A proprioceptív rendszer multimodális integrációs zavara a testséma - testkép összefüggéseiben Parkinson-kórban

Abstract

The most common definition of kinesthesia could be described as the awareness of the body’s and the limbs’ position and movement in space. A disorder of kinesthesia is especially typical of Parkinson’s. We use the term, kinesthesia, when defining the conscious cognition of the body’s and the limbs’ movement. Proprioception applies to the regulation of the reflexive and postural motor control. The importance of proprioception can be encountered with the motor functions, such as reaching and grasping, static balance and locomotion. With the decrease of proprioception, patients are still able to execute motor tasks, but goal-directed locomotive movement is greatly impaired. The accuracy of goal-directed movements as well as the postural and spinal reflexes change, which leads to problems with balance and walking. The basal ganglions play an important part in kinesthesia, movement cognition and purposeful movements. Those affected with Parkinson’s disease (PD) possess lessened kinesthetic „feedback”, which these patients compensate by directing increased focus at visual information. Body schema and body image are fundamental elements of our own self-definition. According to Head and Holmes’ (1911) classic definition, body schema is the system of proprioceptive and kinesthetic afferent impulses that also possesses sensomotoric organization responsible for localization of impulses generated by excitation of the body surface that is related to posture or body movement. Body schema is relatively independent of the visually controlled body image. Body schema relies on background information such as, posture, foot size and distance, balance, forward movement and turning. Body image relies on conscious information, and is directed visually and controlled, oriented and influenced by attitudes and beliefs.