces cellules produisent une substance appel\u00e9e dopamine est n\u00e9cessaire \u00e0 la transmission nerveuse pour un meilleur contr\u00f4le des mouvements, en particulier ceux des machines dont les expressions faciales, les mouvements des bras tout en conduisant les navetteurs, mais aussi les beaux mouvements tels que boutonner ou \u00e0 lacer vos chaussures. Incompl\u00e8tement connus causes de la maladie. Sont certainement impliqu\u00e9es \u00e0 la fois des facteurs externes tels que les toxines, que la pr\u00e9disposition biologique qui conduit \u00e0 la mort des cellules nerveuses.<\/em><\/p>\n

Il semble que | contact prolong\u00e9 avec des pesticides, des engrais et des pesticides pourrait conduire \u00e0 des \u00e9pid\u00e9mies particuli\u00e8rement chez les agriculteurs expos\u00e9s \u00e0 de grandes quantit\u00e9s de ces substances. Certes, certains m\u00e9dicaments sont en cause ou les traumatismes cr\u00e2niens r\u00e9p\u00e9t\u00e9s (cf. le cas du boxeur Muhammad Ali). Il existe aussi de rares cas d’apparition h\u00e9r\u00e9ditaire juv\u00e9nile, o\u00f9 plusieurs membres d’une m\u00eame famille sont touch\u00e9s, et sur la base de ce que sont certaines mutations g\u00e9n\u00e9tiques qui ont \u00e9t\u00e9 partiellement identifi\u00e9s.<\/em><\/p>\n

Comment pouvez-vous faire le diagnostic? Maladie | maladie de Parkinson se pr\u00e9sente avec trois types d’\u00e9v\u00e9nements. Le tremblement au repos, principalement aux mains et c’est en se concentrant initialement sur un seul c\u00f4t\u00e9. Une r\u00e9duction de la vitesse du mouvement appel\u00e9 hypokin\u00e9sie, akin\u00e9sie: les mouvements du corps deviennent lents, la marche est difficile, comme le pansement, \u00e9crit, parl\u00e9. Rigidit\u00e9: le patient se plaint de ses jambes raides et la mobilisation forte et passive d’un membre est difficile de donner l’impression d’avancer un \u00abtuyau de plomb”. Ces signes cliniques lors de la pr\u00e9sentation mai \u00eatre l\u00e9g\u00e8re et il est rare que la maladie est reconnue d’abord par mois, voire des ann\u00e9es, avec de graves cons\u00e9quences support\u00e9es par les patients. Le tremblement ou la motilit\u00e9 r\u00e9duite mai \u00e0 tort \u00eatre attribu\u00e9s \u00e0 la fatigue, l’\u00e2ge ou un \u00e9tat de d\u00e9pression. Anamn\u00e8se m\u00e9dicale A ‘et en particulier un examen neurologique d\u00e9taill\u00e9 sera conduit au diagnostic final. Examens neuroradiologiques (CT, NMR, PET) ainsi que sur l’histoire, le travail familial et la pharmacologie sont de contribuer \u00e0 exclure les formes de parkinsonisme secondaire \u00e0 des facteurs vasculaires, toxiques, pharmacologiques (neuroleptiques, par exemple, etc.)<\/em><\/p>\n

\u00c9volue \u00e0 mesure que la maladie de Parkinson? | L’\u00e9volution de la maladie est tr\u00e8s variable. Dans la plupart des cas, il y aura une \u00e9volution lente et progressive. Sont \u00e9ventuelles fluctuations de l’\u00e9tat clinique avec des p\u00e9riodes d’exacerbation (m\u00eame en pr\u00e9sence de pathologies concomitantes interne ou infectieuse) suivies de p\u00e9riodes de stabilisation. Sch\u00e9matiquement, on peut distinguer les \u00e9tapes suivantes: une premi\u00e8re \u00e9tape, appel\u00e9e \u00ablune de miel”, o\u00f9 l’am\u00e9lioration des sympt\u00f4mes avec un traitement, peu d’interf\u00e9rer avec la vie normale. Une deuxi\u00e8me \u00e9tape dans laquelle il ya des probl\u00e8mes dans le mois de mars et dans les activit\u00e9s quotidiennes, n\u00e9cessitant un ajustement de la th\u00e9rapie et dans lequel le patient est encore autonome. Une troisi\u00e8me \u00e9tape dans laquelle le patient se pr\u00e9sente avec une difficult\u00e9 progressive \u00e0 la marche et ont besoin d’aide que de perdre son autonomie. Avec le passage du temps mai apparaissent d’autres probl\u00e8mes comme la difficult\u00e9 \u00e0 uriner, troubles du sommeil, la constipation, la d\u00e9pression et les troubles cognitifs.<\/em><\/p>\n

Comment la maladie de Parkinson? | Le traitement consiste \u00e0 \u00abcompenser\u00bb la dopamine manquante par la consommation de drogues, qui reproduisent les effets. Ils sont tr\u00e8s efficaces au moins au d\u00e9but de la maladie. Apr\u00e8s quelques ann\u00e9es mai vois une sorte de “ph\u00e9nom\u00e8ne de l’\u00e9puisement de la drogue avec une variation cons\u00e9quente des effets du traitement. La dur\u00e9e de la prestation de chaque dose peut raccourcir les blocs moteurs et peuvent appara\u00eetre ou des mouvements involontaires. Il nous faut donc modifier ou de combiner un traitement m\u00e9dicamenteux multiples. Le maintien de l’activit\u00e9 physique et de r\u00e9adaptation neurologique sont indispensables pour retarder l’apparition de la forme \u00e9volu\u00e9e et complexe de la maladie. Neurorehabilitation en particulier un traitement appropri\u00e9 dans des centres sp\u00e9cialis\u00e9s mai permettre au patient de la maladie de Parkinson afin de maintenir aussi longtemps que l’autonomie personnelle possible et de r\u00e9duire au minimum les ajustements pour \u00e9viter les complications li\u00e9es \u00e0 la drogue \u00e0 l’utilisation de ces m\u00e9dicaments . Physioth\u00e9rapie mai permettra la r\u00e9duction de la r\u00e9traction des muscles, en maintenant les fonctions de la colonne vert\u00e9brale, d’am\u00e9liorer l’\u00e9quilibre pendant le mouvement et le maintien d’une d\u00e9marche normale que possible. L’ergoth\u00e9rapie peut am\u00e9liorer l’autonomie dans les activit\u00e9s de la vie quotidienne. Logop\u00e9die mai conduire \u00e0 une am\u00e9lioration du mot. Mai \u00eatre utile un soutien psychologique \u00e0 la fois pour le patient et le soignant. Le r\u00f4le de l’environnement et l’autonomisation des patients de suivre un traitement sont essentiels. Plusieurs associations peuvent \u00eatre utiles et de ces derniers, en Italie, l’Italien de Parkinson Association (AIP) et l’action de Parkinson (AP). Plus r\u00e9cemment d\u00e9velopp\u00e9 une technique de stimulation c\u00e9r\u00e9brale profonde avec une technique appel\u00e9e neurochirugica st\u00e9r\u00e9otaxique par lesquels certaines \u00e9lectrodes sont ins\u00e9r\u00e9s au niveau de dysfonctionnements des noyaux gris centraux. Cette action est r\u00e9alis\u00e9e en plusieurs divisions de la neurochirurgie en Italie et trouve son indication demeure relativement fr\u00e9quentes chez les sujets jeunes ayant une maladie de longue date, sans troubles cognitifs et une mauvaise r\u00e9ponse \u00e0 la m\u00e9dication.<\/em><\/p>\n

Nuove prospettive di terapia per il Parkinson<\/a><\/strong><\/span><\/p>\n

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351 \t\t\t\t\t\tmetri in 6 minuti di cammino, all\u2019incirca la stessa \t\t\t\t\t\tdistanza che percorre un soggetto sano della stessa et\u00e0: \t\t\t\t\t\tquesto \u00e8 il risultato ottenuto dai pazienti affetti da \t\t\t\t\t\tMalattia di Parkinson utilizzando il Locomotor training \t\t\t\t\t\tnella riabilitazione anzich\u00e9 il tradizionale protocollo \t\t\t\t\t\tche prevede solo stimoli acustici e visivi. \u00c8 il dato \t\t\t\t\t\tpi\u00f9 importante che emerge dallo studio \u201cIl trattamento \t\t\t\t\t\triabilitativo della deambulazione nei pazienti con \t\t\t\t\t\tMalattia di Parkinson e freezing della marcia: confronto \t\t\t\t\t\tfra due protocolli riabilitativi che utilizzano cues \t\t\t\t\t\tvisivi e uditivi associati o meno a treadmill training\u201d \t\t\t\t\t\tpubblicato lo scorso anno sulla prestigiosa rivista \t\t\t\t\t\tMoviment Disorders. Il lavoro \u00e8 stato presentato al \t\t\t\t\t\t\u201cXIII Congresso Mondiale sulla Malattia di Parkinson e i \t\t\t\t\t\tDisturbi del Movimento\u201d tenutosi a Parigi lo scorso \t\t\t\t\t\tanno. La ricerca, condotta dall\u2019equipe del dr. \t\t\t\t\t\tGiuseppe Frazzitta, responsabile del Laboratorio di \t\t\t\t\t\tDiagnostica e Rieducazione Neuromuscolare dell\u2019Istituto \t\t\t\t\t\tScientifico dell\u2019IRCCS Fondazione Maugeri di Montescano, \t\t\t\t\t\tapre nuove prospettive terapeutiche ed ha infatti \t\t\t\t\t\tsuscitato un grande interesse nel mondo scientifico \t\t\t\t\t\tinternazionale, in particolare nel prof. Nir Giladi, \t\t\t\t\t\tresponsabile del Moviment Disorders Unit del Souraski \t\t\t\t\t\tMedical Center di Tel Aviv.<\/strong><\/span><\/p>\n

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dr. Giuseppe \t\t\t\t\t\tFrazzitta<\/em><\/span><\/strong><\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

<\/span>Lo studio, prevedeva il confronto fra due gruppi di \t\t\t\t\t\tpazienti di cui il primo veniva sottoposto ad un \t\t\t\t\t\ttrattamento riabilitativo del cammino utilizzando il \t\t\t\t\t\tlocomotor training ed il secondo invece ad un classico \t\t\t\t\t\ttrattamento con cues (= stimoli) visivo ed uditivo. \t\t\t\t\t\tNumerosi studi hanno dimostrato in passato l\u2019efficacia \t\t\t\t\t\tdell\u2019utilizzo di cues visivi e uditivi oppure di tapis \t\t\t\t\t\troulant, usati singolarmente, nella riabilitazione del \t\t\t\t\t\tcammino nei pazienti con Malattia di Parkinson. \u201cIl \t\t\t\t\t\tnostro lavoro <\/em>\u2013 racconta il dr. Frazzitta \u2013 nasce nel 1999 quando, con l\u2019allora responsabile dr. \t\t\t\t\t\tCasale, abbiamo iniziato a sviluppare un percorso \t\t\t\t\t\triabilitativo per i pazienti affetti da Malattia di \t\t\t\t\t\tParkinson che afferivano al nostro centro. La svolta \t\t\t\t\t\tnella nostra ricerca \u00e8 avvenuta per\u00f2 a partire dal 2006 \t\t\t\t\t\tquando, dal responsabile della Neuroriabilitazione dr. \t\t\t\t\t\tFelicetti, mi \u00e8 stato affidato il laboratorio di \t\t\t\t\t\tDiagnostica e rieducazione neuromuscolare e abbiamo \t\t\t\t\t\tquindi iniziato ad utilizzare il locomotor training con \t\t\t\t\t\ti risultati ora noti.\u201d<\/em> Il locomotor training \u00e8 \t\t\t\t\t\tinfatti una macchina che permette di utilizzare tutti i \t\t\t\t\t\tcues contemporaneamente; \u00e8 costituito da un tapis \t\t\t\t\t\troulant, da uno stimolo acustico che determina il ritmo \t\t\t\t\t\tdella marcia e da uno schermo su cui appaiono l\u2019immagine \t\t\t\t\t\tgrafica di un box e del piede del paziente. Quando \t\t\t\t\t\tl\u2019immagine del piede si sovrappone correttamente al box \t\t\t\t\t\tdurante la marcia appare un feedback positivo.
\nIl confronto tra le performance ottenute nei due gruppi, \t\t\t\t\t\tprima e dopo il trattamento, ha dimostrato che i \t\t\t\t\t\tpazienti trattati con il locomotor raggiungevano \t\t\t\t\t\trisultati di gran lunga superiori rispetto al gruppo \t\t\t\t\t\ttrattato con la riabilitazione tradizionale. I riscontri \t\t\t\t\t\tpi\u00f9 importanti dal punto di vista clinico si sono visti \t\t\t\t\t\tnel test che misura quanti metri compie un soggetto in 6 \t\t\t\t\t\tminuti.
\nI pazienti del gruppo che ha utilizzato il locomotor, al \t\t\t\t\t\ttermine del trattamento, percorrevano in 6 minuti 351 \t\t\t\t\t\tmetri, all\u2019incirca la stessa distanza che percorre un \t\t\t\t\t\tsoggetto sano della stessa et\u00e0. Confrontando i dati \t\t\t\t\t\tfinali con quelli registrati all\u2019inizio del trattamento, \t\t\t\t\t\ti pazienti percorrevano ben 130 metri in pi\u00f9, a \t\t\t\t\t\tdifferenza dei 57 metri in pi\u00f9 percorsi dai pazienti del \t\t\t\t\t\tgruppo sottoposto al trattamento tradizionale. Dai dati \t\t\t\t\t\tpreliminari del follow up, si pu\u00f2 affermare che \t\t\t\t\t\tl\u2019efficacia della riabilitazione con locomotor training \t\t\t\t\t\tsi protrae per un periodo di circa 10 mesi. In sostanza \t\t\t\t\t\til locomotor, permettendo di associare pi\u00f9 stimoli \t\t\t\t\t\tcontemporaneamente, \u00e8 in grado di migliorare l\u2019efficacia \t\t\t\t\t\tottenuta con i tradizionali stimoli utilizzati \t\t\t\t\t\tsingolarmente.<\/strong><\/span><\/p>\n

\u201cCertamente si tratta di un momento importante sia \t\t\t\t\t\tper i pazienti affetti da Malattia di Parkinson, che \t\t\t\t\t\thanno a disposizione una nuova prospettiva terapeutica, \t\t\t\t\t\tsia per la ricerca Italiana nel campo della \t\t\t\t\t\triabilitazione \u2013<\/em> conclude il<\/strong> dr. Frazzitta \u2013. \t\t\t\t\t\tCi\u00f2 che \u00e8 ulteriormente rilevante, a nostro parere, \u00e8 \t\t\t\t\t\tche i pazienti sono estremamente soddisfatti dei \t\t\t\t\t\trisultati ottenuti e ci chiedono di poter tornare per un \t\t\t\t\t\tnuovo trattamento. Inoltre, la ricerca in questo campo \u00e8 \t\t\t\t\t\tin continua evoluzione: abbiamo condotto altri due studi \t\t\t\t\t\tper indagare ulteriori parametri in grado di provare \t\t\t\t\t\tl\u2019efficacia del trattamento riabilitativo dei malati di \t\t\t\t\t\tParkinson; uno in particolare, di prossima pubblicazione \t\t\t\t\t\ton-line su Moviment Disorders, ci permette di calcolare \t\t\t\t\t\ti progressi raggiunti dai pazienti attraverso la \t\t\t\t\t\tvalutazione delle modificazioni della curva metabolica \t\t\t\t\t\tdurante il cammino.\u201d<\/em><\/strong><\/span><\/p>\n

Lo studio<\/span> ha coinvolto 40 pazienti affetti da \t\t\t\t\t\tmalattia di Parkinson di et\u00e0 media 71 anni, divisi in \t\t\t\t\t\tdue gruppi da 20. Il primo gruppo \u00e8 stato sottoposto al \t\t\t\t\t\tprotocollo sperimentale con locomotor per 20 minuti ogni \t\t\t\t\t\tgiorno per 4 settimane a velocit\u00e0 di scorrimento del \t\t\t\t\t\ttapis roulant progressivamente crescente, in tutto 28 \t\t\t\t\t\tsessioni. Nel display viene visualizzato un obiettivo da \t\t\t\t\t\traggiungere mentre appare la forma dei piedi in marcia. \t\t\t\t\t\tQuando la marcia del paziente procede correttamente, \t\t\t\t\t\tl\u2019impronta dei piedi \u00e8 sincronizzata con la \t\t\t\t\t\tforma-obiettivo e sullo schermo appare la scritta \u201cben \t\t\t\t\t\tfatto\u201d; quando invece il cammino esce dal range \t\t\t\t\t\tdefinito, l\u2019appoggio del piede e l\u2019impronta-obiettivo, \t\t\t\t\t\tnon sono sincronizzati e il paziente viene invitato a \t\t\t\t\t\tmodificare l\u2019andatura. Contemporaneamente, uno stimolo \t\t\t\t\t\taudio, che consiste in battute sincronizzate con gli \t\t\t\t\t\tstimoli visivi, d\u00e0 al paziente il ritmo della marcia.
\nI pazienti del secondo gruppo, che venivano sottoposti \t\t\t\t\t\tal trattamento \u201cclassico\u201d dovevano invece camminare su \t\t\t\t\t\tun semplice percorso definito da linee orizzontali \t\t\t\t\t\taccompagnati dallo stimolo audio che scandiva il ritmo \t\t\t\t\t\tdel cammino incrementando progressivamente la velocit\u00e0 \t\t\t\t\t\tdel passo.<\/strong><\/span><\/p>\n

http:\/\/www.gosalute.it\/notizie\/?id=1202<\/a><\/strong><\/span><\/p>\n

http:\/\/archiviostorico.corriere.it\/2010\/febbraio\/03\/Tapis_roulant_anti_Parkinson_con_co_8_100203046.shtml<\/a><\/strong><\/span><\/p>\n

http:\/\/www.agipapress.it\/site\/print.php?noe_cod=16417<\/a>
\n<\/strong><\/span><\/p>\n

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351 meters in 6 minutes walking distance, approximately the same distance along a healthy person of the same age: this is the result obtained from patients suffering from Parkinson’s disease using the Locomotor training in rehabilitation rather than the traditional protocol that provides only acoustic stimuli and visual. It is the most important fact which emerges from the study “The treatment of gait rehabilitation in patients with Parkinson’s disease and freezing of walking: comparison of two rehabilitation protocols that use visual and auditory cues or less associated with treadmill training” published last year on the prestigious magazine Moviment Disorders. The work was presented at the “XIII World Congress on Parkinson’s Disease and Movement Disorders” held in Paris last year. The research, conducted by the team of dr. FRAZZITTA Joseph, Head of Laboratory Diagnostics and Rehabilitation Neuromuscular Scientific Institute IRCCS Fondazione Maugeri of Montescano, opens up new possibilities of treatment and has indeed attracted much attention in the international scientific world, especially in the prof. Nir Giladi, head of the bustling Souraski Disorders Unit of the Medical Center of Tel Aviv.<\/em><\/p>\n

dr. Joseph FRAZZITTA<\/em><\/p>\n

The study, which included a comparison between two groups of patients whose first treatment was subjected to a rehabilitation of the road using the locomotor training and the second hand to a classical treatment cues (= stimuli) visual and auditory. Numerous studies have previously shown the effectiveness of using visual and auditory cues or treadmill, used alone, in the rehabilitation of the road in patients with Parkinson’s disease. “Our work – says the dr. FRAZZITTA – born in 1999 when, with the then head dr. Casale, we started to develop a course of rehabilitation for patients suffering from Parkinson’s disease that relate to our center. The turning point in our research took place but since 2006 when, by the head of Neurorehabilitation dr. Felicetti, I was given the laboratory diagnostics and neuromuscular re-education and have thus started to use the locomotor training with results now known. “The locomotor training is in fact a machine that allows you to use all cues simultaneously, consists of a conveyor walkway, one acoustic stimulus that determines the pace of the march and a screen on which appear the graphic image of a box and the foot of the patient. When the image of the foot overlap correctly at the box while driving is a positive feedback.
\nComparison of the performance obtained in both groups before and after treatment showed that patients treated with the locomotive achieving results far greater than the group treated with conventional rehabilitation. The most important findings from the clinical point of view have been seen in tests that measure how a person performs meters in 6 minutes.
\nPatients in the group that used the locomotive, at the end of treatment, 6 minutes to travel the 351 meters, roughly the same distance along a healthy person the same age. By comparing the final data with those recorded at the beginning of treatment, patients traveled 130 meters more, unlike the 57 meters in multiple paths to the patients in the group receiving traditional treatment. Preliminary data from follow-up, we can say that the effectiveness of rehabilitation with locomotor training lasts for a period of about 10 months. In essence, the locomotive, allowing you to associate multiple stimuli simultaneously, you can improve the efficiency obtained with the traditional stimuli used individually.<\/em><\/p>\n

“Certainly this is an important moment both for patients suffering from Parkinson’s disease, which provide a new therapeutic approach, both for the Italian research in the field of rehabilitation – concludes dr. FRAZZITTA -. What is more important, in our opinion, is that patients are extremely satisfied with the results and ask us to come back for a new treatment. In addition, research in this area is evolving, we have conducted two studies to investigate additional parameters to test the effectiveness of rehabilitation treatment of patients with Parkinson’s, one in particular, to be published online at Moviment Disorders allows us to calculate the progress achieved by the patients through the evaluation of metabolic changes of the curve along the way. “<\/em><\/p>\n

The study involved 40 patients suffering from Parkinson’s disease patients, average age 71 years, divided into two groups of 20. The first group was subjected to an experimental protocol loco for 20 minutes every day for 4 weeks in flow speed of the treadmill progressively increasing in all 28 sessions. In the display appears as a goal to achieve the shape of the foot during running. When the movement of the patient checks out, the imprint of the feet is synchronized with the target shape and the screen displays the words “well done”, even though the path leaves the defined range, the support of the foot el’impronta target are not synchronized and the patient is asked to change the pace. Simultaneously, an audio stimulus, which consists of bars synchronized with visual stimuli, gives the patient the pace of the march.
\nPatients in the second group, who were treated “classic” instead had to walk on a simple path defined by horizontal lines accompanied by audio stimulus that the rhythm of the road gradually increasing the speed of the pitch.<\/em><\/p>\n

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351 m\u00e8tres en 6 minutes \u00e0 pied, environ la m\u00eame distance le long d’une personne en bonne sant\u00e9 de m\u00eame \u00e2ge: c’est le r\u00e9sultat obtenu chez des patients souffrant de la maladie de Parkinson en utilisant la formation en r\u00e9adaptation locomotrice plut\u00f4t que le protocole traditionnel qui fournit seulement des stimuli acoustiques et visuelles. C’est le fait le plus important qui se d\u00e9gage de l’\u00e9tude intitul\u00e9e “Le traitement de la d\u00e9marche de r\u00e9adaptation chez les patients pr\u00e9sentant la maladie de Parkinson et le gel de la marche: comparaison de deux protocoles de r\u00e9habilitation qui utilisent des rep\u00e8res visuels et auditifs ou moins associ\u00e9s \u00e0 la formation de tapis roulant\u00bb, publi\u00e9 l’an dernier sur le prestigieux Magazine Disorders Moviment. Les travaux ont \u00e9t\u00e9 pr\u00e9sent\u00e9s \u00e0 la \u00abXIII Congr\u00e8s mondial sur la maladie de Parkinson et les troubles du mouvement\u00bb qui s’est tenu \u00e0 Paris l’an dernier. L’\u00e9tude, r\u00e9alis\u00e9e par l’\u00e9quipe du dr. FRAZZITTA Joseph, chef de diagnostics de laboratoire et r\u00e9adaptation neuromusculaire Institut Scientifique IRCCS Fondazione Maugeri de Montescano, ouvre de nouvelles possibilit\u00e9s de traitement et a en effet attir\u00e9 beaucoup d’attention dans le monde scientifique international, en particulier dans le prof. Nir Giladi, chef de l’anim\u00e9 Souraski unit\u00e9 des d\u00e9sordres du Centre m\u00e9dical de Tel Aviv.<\/em><\/p>\n

dr. Joseph FRAZZITTA<\/em><\/p>\n

L’\u00e9tude, qui comprenait une comparaison entre deux groupes de patients dont le premier traitement a \u00e9t\u00e9 soumis \u00e0 une r\u00e9habilitation de la route en utilisant la formation locomoteur et de l’aiguille des secondes \u00e0 un traitement classique des signaux (= stimuli) visuelles et auditives. De nombreuses \u00e9tudes ont d\u00e9j\u00e0 montr\u00e9 l’efficacit\u00e9 de l’utilisation de rep\u00e8res visuels et auditifs, ou un tapis roulant, utilis\u00e9 seul, dans la r\u00e9habilitation de la route chez les patients atteints de la maladie de Parkinson. \u00abNotre travail – dit le dr. FRAZZITTA – n\u00e9 en 1999 quand, avec le Dr, puis la t\u00eate. Casale, nous avons commenc\u00e9 \u00e0 \u00e9laborer un cours de r\u00e9habilitation pour des patients souffrant de la maladie de Parkinson, qui se rapportent \u00e0 notre centre. Le point tournant dans notre recherche a eu lieu mais, depuis 2006, lorsque, par le chef de dr Neurorehabilitation. Felicetti, on m’a donn\u00e9 le diagnostic de laboratoire et r\u00e9 neuromusculaire l’\u00e9ducation et ont donc commenc\u00e9 \u00e0 utiliser la formation locomotrice avec des r\u00e9sultats d\u00e9sormais connus. \u00abLa formation locomotrice est en fait une machine qui vous permet d’utiliser tous les indices simultan\u00e9ment, se compose d’un convoyeur , d’un passage un stimulus acoustique qui d\u00e9termine le rythme du mois de mars et un \u00e9cran sur lequel appara\u00eet l’image d’une bo\u00eete et le pied du patient. Lorsque l’image du pied se chevauchent correctement \u00e0 la case tout en conduisant est une r\u00e9troaction positive.
\nComparaison des performances obtenues dans les deux groupes avant et apr\u00e8s le traitement ont montr\u00e9 que les patients trait\u00e9s avec la locomotive de parvenir \u00e0 des r\u00e9sultats beaucoup plus grande que le groupe trait\u00e9 par r\u00e9\u00e9ducation conventionnelle. Les r\u00e9sultats les plus importants du point de vue clinique, ont \u00e9t\u00e9 vus dans les tests qui mesurent la fa\u00e7on dont une personne accomplit m\u00e8tres en 6 minutes.
\nLes patients dans le groupe qui a utilis\u00e9 la locomotive, \u00e0 la fin du traitement, \u00e0 6 minutes de Voyage des 351 m\u00e8tres, soit environ la m\u00eame distance le long d’une personne en bonne sant\u00e9 du m\u00eame \u00e2ge. En comparant les donn\u00e9es finales \u00e0 ceux enregistr\u00e9s au d\u00e9but du traitement, les patients ont parcouru 130 m\u00e8tres de plus, contrairement aux 57 m\u00e8tres dans des voies multiples pour les patients dans le groupe recevant un traitement traditionnel. Les donn\u00e9es pr\u00e9liminaires de suivi, nous pouvons dire que l’efficacit\u00e9 de la r\u00e9adaptation locomotrice \u00e0 la formation dure pendant une p\u00e9riode d’environ 10 mois. En substance, la locomotive, vous permettant d’associer plusieurs stimuli en m\u00eame temps, vous pouvez am\u00e9liorer l’efficacit\u00e9 obtenue avec les stimuli traditionnelles utilis\u00e9es individuellement.<\/em><\/p>\n

“Certainement c’est un moment important tant pour les patients souffrant de la maladie de Parkinson, qui offrent une nouvelle approche th\u00e9rapeutique, tant pour la recherche italien dans le domaine de la r\u00e9adaptation -, conclut le docteur. FRAZZITTA -. Ce qui est plus important, \u00e0 notre avis, est que les patients sont extr\u00eamement satisfaits des r\u00e9sultats et nous demandent de revenir pour un nouveau traitement. En outre, la recherche dans ce domaine est en constante \u00e9volution, nous avons men\u00e9 deux \u00e9tudes pour \u00e9tudier les param\u00e8tres suppl\u00e9mentaires pour tester l’efficacit\u00e9 du traitement de r\u00e9adaptation des patients atteints de Parkinson, une en particulier, qui sera publi\u00e9 en ligne \u00e0 des troubles Moviment nous permet de calculer les progr\u00e8s r\u00e9alis\u00e9s par les patients \u00e0 travers l’\u00e9valuation des changements du m\u00e9tabolisme de la courbe le long du chemin. “<\/em><\/p>\n

L’\u00e9tude a port\u00e9 sur 40 patients souffrant de patients la maladie de Parkinson, \u00e2ge moyen 71 ans, r\u00e9partis en deux groupes de 20. Le premier groupe \u00e9tait soumis \u00e0 une loco protocole exp\u00e9rimental pendant 20 minutes chaque jour pendant 4 semaines en vitesse d’\u00e9coulement du tapis de course progressivement croissante en tout 28 s\u00e9ances. Dans l’affichage appara\u00eet comme un objectif \u00e0 r\u00e9aliser la forme du pied pendant la marche. Lorsque le mouvement du patient sur les contr\u00f4les, l’empreinte des pieds est synchronis\u00e9e avec la forme de la cible et l’\u00e9cran affiche les mots “bien fait”, m\u00eame si le chemin quitte la plage d\u00e9finie, le soutien de la cible el’impronta pied ne sont pas synchronis\u00e9s et le patient est invit\u00e9 \u00e0 changer le rythme. Simultan\u00e9ment, un stimulus sonore, qui se compose de barres synchronis\u00e9es avec des stimuli visuels, donne au patient le rythme du mois de mars.
\nLes patients du second groupe, qui ont \u00e9t\u00e9 trait\u00e9s “classiques” \u00e0 la place ont d\u00fb marcher sur une voie simple d\u00e9finie par des lignes horizontales accompagn\u00e9es par un stimulus sonore que le rythme de la route en augmentant progressivement la vitesse de la pelouse.<\/em><\/p>\n


\n<\/em><\/strong><\/p>\n

Curriculum Vitae di Frazzitta Dot. Giuseppe<\/a><\/em><\/strong><\/p>\n

Dott. Frazzitta Giuseppe
\nCurriculum Vitae et Studiorum
\nAutorizzo al trattamento dei miei dati personali ai sensi del D.L. 30 giugno 2003 n.196.
\nNato a Marsala il 07 agosto 1962
\nMedico Specialista in Neurologia
\nDirigente Medico presso l\u2019IRCCS Fondazione \u201cS. Maugeri\u201d
\nCentro di Montescano (PV)
\nEsperto in malattie neurodegenerative (Parkinson ed Alzheimer)
\nEsperto nella diagnosi e cura delle cefalee
\nStudi e Formazione
\nLaureato in Medicina e Chirurgia presso l’Universit\u00e0 di Pavia nel 1988 con il massimo di voti discutendo una tesi sul trattamento farmacologico delle complicanze neurologiche nei pazienti con abuso cronico di alcool;
\nSpecializzato in Neurologia presso l’Universit\u00e0 di Pavia nel 1992 con il massimo dei voti e lode discutendo una tesi sulla riabilitazione dei pazienti affetti da esiti di ictus cerebri;
\nPer il quadriennio della Specialit\u00e0 di Neurologia ha usufruito di una “Borsa di Studio per la frequenza della Scuola di Specializzazione” dell’Universit\u00e0 di Pavia;
\ndal 1989 al 1990 come Ufficiale Medico ha ricoperto l’incarico di assistente presso il reparto di Ortopedia dell’Ospedale Militare di Milano;
\n-dal 1992 al 1993 ha frequentato, con una borsa di studio dell\u2019Istituto Neurologico \u201cC. Mondino\u201d di Pavia, il Centro di Riabilitazione Funzionale “G. Verdi” di Villanova sull’Arda (PC) occupandosi della riabilitazione dei pazienti mielolesi.
\nEsperienze Lavorative
\n-dal Luglio 1992 al Luglio 1999 ha lavorato come consulente del Ministero di Grazia e Giustizia presso la Casa Circondariale di Pavia;
\n-dal Dicembre 1993 al Dicembre 1999 ha lavorato in qualit\u00e0 di Dirigente Medico di 1\u00b0 livello presso l’U.O. di Neurologia dell’Azienda Ospedaliera di Busto Arsizio (VA) dove \u00e8 stato Responsabile dell\u2019Ambulatorio per le malattie neurodegenerative (Parkinson ed Alzheimer) e dell\u2019ambulatorio per le cefalee. In questo periodo \u00e8 stato membro del Gruppo di lavoro Provinciale per la malattia di Alzheimer, promosso dall\u2019Assessorato alle Politiche Sociali della Provincia di Varese;
\n-dal Dicembre 1999 lavora con la qualifica di Dirigente Medico di 1\u00b0 livello-Aiuto presso l\u2019IRCCS Fondazione \u201cS. Maugeri\u201d – Centro di Montescano (PV). Oltre ad occuparsi degli esami neurofisiologici (EEG, EMG, Potenziali evocati) e dell\u2019ambulatorio UVA (Unit\u00e0 valutativa Alzheimer). Ha sviluppato in questi anni un protocollo riabilitativo multidisciplinare specifico per il trattamento dei pazienti affetti da Malattia di Parkinson cui partecipano fisiatri, nutrizionisti, angiologi, psicologi, terapisti occupazionali;
\n-Dall\u2019Aprile 2006 \u00e8 Responsabile del \u201cLaboratorio di Diagnostica e Rieducazione neuromotoria\u201d presso l\u2019IRCCS Fondazione \u201cS. Maugeri\u201d – Centro di Montescano (PV) dove, tra gli altri argomenti di ricerca, si occupa dello studio dell\u2019efficacia delle tecniche riabilitive sul cammino nei pazienti affetti da malattia di Parkinson, della valutazione dell\u2019efficacia delle metodiche di riabilitazione propriocettive sui disturbi dell\u2019equilibrio in pazienti affetti da malattia di Parkinson ed atassia sensitiva periferica e centrale, dello studio mediante valutazione isocinetica delle patologie neurologiche piramidali ed extrapiramidali;
\nEsperto nell\u2019uso della tossina botulinica nel trattamento sia della spasticit\u00e0 che delle distonie;
\nCoautore di circa 90 pubblicazioni scientifiche su riviste internazionali e nazionali, ed \u00e8 stato relatore in numerosi congressi di Societ\u00e0 mediche nazionali (SIN, SIMFER, LIMPE).
\nAutorizzo al trattamento dei miei dati personali ai sensi del D.L. 30 giugno 2003 n.196.<\/span><\/strong><\/p>\n

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Curriculum Vitae FRAZZITTA Dot. Joseph<\/em><\/p>\n

Dr. Joseph FRAZZITTA <\/em>
\nCurriculum Vitae et Studiorum
\nAuthorize to handle my personal data according to DL June 30, 2003 196.
\nBorn in Marsala 07 agosto 1962
\nMedical Specialist in Neurology
\nMedical Director at the IRCCS Fondazione “S. Maugeri ”
\nCenter Montescano (PV)
\nExpert in neurodegenerative diseases (Parkinson and Alzheimer)
\nExperienced in the diagnosis and treatment of headaches
\nStudies and Training
\nGraduated in Medicine at the University of Pavia in 1988 with the most votes with a thesis on the pharmacological treatment of neurological complications in patients with chronic abuse of alcohol;
\nSpecializing in Neurology at the University of Pavia in 1992 with highest honors with a thesis on rehabilitation of patients with sequelae of stroke cerebri;
\nFor the four specialty of Neurology has received a “Scholarship for attending the School of Specialization of the University of Pavia;
\n1989 to 1990 as a medical officer has served as an assistant at the Department of Military Orthopedic Hospital of Milan;
\n-from 1992 to 1993 he attended, with a scholarship of the Neurological Institute “C. Mondino “of Pavia, the Center for Functional Rehabilitation” G. Verdi “Villanova sull’Arda (PC) addressing the rehabilitation of patients mielolesi.
\nWork Experience
\n-from July 1992 to July 1999 he worked as a consultant to the Ministry of Justice at the House Circondariale of Pavia;
\n-from December 1993 to December 1999 he worked as Medical Director of 1st level at the OU of Neurology of the Hospital of Busto Arsizio (VA) where he was Head of the surgery for neurodegenerative diseases (Parkinson and Alzheimer) and the surgery for headaches. In this period he was a member of the Provincial Working Group on Alzheimer’s disease, promoted by the Social Policy of the Province of Varese;
\nwork-from December 1999 with the rank of Medical Director of 1st level-aid from the IRCCS Fondazione “S. Maugeri “- Center Montescano (PV). Besides dealing neurophysiological examinations (EEG, EMG, evoked potentials) and the surgery UVA (Alzheimer Evaluation Unit). Has developed in recent years, a multidisciplinary rehabilitation protocol specifically for the treatment of patients with Parkinson’s disease involving physiatrists, nutritionists, angiologists, psychologists, occupational therapists;
\n-From ‘April 2006 and principal at the Laboratory of Diagnostic and neuromotor re-education “at the IRCCS Fondazione” S. Maugeri “- Center Montescano (PV), where, among other topics of research concerned with the study of the effectiveness of rehabilitation techniques on the way in patients with Parkinson’s disease, evaluation of the effectiveness of methods of rehabilitation, proprioceptive disorders balance in patients with Parkinson’s disease and ataxia, peripheral sensory and central Europe, the study by isokinetic assessment of the pyramidal and extrapyramidal neurological disorders;
\nExperienced in the use of botulinum toxin in the treatment of spasticity is that of dystonia;
\nCo-author of 90 scientific publications in international journals and national and has been a speaker at numerous conferences of national medical societies (SIN, SIMFER, Limp).
\nAuthorize to handle my personal data according to DL June 30, 2003 196. <\/em><\/p>\n

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Curriculum Vitae FRAZZITTA Dot. Joseph
\nDr Joseph FRAZZITTA
\nCurriculum vitae et studiorum
\nD’autoriser le traitement de mes donn\u00e9es personnelles selon la DL 30 juin 2003 196.
\nN\u00e9 \u00e0 Marsala 07 agosto 1962
\nM\u00e9decin sp\u00e9cialiste en neurologie
\nDirecteur m\u00e9dical de l’IRCCS Fondazione “S. Maugeri ”
\nCentre Montescano (PV)
\nExpert dans les maladies neurod\u00e9g\u00e9n\u00e9ratives (Parkinson et d’Alzheimer)
\nExp\u00e9riment\u00e9 dans le diagnostic et le traitement des maux de t\u00eate
\n\u00c9tudes et formation
\nDipl\u00f4m\u00e9 en m\u00e9decine de l’Universit\u00e9 de Pavie en 1988, avec le plus de voix avec une th\u00e8se sur le traitement pharmacologique des complications neurologiques chez les patients \u00e0 l’abus chronique d’alcool;
\nSp\u00e9cialis\u00e9e en neurologie \u00e0 l’Universit\u00e9 de Pavie en 1992 avec mention tr\u00e8s bien avec une th\u00e8se sur la r\u00e9habilitation des patients pr\u00e9sentant des s\u00e9quelles d’accident vasculaire c\u00e9r\u00e9bral du cerveau;
\nPour la sp\u00e9cialit\u00e9 quatre de neurologie a re\u00e7u une bourse d’\u00e9tude \u00bbpour assister \u00e0 l’\u00c9cole de sp\u00e9cialisation de l’Universit\u00e9 de Pavie;
\n1989 \u00e0 1990 comme m\u00e9decin militaire a servi comme adjoint au minist\u00e8re de l’H\u00f4pital orthop\u00e9dique militaire de Milan;
\n-de 1992 \u00e0 1993 il a assist\u00e9, avec une bourse de l’Institut neurologique de “C. Mondino “de Pavie, le Centre de r\u00e9adaptation fonctionnelle” G. Verdi “de Villanova sull’Arda (PC) traitant de la r\u00e9habilitation des mielolesi patients.
\nExp\u00e9rience professionnelle
\n-de Juillet 1992 \u00e0 Juillet 1999, il a travaill\u00e9 comme consultant aupr\u00e8s du Minist\u00e8re de la Justice \u00e0 la Chambre des circondariale Pavie;
\n-A partir de D\u00e9cembre 1993 \u00e0 D\u00e9cembre 1999, il a travaill\u00e9 comme directeur m\u00e9dical de 1er niveau \u00e0 l’UO de neurologie de l’H\u00f4pital de Busto Arsizio (VA), o\u00f9 il \u00e9tait chef de la chirurgie pour les maladies neurod\u00e9g\u00e9n\u00e9ratives (Parkinson et d’Alzheimer) et la chirurgie pour les maux de t\u00eate. En cette p\u00e9riode, il a \u00e9t\u00e9 membre du Groupe de travail provincial sur la maladie d’Alzheimer, promu par la politique sociale de la province de Varese;
\ntravail \u00e0 partir de D\u00e9cembre 1999 avec le grade de directeur m\u00e9dical de 1er niveau des aides de l’IRCCS Fondazione “S. Maugeri “- Centre Montescano (PV). En plus de traiter des examens neurophysiologiques (EEG, EMG, potentiels \u00e9voqu\u00e9s) et \u00e0 la chirurgie UVA (Unit\u00e9 d’\u00e9valuation d’Alzheimer). A d\u00e9velopp\u00e9 ces derni\u00e8res ann\u00e9es, un protocole de r\u00e9adaptation multidisciplinaire sp\u00e9cifiquement pour le traitement des patients atteints de la maladie de Parkinson impliquant des physioth\u00e9rapeutes, nutritionnistes, m\u00e9decins vasculaires, des psychologues, des ergoth\u00e9rapeutes;
\n-A partir de ‘avril 2006 et principal au Laboratoire de Diagnostic et neuromoteurs Re-\u00e9ducation “\u00e0 l’IRCCS Fondazione” S. Maugeri “- Centre Montescano (PV), o\u00f9, entre autres sujets de recherche concernant l’\u00e9tude de l’efficacit\u00e9 des techniques de r\u00e9habilitation de la voie chez les patients pr\u00e9sentant la maladie de Parkinson, l’\u00e9valuation de l’efficacit\u00e9 des m\u00e9thodes de r\u00e9\u00e9ducation, les troubles proprioceptifs l’\u00e9quilibre chez les patients atteints de la maladie de Parkinson et d’ataxie, sensorielles et p\u00e9riph\u00e9riques de l’Europe centrale, l’\u00e9tude de l’\u00e9valuation isocin\u00e9tique des troubles neurologiques pyramidaux et extrapyramidaux;
\nExp\u00e9riment\u00e9 dans l’utilisation de la toxine botulique dans le traitement de la spasticit\u00e9 est celui de la dystonie;
\nCo-auteur de 90 publications scientifiques dans des revues internationales et nationales et a \u00e9t\u00e9 conf\u00e9rencier lors de nombreuses conf\u00e9rences de soci\u00e9t\u00e9s m\u00e9dicales nationales (NAS, SIMFER, Limp).
\nD’autoriser le traitement de mes donn\u00e9es personnelles selon la DL 30 juin 2003 196.<\/em><\/p>\n

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\n<\/em><\/p>\n


\n<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Novit\u00e0 importanti sul Morbo di Parkinson. ne \u00e8 autore un medico marsalese, il dottor Giuseppe Frazzitta. dal sito: http:\/\/www.marsala.it\/cronaca\/salute\/12151-il-morbo-di-parkinso-e-le-scoperte-del-dottore-giuseppe-frazzitta-marsalese.html Esiste in Montescano in provincia di Pavia, presso la Fondazione Salvatore Maugeri un Centro riabilitativo, dove vengono seguiti i pazienti affetti dalla Malattia di Parkinson. Una sezione dedicata agli stessi pazienti e inoltre a coloro che … Continua a leggere Fondazione Salvatore Maugeri di Montescano e Frazzitta Giuseppe<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[26],"tags":[144,146,212,224,234,265],"class_list":["post-236","post","type-post","status-publish","format-standard","hentry","category-parkinson-e-dintorni","tag-frazzitta","tag-fsm","tag-montescano","tag-neurologo","tag-parkinson","tag-riabilitazione"],"_links":{"self":[{"href":"https:\/\/viscontitoscoalda.com\/index.php\/wp-json\/wp\/v2\/posts\/236","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/viscontitoscoalda.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/viscontitoscoalda.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/viscontitoscoalda.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/viscontitoscoalda.com\/index.php\/wp-json\/wp\/v2\/comments?post=236"}],"version-history":[{"count":0,"href":"https:\/\/viscontitoscoalda.com\/index.php\/wp-json\/wp\/v2\/posts\/236\/revisions"}],"wp:attachment":[{"href":"https:\/\/viscontitoscoalda.com\/index.php\/wp-json\/wp\/v2\/media?parent=236"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/viscontitoscoalda.com\/index.php\/wp-json\/wp\/v2\/categories?post=236"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/viscontitoscoalda.com\/index.php\/wp-json\/wp\/v2\/tags?post=236"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}