Grasso Anna Maria (UOC MEdicina Fisica e Riabilitazione AST Fermo, Porto San Giorgio, Italy)
Malaspina Vissia (UOC MEdicina Fisica e Riabilitazione AST Fermo, Porto San Giorgio, Italy)
Bragagnolo Matteo (UOC MEdicina Fisica e Riabilitazione AST Fermo, Porto San Giorgio, Italy)
Body image is a multidimensional construct that includes perceptual, cognitive, emotional and behavioral aspects towards one’s body.
A negative body image is a significant factor in Eating Disorder; in eating disorders, this disorder represents a specific symptom of the disease, a triggering cause of the pathology and an obstacle to therapeutic intervention.
This study aims to evaluate the effectiveness of using high-tech tools in caring for patients diagnosed with Anorexia Nervosa associated with hyperactivity and body image disturbance. This evaluation was conducted through a qualitative research project which involved a large multidisciplinary team (Physiotherapists, Educators, Dietitians, Physiatrists, Psychiatrists and Psychologists). The rehabilitation protocol was defined using the Walker View and the D-Wall (Tecnobody).
The reporting standards sheet aims to evaluate the containment of hyperactivity and the restoration of fluid, conscious and purposeful motor activity.
12 girls were recruited according to the inclusion criteria (diagnosis of Anorexia nervosa with hyperactivity, body image disturbance, BMI>16 and acceptance of increased caloric intake); the measurement of the results was carried out through the observation of the researchers and the definition of scales and evaluation tools: for motor activity we chose stabilometric analysis, gait analysis and 6-minute walking test; the psycho-educational staff took care of the administration of SPPB (sarcopenia) and IPAQ questionnaire.
The treatment protocol was calibrated on the patients with training programs and exergames with the exclusion of the mirror or avatar function; the treatment lasted ten weekly sessions plus two focus group sessions (one in the middle and one at the end of the treatment) led by the Educator of the DCA center.
The exercises, based on the exploration of body boundaries and performed excluding the mirror function, led to a greater awareness of the difference between one’s own body and the outside world. The movements, recorded by the instruments used, initially appeared “broken”, lacking harmony and with reduced motor control; compared with those recorded at the end of the treatment, there was greater familiarity with the patient’s own body and his motor potential.
The specific physiotherapy process had a positive impact on the perception of body image, allowing greater awareness of both somatosensory afferents and the bodily self.
During the Focus Group, all the participants found that the exercise helped them better manage the anxiety, stress and depression components that are often associated with this condition, promoting greater compliance and also allowing greater adherence to the plan food.
From a physiotherapeutic point of view, to correctly approach this type of patient, it is necessary to know the physiology and what the alterations the subject may encounter. The treatment allows you to manage purely biomechanical complications (for example muscle hipotrophy, greater risk of fractures, postural alterations, etc.), but also to lay the foundations for restoring correct body perception, a fundamental prerequisite for healing.
Physiotherapy aimed at perceptive re-education, supported by the use of high-tech tools, has demonstrated significant improvements that are reported by the patients themselves. However, the actual effectiveness of this approach will need to be further analyzed, given the limited diffusion of high-tech tools and physiotherapy treatment protocols for patients with Anorexia Nervosa.
