Nyaya Inonyanya Kufadza: Tango rekuArgentina riri mukugadzirisa vanhu vane chirwere cheParkinson

Ndinotenda zvikuru kuti ndakabatana naMubatsiri waPurofesa Hae-Young Hawong, chiremba wezvirwere zvetsinga paYale School of Medicine, Doctor of Osteopathic Medicine, uye ndinotenda kuti makadzidzirawo neuro-ophthalmology uye munotaura chiKorea zvakanaka.

Ndizvozvo here?

Purofesa Hae-Young Hawong: Ehe.

Ms. Nicole Duff: Zvinoshamisa. Pandaiverenga nhoroondo yehupenyu hwako, ndakati, "Wow, pane zvimwe zvekuwedzera pane izvozvo here?" Zvinoshamisa.

[00:01:00] Saka kana uchinyatsoongorora nyaya iyi inopisa, kutamba kune humwe humbowo hwakasimba sekurapa kwekudzoreredza muviri pamwe chete neaquatherapy neTai Chi semuenzaniso.

Uye pakati pemhando dzese dzekutamba, tango yekuArgentina ine humbowo hwepamusoro-soro hwekushanda kwayo, uye izvozvo zvatisvitsa kwauri. Saka ndinoziva kuti une ruzivo rwekutamba ballet, asi chii chakakusvitsa kutango yekuArgentina?

Purofesa Hae-Young Hawong: Ndatenda zvikuru nekutaura kwenyu kwakanaka uye ndatenda nemukana uyu. Ehe. Chinhu changu chikuru ndechekusimudzira pfungwa zvakadzama. Uye kunyangwe tichishanda nesimba pakurapa kudengenyeka, kuomarara, bradykinesia neDBS nelevodopa pharmacotherapy, asi kufamba nepfungwa dzakanaka kunogona kunetsa zvikuru.

Uye tinowanzo tarisa zvakanyanya pazvirwere nezviratidzo zvemuviri, [00:02:00] uye tinokanganwa varwere vese, hupenyu hwavo, manzwiro avo, kuziva kwavo, uye hukama hwavo nevanhu. Kuziva izvozvo kwakaita kuti ndibvunze mubvunzo uri nyore, chii chimwe chandingapa varwere vangu? Uye ndine ruzivo rwekuArgentina tango, saka zvaive zvechisikigo kuti ndifunge kupfuura mishonga yechinyakare ndotarisa Argentina tango.

Asi sei tango yekuArgentina? Kune zvidzidzo zvakawanda, miedzo yekiriniki, ongororo yesystemic, meta-analysis yatoratidza UPDRS, Time Up Go, uye zvakanaka, zviri pachena, kuderedza njodzi yekudonha. Asi sei? Tango yekuArgentina inobatanidza nzvimbo dzakasiyana panguva imwe chete. Kufamba kwakarongeka kwemuviri, kukurudzira kunzwa kuburikidza nemimhanzi, uye kudyidzana kwakapfuma kwevanhu kuburikidza nekutamba kwevadikani.

Musanganiswa uyu haungogadzirisi chete matambudziko ekufamba kwemuviri [00:03:00], asiwo unovandudza manzwiro uye hukama hwemunhu nechirwere ichi. Uye kuburikidza netango, varwere havasi kungodzidzira kufamba, vari kuita mabasa anonakidza uye ane chinangwa anokurudzira chivimbo, kubatana, uye kunzwa kwehunhu kunze kwechirwere.

Asi zvakare, sei tango? Saka tango chinhu chakasiyana chatinonziwo kutamba uchifamba. Chinosanganisira kufamba uchiita rhythm, kutsika nemaune, maitiro ekufamba anobatsira varwere kudzidzazve kufamba uye kuvandudza kuenzana, kunyanya pfungwa yekubva pachitsitsinho kuenda kuchigunwe, iyo shanduko yatinogara tichiudza varwere vedu, iyo ndiyo nzira huru yekutamba mutango yeArgentina.

Uye nekugara uchidzidzira, uropi hunogona kugadzira nzira itsva dzetsinga, huchitsigira kudzidza kwakawanda, huchivandudza kufamba kuburikidza ne neuroplasticity. Uye tango idhindindi remubatsiri, [00:04:00] rinopa rutsigiro rwemuviri uye chiratidzo chekunze. Kufamba uku kwakabatana kunobvumira murwere kudzidzira kufamba nenzira yakachengeteka, yakatungamirirwa zviri nani, zvichivandudza chivimbo uye kugadzikana.

Chimwe chinhu chakasiyana chetango yeArgentina ipfungwa yekuti, ichi ndicho chikamu chandinofarira, kubatana. Izvi zvinoitwa kuburikidza nekumbundirana, zvichireva kuti munobatana sei. Kubatana uku ndekwemuviri, kwemanzwiro, uye kwete kwekutaura, hurukuro inochinja-chinja pakati pevakaroorana inovabvumira kufamba senzira imwe chete. Chikamu ichi chetango chinopfuurira kupfuura kufamba uye chinoita basa rakakosha rekurapa.

Varwere vanosvika 64% vane chirwere cheParkinson vanoti vanonzwa vakasurukirwa nevamwe, 38% vakaora mwoyo, 37% vanoti [00:05:00] havana hanya. Kurapa netango kwakaratidza kuvandudzika mumanzwiro, kuora mwoyo, uye kusava nehanya. Uye patinotanga kudzidzisa tango kumbundirana, tinotanga nekumbundirana. Kumbundirana kwakanaka, kukuru, kunodziya, kutamba tichimbundirana.

Saka kumbundirana uye kubatana kwakabatana kunoita kuti munhu anzwe ari werudzi rumwe uye ari munharaunda. Izvi zvinopesvedzera zvakanaka kurudziro, kuzvibata, uye kugara zvakanaka kwepfungwa. Zvakanaka, ngatitaurei nezvesainzi. Kana ndikatsanangura nenzira yepfungwa, mimhanzi nekutamba zvinomutsa nzira dzakawanda dzedopaminergic. Tinoziva kuti Parkinson inyaya ye nigrostriatal dopaminergic pathways uye tese tinoziva izvozvo.

Asi kunewo mesolimbic reward system, mesolimbic dopaminergic neurons. Kubatanidzwa nerhythm nemimhanzi kunogona kuwedzera mashandiro ari mu nucleus accumbens, uye izvi zvinowedzera dopamine [00:06:00] kusunungurwa uye kusimbisa kukurudzira uye mufaro. Kunzwa kwemanzwiro panguva yekutamba kunogonawo kukurudzira kusunungurwa kweprolactin, uye prolactin inobatsira kunzwa kunyaradzwa, kubatana, uye mufaro.

Izvi zvinoenderana nepfungwa yekubatana muTango yeArgentina. Ko kufamba nerhythm? Chimwe chinhu chakasiyana cheTango yeArgentina kufamba nerhythm. Rhythm yacho inokosha sezvo kufamba pachako kuri maitiro akaomarara etsinga. Kufamba kunodzorwa ne striatal thalamocortical network inobatanidza cortical, subcortical, uye brainstem structures.

Chikamu chakakosha che prefrontal cortex, isu zvakare-- PFC, chinotsigira kutonga kwemukuru uye kutarisisa. Supplementary motor area, SMA, ine basa rekuronga mafambiro emuviri uye kutanga. Primary motor cortex m1, [00:07:00] iyo inogadzira mafambiro ekuzvidira ne corticospinal tract. Iyi cortical region inosangana zvakanyanya ne basal ganglia, iyo inoita basa guru mukugadzirisa mafambiro emuviri, kufamba otomatiki, uye mukati memukati, izvo zviri kukanganisa chirwere cheParkinson.

Uye zvidzidzo zvinoratidza kuti muvanhu vakuru vane hutano hwakanaka, vane kuwedzera kwePFC activation panguva yekufamba, zvichiratidza kuti nzira yekudzorera simba uye kuvimba zvakanyanya nekudzora pfungwa kana nzira dzemotokari dzinongoerekana dzadzikira. Saka apa ndipo panobva tango. Muchirwere cheParkinson, kusashanda zvakanaka kwe basal ganglia kunokanganisa kugadzirisa kwemota, kusarudza chiito, kutanga, uye mafambiro ega ega.

Kurapa netango kunogadzirisa zvinhu kunobatsira kudzivirira mafambiro aya asina kunaka nekupa chiratidzo chakasimba chekunze. Zviratidzo zvekunzwa kubva mumimhanzi, mutinhimira [00:08:00], uye mabheti. Zviratidzo zvinoonekwa kubva pamatanho uye nzvimbo. Zvinopinda muSomatosensory, kuchinja huremu, kugamuchira zvinhu, uye kunzwa kubva kune vadikani. Mhinduro dzemudikani kuburikidza nekumbundirana uye mafambiro anoitwa pamwe chete.

Izvi zvinoshandisa nzira dzakasiyana dzetsinga uye zvinoita kuti kufamba kufambiswe kuburikidza nenhungamiro yekunze pane kukanganisa zviratidzo zvemukati zvechirwere cheParkinson. Uye izvi zvinosimbisa maitiro ekufamba uye zvichigonesa kuumbwa kwekubatana kwetsinga itsva, maitiro aya anoratidza neuroplasticity, kugona kweuropi kuronga patsva uye kugadzira macircuit matsva anoshanda.

Ms. Nicole Duff: Ndinonzwa kuda kwako basa rawakaita, uye wakarironga zvakanaka kwazvo. Ndatenda. Ndichingoratidza mativi akasiyana eTango uye tsinga dzemuviri [00:09:00] padzinopindira. Uye kwandiri, pandinofunga nezveTango, ndinogara ndichifunga nezvehunyanzvi ihwohwo, hwatinoona vanhu vanahwo.

Uye kwandiri, izvozvo zvinofanirawo kugadzira pfungwa yekusika mukati memunhu ari kuita Tango, kunyangwe kana asingakwanise kugadzira kufamba ikoko. Ndingafungidzira mukati meuropi, vari kufungidzira pamwe rudzi rwekufamba kwavanoda kugadzira. Uye izvozvo zvingave zvichiita chimwe chinhu mukati mehurowo here?

Purofesa Hae-Young Hawong: Ehe. Ehe. Ndosaka kana ndine hurongwa hweParkinson's adaptive tango therapy structure, ndingati nditaure nezvemaitiro andinoita. Chirongwa cheLed structure adaptive tango therapy chine chikamu chevhiki nevhiki gumi nemaviri. Chimwe nechimwe chinotora maminetsi makumi mapfumbamwe. Chirongwa ichi chinoitwa seboka revadzidzisi vaviri.

Vatori vechikamu vanotamba nevazvipiri vakadzidziswa [00:10:00] kana vadikani vavo, vachigadzira nzvimbo yekutsigirana uye yekudyidzana. Saka ndinotanga nekudziisa muviri, nziyo mbiri dzinodzivirira... Ndinoita kudziisa muviri zvakanyanya nekuti izvo zvinodzivirira kukuvara uye zvinowedzera mafambiro, uye apa ndipo pandinoshanda pakusimbisa muviri uye kuziva muviri uye kufunga.

Uye ndobva ndaita maekisesaizi emimhanzi. Kuti ndive neunyanzvi hwekugadzira, ndinoshanda pamimhanzi. Saka ndinodzidzisa mutinhimira, nguva ndichishandisa zviratidzo zvekunzwa, kudzidzisa kuziva mabhiti, kuombera maoko, kugogodza zvigunwe, kushandura uremu, kufamba. Tinodzidzisa kuziva mabhiti tobva tatanga kushandisa mutinhimira uye zvino kurova maoko nekurova, kugogodza zvigunwe nekurova, kushandura uremu nekurova, kufamba nemimhanzi.

Zvadaro ndinoita chiitwa chepfungwa chekubata zvinhu zviviri. Famba nemumwe wako, dzidza kufamba nemumwe wako muchienderana, uchibatanidza kufamba nepfungwa dzekubata zvinhu [00:11:00], uchinyora uchidzokera shure uchifamba nemumwe wako. Saka shanda pamabasa ekucherechedza, kurongeka, uye ekurangarira kuti uvandudze mashandiro emuviri uye kubatana kwenhengo dzemuviri.

Ndichapindura mubvunzo wako munguva pfupi iri kutevera. Kusvika ikoko. Uye ndobva ndashanda padanho re tango rinochinjika uye ma sequences. Ma sequences ekufamba kweTango akagadzirirwa kugadzirisa mashandiro emota, kuenzana uye kufamba, ukuwo ndichideredza njodzi yekudonha. Uye ndobva ndaita mitambo yekurovedza muviri inopindirana. Tinoita mutambo wekubatana, kurovedza muviri wakaenzana, saka nemaziso akavharwa asi nemimhanzi chete, vanonzwa kufamba kwevadikani vavo nevanobatana vakasiyana.

Uye dzimwe nguva tinotamba mwenje mutsvuku nemwenje wegirini mu "Squid Game." Wakaona here "Squid Game"? Ehe. Uye tinoshanda pakudzora mashandiro emuviri uye nguva mumutambo uyu. Saka chiitiko ichi chakagadzirirwa kusimudzira kubatana kwevadikani, kuenzana, uye [00:12:00] kupindura nenzira inochinja-chinja uye inonakidza. Uye tobva taita kuvaka kwesequence uye kufambira mberi.

Tinoongorora uye tinodzokorora kutevedzana kwatinodzidza, tobva tawedzera musiyano kwavanogona kuva neunyanzvi. Kudzokorora zvinhu zvakadzidzwa nekutungamirirwa, zvishoma nezvishoma kuoma kwakawedzerwa, tichiunza musiyano uye tichivaka chivimbo mumafambiro emafambiro. Zvadaro tinoita mini practica. Vatori vechikamu vanodzidzira vakasununguka, vachikurudzira hunyanzvi uye kuzvitonga mukufamba.

Uri kutaura chokwadi. Tanda muArgentina tango irwiyo rune nziyo mbiri kusvika ina. Tinotamba nemumwe munhu nerwiyo rumwe chete, tobva tachinjana, uye ndosaka iyi iri danzi rekushamwaridzana. Uye mutsika dzeArgentina tango, tanda yekupedzisira inowanzo tamba nemutarisiri pamwe chete nevamwe [00:13:00] kuti vasimbise hukama hwemanzwiro uye kusimbisa hunyanzvi hwavakadzidza, uye vanogona kugadzira mimhanzi, nemanzwiro.

Uye tobva tadzikamisa hasha, izvo zvinoreva kutambanudza zvinyoro nyoro uye kuzorora kuti tipedze chikamu. Saka hongu, hunyanzvi mukufamba kwacho hwakakosha zvikuru, uye ndizvo zvandinosimbisawo pachirongwa changu chetango.

Ms. Nicole Duff: Chirongwa chenyu chakagadzirirwa kutarisa nzvimbo dzakasiyana-siyana dziri muchirwere cheParkinson. Uye, unoziva, ndaiva nemibvunzo pano yekuti zvichakanganisa sei nzvimbo dzisiri dzemotokari nedzisingafambi, asi maenda kure kupfuura izvozvo mukufunga nezvehupenyu hwakanaka uye hukama nevanotarisira, uye zvinoshamisa kuti makanyatsoongorora zvakadzama sei muchirongwa ichi.

Uye wakambotevedzera mune dzimwe nzvimbo here, kana kuti chimwe chinhu chaunofunga kuti chinogona kutevedzera? Nekuti kuona chido chako [00:14:00] ndinofungidzira kuti chingave chinhu chekuti kunze kwekunge wawana mumwe munhu ane chido chakafanana nacho chingave chakaoma kutevedzera. Asi chinhu chaunofunga kuti mune ramangwana chingagone kuitwa here?

Purofesa Hae-Young Hawong: Ehe, zvechokwadi. Izvi zvinogona kuitwa. Kune sangano rechirongwa chekurapa tango rinonzi Tango Therapy Project muPhiladelphia. Vari kuitawo chirongwa ichi chekurapa tango. Uye ndiri kutaura neni-- ndiri kutanga chirongwa chekurapa tango muNew York City nemumwe wangu ari nyanzvi yekutamba tango.

Izvi zvinoitwa zvakanaka munzvimbo dzakawanda muArgentina. Saka hongu, izvi zvinogoneka. Ingondifonera, undibate. Ndichakudzidzisa. Tinogona kudzidziswa pamwe chete. Ndinogona kukuratidza kuti zvinoitwa sei, uye pane kudzidziswa kwakaitwa naDr. Hackney, uye apa ndipo pandakadzidziswawo.

Ms. Nicole Duff: Ndizvo zvandinoreva, mikana inonakidza, mikana yekutsvaga [00:15:00] zvichienda mberi. Nekuda kwezvinonakidza, varwere vanofanira kusangana nezvimwe zvinodiwa kuti vave chikamu cheboka here?

Purofesa Hae-Young Hawong: Ehe. Kazhinji tinoda Hoehn naYahr padanho rekutanga kusvika rechitatu, asi ini ndine murwere padanho rechina. Ndinokurudzira HY padanho rekutanga kusvika rechitatu, asi ndinobvuma danho rechina, uye ndinoronga maekisesaizi ega ega naye panguva yeboka kuti vachengetedzeke. Nekuti ndine-- vanozvipira vese vakadzidziswa.

Ndinoita kudzidziswa pachine nguva uye ndinovadzidzisa nezvekuchengetedza. Uye ndine mumwe mudzidzisi wetango, uye kutaura chokwadi vazhinji vanozvipira vanotamba tango. Saka ndine vanhu vakakwana. Saka ndinogamuchira danho rechina uye ndinoita maekisesaizi ega ega. Asi kurudziro yacho ingave danho rekutanga kusvika rechitatu.

Ms. Nicole Duff: Maita basa. Uye wave uchiwana mhinduro dzakaita sei kubva kuvarwere? Kwete kungoona kuvandudzwa, kubva kwauri kana kuti kubva kwauri, asi [00:16:00] kunzwa kubva kwavari. Vari kuti chii?

Purofesa Hae-Young Hawong: Ndakawana uchapupu kubva kune mumwe wevarwere vangu, kana ndichigona kugovera. Akanyora tsamba yese, uye ndinoda kugovera chikamu ichi. Zvakaita kuti ndinzwe... zvakabata mweya wangu. "Zvandakasangana nazvo netango zvinondiyeuchidza nezvekudzidza kwandakaverenga kare nezvemurwere wePD, murwere weParkinson, ane zviratidzo zvinoita sekunge zvinopera pavakanga vari pabhasikoro."

Saizvozvowo, ndakaona kuti kudzidzira danho rebhokisi retango kunovandudza kufamba kwangu zvakanyanya. Pose pandinosangana nematambudziko ekufamba kana kuomarara, kuita danho rebhokisi kunounza zororo rinooneka. Pandinonyanya kudzidzira danho iri zuva nezuva, zviratidzo zveParkinson izvi zvinoita sezvishoma. Iyi inyaya yangu yega yekuti chishamiso chetango chakavandudza sei hupenyu hwangu.

Kune vamwe varwere vangu vane chirwere cheParkinson [00:17:00], ndinovimba kuti mungafunga nezvekuedza tango uye pamwe mungawana mhedzisiro yakanaka yakafanana." Saka izvi ndizvo zvaakanyora, uye ndinoyeuka ndakamisa mota yangu kuti ndiende kuchirongwa chekurapa tango. Ndakamuona ari padivi penzvimbo yekupaka mota achidzidzira tango box, uye ipapo ndakaona humbowo uhu.

Hongu.

Ms. Nicole Duff: Ndizvo zvinoita kuti zvese zvive zvakakosha, Hae. Kufunga kwese nekuronga uye kuunganidza zvese pamwe chete uye kungoona kuti hupenyu hwevarwere hunochinja sei. Chandinofunga kuti chinonyanya kundishamisa kubva muuchapupu ihwohwo ndechekuti, dzimwe nguva mukati memisangano tinoona kuvandudzika kukuru uye tobva tadzoka vhiki rinotevera uye zvinosuwisa kuti vanenge vadzokera padanho ravo rekutanga rekare.

Asi ari kutaura nezvekuti ari kuramba achienderera mberi sei mukati mevhiki, nezvekuti achiri kuona sei, uye ndizvo zvauri kutaura nezvazvo [00:18:00], neuroplasticity yekuti kune mativi akawanda ari kudyara muuropi nzira dze dopaminergic dziri kungozadzwa nemativi ese akasiyana awakaisa uye ndinofunga kuti ndizvo zvinoshamisa nekuti mamwe marapirwo mazhinji haawanzo kuva neanogara achienderera mberi uye ndinofunga kuti chimwe chinhu chakasiyana nemamwe marapirwo akawanda.

Purofesa Hae-Young Hawong: Ehe. Uye hazvina kungobatsira varwere chete. Basa iri rakaumbawo basa rangu sachiremba. Ndinowana mukana wekutarisa varwere vangu vari munzvimbo yekutamba uye kuongorora mafambiro avo, mashandiro avo mukati menguva yemaminitsi makumi mapfumbamwe pane kushanya kukiriniki kwemaminitsi makumi matatu. Semuenzaniso, ndakaona mumwe murwere, paaitamba, aifamba-famba akasununguka panguva yechikamu, uye izvozvo zvakaita kuti ndigadzirise huwandu hwemishonga kuti ndivandudze dyskinesia yake.

Mune imwe nyaya, ndakava nemurwere [00:19:00] akabuda achidhonza tsoka yake. Nyaya iripo ndeyekuti, murwere haazvizivi izvozvo. Havakwanise kutipa nhoroondo idzi. Uye ndakakwanisa kuchinja nguva yemushonga kuti ndivandudze zviratidzo zvake. Uye kutamba nevarwere vhiki nevhiki, izvo zvinosimudzira kunzwa kwenharaunda uye zvinosimbisa hukama pakati pachiremba nemurwere.

Uye ruzivo urwu rwakagovaniswa runogadzira boka rekutsigirana risina kurongeka, richibatsira varwere neni. Uye sechiremba, ndinowana basa iri richibatsira zvikuru. Rinopa pfungwa yechinangwa chekuti ndinokwanisa kubatsira varwere vangu, rinosimbisa chido chekubatsira vamwe, rinondiyeuchidza nezvebasa rangu, uye rinoshanda senzira ine chinangwa yekuderedza kuneta.

Ms. Nicole Duff: Iwe, une chokwadi. Sezvawataura, zvinobatsira murwere sesu, uye ndinofunga kuti ndiyo nzira yakanaka kwazvo [00:20:00] yekuigadzira. Inoita kuti nzira dzedu dzedopaminergic dzishande sedzavo. Saka nekuda kwekufarira, wati unoshanda zvakanyanya mukati meDBS, uye neizvozvo wakaona kuti kusagadzikana kwechimiro uye kufamba uye kuenzana hazvibatsiri zvakanyanya kuburikidza neDBS.

Saka varwere vako vazhinji vari muboka reArgentina retango reDBS here, kana kuti musanganiswa wakazara?

Purofesa Hae-Young Hawong: Sanganisa.

Ms. Nicole Duff: Sanganisa. Zvakanaka. Uye unoona boka rimwe chete here kana rimwe - murwere ane DBS kana kuti DBS isiri kuvandudzika kupfuura rimwe?

Purofesa Hae-Young Hawong: Mubvunzo wakanaka kwazvo. Iro ringave zano rakanaka kwazvo rekutsvagisa.

Ms. Nicole Duff: Tasvika ipapo. Pfungwa dzeramangwana. Pfungwa dzeramangwana. Ndatenda zvikuru nenguva yenyu. Ndafarira kunzwa chido chenyu. Ndafarira kunzwa kuoma kwezvinhu zvese zvamaisa muchirongwa uye kuti zvinopinda sei mune zvese zvine chekuita neParkinson's, uye ndinotarisira kuti vanhu [00:21:00] vachatanga kusvika kwamuri, uye tinogona kutanga mapurogiramu.

Kubva pano kuSouth Africa, ndinofara kuona kana tichigona kuwana chimwe chinhu chinobatsira varwere vedu zvakanyanya. Uye ndinotenda zvikuru nenguva yenyu. Ndinokutendai zvikuru.

Purofesa Hae-Young Hawong: Tatenda zvikuru. Uye tisati tapedza, ndinoda kutenda Dr. Hackney nekutsvaga kwavo munyaya iyi, uye vakagadzirisa chimiro chese ichi chekurapa tango. Saka tatenda zvikuru.

Ms. Nicole Duff: Ndinokutendaiwo.

Purofesa Hae-Young Hawong: Kana paine ane mubvunzo, ndapota inzwa wakasununguka kundibata.

Ms. Nicole Duff: Tichaisa ruzivo rwako pasi pepodcast pawebhusaiti.

Purofesa Hae-Young Hawong: tenda 

Ms. Nicole Duff: Ndatenda.

Sara zvakanaka [00:22:00]