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COME INTERFERISCE L’APPARATO VESTIBOLARE SULLA POSTURA? – Posturoconsapevoli
Posturoconsapevoli - La prima Community Italiana sulla Posturologia

COME INTERFERISCE L’APPARATO VESTIBOLARE SULLA POSTURA?

by pconsapevoli
COME INTERFERISCE L’APPARATO VESTIBOLARE SULLA POSTURA?

Il Sistema Tonico Posturale, come tutti gli altri Sistemi del nostro corpo, è complesso. Sarebbe forse meglio definirlo in un altro modo: non lineare. Il miglior esempio è stato dato dal Prof. Fabio Moro: “Provate a trovare l’origine di un cerchio!”

Quante possono essere le interferenze in questo Sistema? Forse è il caso di dire che l’aspetto più importante è di trovare il recettore posturale che crea la maggior interferenza. E per farlo servono due cose:

  • una conoscenza del principio della non linearità del Sistema Tonico Posturale;
  • un’ottima umiltà professionale, e nel miglior networking possibile per creare collaborazioni professionali intorno al paziente.

Entrando nello specifico dell’articolo di oggi, tratteremo dell’interferenza dell’Apparato Vestibolare e di come, attraverso una visione molto specifica, sia possibile lavorarci. Ma prima di addentrarci, facciamo un piccolo remind sul nostro attore principale, l’Apparato Vestibolare (grazie ad un’ottima descrizione del Dott. Giovanni Chetta, che potete trovare qui).

L’Apparato Vestibolare (vestibolo, labirinto) è situato in profondità nell’osso temporale (rocca petrosa), dietro l’orecchio interno. Il canale cocleare della chiocciola (coclea), infatti, è in collegamento con un rigonfiamento (2-3 mm) colmo di endolinfa, il sacculo. Al suo interno sono inoltre presenti dei microcristalli (otoliti, statoconi) che consentono ai recettori sensoriali (meccanocettori), posti nella parete del sacculo, di percepire l’accellerazione verticale (quella, ad esempio, che si prova salendo in ascensore). Esso è inoltre sensibile a suoni a bassa frequenza (sotto i 500 Hertz) e alto volume (superiori ai 100 decibel) che quindi stimolano il movimento.
Il sacculo è, a sua volta, in comunicazione con un’altra vescicola, l’utricolo (otricolo), che, tramite lo stesso meccanismo, fornisce informazioni sull’accellerazione orizzontale (quella subita su un auto o moto, ad esempio).
L’utricolo, inoltre, rappresenta lo sbocco comune dei tre canali semicircolari (ca. 1 cm di diametro e perpendicolari tra di loro, con all’interno endolinfa) del labirinto. I recettori sensoriali dei canali semicircolari percepiscono i movimenti rotatori di testa e corpo (accellerazioni angolari).

Questi sistemi, tutti insieme, forniscono al cervello informazioni sulla posizione della testa e del corpo nello spazio. In particolare, sembra che solo il sistema otolitico (sacculo e utricolo) partecipi alla regolazione posturale fine (influenzando il tono muscolare), mentre il sistema semicircolare intervenga esclusivamente nell’equilibrio dinamico.

 Quindi, in cosa consiste la terapia riabilitativa vestibolare ?

“La terapia riabilitativa vestibolare è una terapia funzionale e non è dunque in grado di interferire con gli agenti etiologici e coi meccanismi patogenetici. Il suo obiettivo è esclusivamente il ripristino delle funzioni alterate, ottenuto favorendo l’attività adattivo-compensatoria o inducendo l’abitudine allo stato patologico.”

Queste le parole del Dott. Leonardo Manzari, specialista otorinolaringoiatra. Il quale ha sempre spinto verso l’unica direzione possibile, la collaborazione tra le diverse figure professionali:

“Di fronte ad una difficoltà di adattamento è fondamentale che il vestibologo si dedichi alla ricerca delle cause (patologiche centrali, età, muscolo tensione da disfunzione rachidea e/o da disordine cranio mandibolare, psicologiche, etc.) Si dovrà dunque dedicare alla rimozione delle cause (così detta fase multidisciplinare) in accordo con altri specialisti (fisiatra, odontoiatria e/o gnatologo, psichiatra, oculista).”

Come per ogni altra situazione, la miglior cura è la prevenzione e tempestività di intervento. Per poterlo fare, però, bisogna avere gli strumenti giusti. E quali sono i test migliori per poter definire la priorità di interferenza dell’Apparato Vestibolare in caso di disturbi posturali?

Scoprilo leggendo l’articolo del Dott. Leonardo Manzari: PRINCIPI E PRASSI DELLA RIABILITAZIONE VESTIBOLARE


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