EM495: IBITA Advanced Course: Neuromotor Treatment Across the Continuum of Neurodegenerative Disorders: Clinical Reasoning, Functional Assessment and Rehabilitation Management

Rationale

The increasing prevalence of neurodegenerative disorders represents one of the major challenges in contemporary neurological rehabilitation. Parkinson's disease, atypical parkinsonian syndromes, amyotrophic lateral sclerosis, hereditary and sporadic ataxias, and other neurodegenerative conditions share a progressive clinical course characterised by motor, sensory, cognitive, and behavioural impairments that evolve over time, continuously modifying the individual's functional needs.

Over the past decade, growing scientific evidence has driven a profound paradigm shift in rehabilitation. Rehabilitation is no longer regarded as an adjunctive intervention or as a treatment reserved for the advanced stages of disease; rather, it is recognised as an essential component of the continuum of care, to be initiated early and continuously adapted throughout the course of the disease. The primary aim extends beyond the restoration of function to include the preservation of mobility, participation, independence, and quality of life through a dynamic rehabilitation programme tailored to the individual's needs and responsive to clinical progression.

Within this context, neuromotor rehabilitation plays a central role. Impairments in postural control, balance, locomotion, upper limb function, and movement strategies should not be interpreted merely as direct consequences of neuronal loss, but rather as the result of complex interactions among motor, sensory, cognitive, and environmental systems. Functional assessment must therefore support a comprehensive process of clinical reasoning aimed at identifying the mechanisms underlying impaired performance, establishing therapeutic priorities, and guiding personalised, meaningful, goal-oriented interventions.

The complexity of neurodegenerative disorders also requires a multidisciplinary rehabilitation approach in which professionals with complementary expertise collaborate to develop a shared rehabilitation programme. Within this framework, the physiotherapist plays a pivotal role in movement analysis, the promotion of adaptive capacity, and the facilitation of effective motor strategies that enable individuals to maintain the highest possible level of function and participation throughout the course of their condition.

This advanced course adopts a clinical reasoning-centred approach, integrating current advances in neuroscience with contemporary rehabilitation practice. Through the analysis of clinical cases, live patient demonstrations, practical sessions, and interdisciplinary discussions, participants will be guided in the functional assessment of individuals with different neurodegenerative disorders and in the design of individualised neuromotor interventions across the various stages of disease progression.

The overall aim is to develop advanced clinical competencies that enable participants to translate functional assessment into effective therapeutic decision-making, thereby promoting person-centred rehabilitation grounded in the best available scientific evidence

Specific Learning Objectives

Upon completion of the course, participants will be able to:

critically analyse the neuromotor manifestations of the major neurodegenerative disorders, interpreting them in the light of underlying neurophysiological mechanisms, disease progression, and the individual's capacity for adaptation; 

develop an advanced clinical reasoning process for the functional assessment of individuals across the continuum of neurodegenerative disease, identifying the relationships among impairments, activity limitations, participation restrictions, and contextual factors in accordance with the International Classification of Functioning, Disability and Health (ICF); 

formulate and critically evaluate clinical hypotheses by recognising the mechanisms underlying postural control, movement, and functional performance in different neurodegenerative conditions; 

distinguish primary impairments in motor performance from compensatory movement strategies, recognising their clinical significance and implications for rehabilitation; 

establish therapeutic priorities and design an individualised rehabilitation programme that is consistent with the person's goals, stage of disease, and potential for functional change; 

design, implement, and adapt evidence-based neuromotor interventions aimed at optimising postural control, locomotion, upper limb function, and performance of meaningful functional activities throughout the different stages of disease progression; 

integrate the principles of motor learning, neuroplasticity, and functional compensation into the planning and implementation of rehabilitation interventions.