शैडोइंग अभ्यास: Breaking down functional movement disorders • 2025 MDS Congress - वीडियो के साथ अंग्रेजी बोलना सीखें
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Good afternoon, everyone, and welcome to a special episode of the MDS podcast coming from the Movement Disorder Congress 2025.
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We are so privileged to have Professor Ibeck with us to discuss today's topic, Functional Movement Disorders.
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Professor Ibeck is a neurologist working at the University of Freiburg.
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To say Professor Ibeck is a specialist in FND is an understatement.
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We are very thankful to have you here today with us.
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I just listened to your talk on functional movement disorders, diagnosis and management.
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Before we dive into the content of functional movement disorders, can you maybe tell us a little bit about what got you interested in this topic?
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Sure.
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Thank you so much, first, for inviting me to take part in this podcast.
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It's a pleasure.
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And to talk about FND, my passion.
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So about how I got into FND, it was actually the fascination for these clinical presentations that I saw during my training.
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I had a mentor who was a movement disorder specialist, and he showed me these unusual cases because back then the diagnosis
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but he started showing me that there are actually positive signs.
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And I got so fascinated because we did not understand the pathophysiology.
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Mainly that was my interest.
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Why do these patients do these symptoms?
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And I wanted to know more.
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And I think that over the years, you've been such an amazing contributor to telling all of us about how that happens.
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And so thank you for the amazing work you've done.
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Yes, so FMD, functional movement disorder,
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is actually a group of symptoms where people present with abnormal movements or abnormal motor patterns such as weakness.
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And it's actually a subgroup of what we call FND,
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functional neurological disorder, because the same disorder can also express in different ways and be seen by other neurologists,
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like non -epileptic or functional seizures, for example, or speech disorder would be part of FMD but sometimes diagnosed by other specialists,
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or sensory problems, vision, hearing, so all the senses.
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And now more recently, we also defined two groups that belong to that, that are functional cognitive disorder and functional vertigo.
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That has also this name of triple PD, PPPD for postural, persistent, perceptual dizziness.
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So this is a whole group.
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But we're focusing today on FMD, right, movement and motor problems.
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Brilliant.
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Thank you.
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That gives us a great overview of where everything sits.
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would you say FMD is?
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FMD, again, in general has been shown to be one of the commonest cause to see a neurologist in different studies.
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So it's very common.
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It's been estimated also to represent up to a third of consultation in a general neurologist setting.
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Now that said, it can also be
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just FND or FND plus neurological disorder because it's not rare to see patients who can have both, right, coexisting.
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And FMD is the commonest subtype.
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So you mentioned that it can also be seen with a neurological condition.
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Are there specific neurological conditions that it's often seen with, or can it be seen with any neurological condition?
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So it can be seen with any.
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So you can have any
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symptom but there are some specific patterns that we now recognize
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and one that is of particular interest I think
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that we discussed in the session is the association of functional Parkinsonism with actually Parkinson's disease
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and it's very interesting because first the clinical presentation is not
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that easy we need to really carefully look for signs one of the signs we discussed in the video is
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that the slowness of movement that you can see in functional
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bit different in the sense that patient will be slow
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when you do the finger tapping but they won't show this loss of amplitude
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that is typical of the bradykinesia that we see in Parkinson's.
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So these help you make the diagnosis of functional Parkinsonism.
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And it's been shown now in a few case series that patients can have both, but when they have both, it tends to be that they start with the functional Parkinsonism,
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sometimes years before we actually find or develop the signs and symptoms of Parkinson.
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but they might develop the disease.
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This is an example where the role of the neurologist is really very important.
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So over the last few years, there's so much research that has been coming out around FND.
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How do you feel that the medical community has responded to this research?
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Do you feel there are still some controversies around it?
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Yeah, so thank you indeed for raising this point
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because we see big lag between what's shown in science and the literature and then the clinical application.
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And here I'm referring to this whole evidence from the literature that now we can make the diagnosis with positive signs,
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that there are a lot of positive signs that have been validated in studies showing a good specificity, showing a good inter -rater reliability,
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and yet In clinical practice, it takes years before neurologists actually know these signs or use them.
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And yeah, but I guess it's normal in the field, right?
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But it takes years until clinical research comes into clinical practice.
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And we need then to bridge that gap.
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A lot of conferences teaching, postgraduate teaching, pregraduate teaching.
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I think if we teach the young medical doctors early how to make the diagnosis, we won't have this issue anymore.
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So to everyone listening, if you understand the ins and outs of diagnosis, go out and share with your colleagues.
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So when making the diagnosis, do you ever discuss the prognosis with the patient?
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Not necessarily.
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I really wait for the patient to ask.
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And we often have patients who ask.
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And then my answer is that for an individual person, we cannot predict, we're not good at it.
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But then I cite studies and I say that roughly 40 % of patients will still have symptoms, but that it really depends.
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And I then tailor my explanation to what I see, because if I see a patient with acute symptoms,
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I tend to be more encouraging and positive because from experience, not really from literature, but from experience, we know that they tend to get better quicker.
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When we see patients with very chronic symptoms, I also want them to have realistic expectations, so I tell them that it will take months or years.
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And again, it's not to discourage them, it's to make a good treatment plan with them that is realistic.
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Thank you.
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And again, when explaining the diagnosis to your patients, are there any big no -nos that you would say,
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"Stay away from everyone, please." Yes, I think there are two words that we should stay away from.
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It's to refer to a functional disorder on one hand and oppose it to a real disorder.
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So the term real disorder should not be used.
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Or genion is the other one to say this is a genion tremor, whereas this is a functional tremor.
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This is really not helpful because it conveys really a sort of hierarchy of symptoms and that FND would be less important.
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And we're talking to people who suffer on a daily basis with the symptoms.
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And other than that, I think we can use term.
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Of course functional is the most appropriate to me
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because it's very descriptive but what matters more is our attitude
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and our behavior and the respect we show to our patient
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and we show them that we not only believe them
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but we have seen many other patients like them
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and it's not rare and we know what we're talking about and this reassures the patients a lot.
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Brilliant, thank you.
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So then moving towards management, how beneficial is it to see or to refer a patient for treatment as early as possible?
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It's very important.
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Going back to the prognosis, if we diagnose patients early and they can get into treatment early, they will get better.
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So this is really the big effort that I've been trying to do in my country, in the different hospitals I've been working for, but also to advocate internationally.
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These patients should be diagnosed really early so that we can influence the prognosis.
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And then in terms of management, how important is an interdisciplinary team?
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It's key.
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To have an interdisciplinary team is key.
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And we still see a lot of centers around the globe where neurologists feel very isolated
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because they're able to make the diagnosis, but then they don't know where to refer.
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They don't have a good physio around.
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They don't have a psychiatrist or psychologist.
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We see the other side where it's the psychiatrist that say, we don't have any neurologists interested in the team.
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Or I've also talked to some OT, occupational therapists, that said, but I need a neurologist to certify it.
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So it's really key that we all work together and that we develop then this teamwork.
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Also because now there are studies that show
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that we can really improve the patient's outcome with interdisciplinary treatment being outpatient setting or inpatient setting.
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Both have now come in studies.
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Thank you.
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I really appreciate your time today and for sharing your knowledge with our listeners.
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Thank you also for your amazing presentation at the Congress.
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And to everyone that's been listening, thank you for opening your mind.
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Thank you.
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clinical practice.
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Any disclosures of the participants can be found within the episode description located on the MDS website.
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इस पाठ की शब्दावली और बोलने के सुझाव
यह C1 स्तर का स्पीकिंग पाठ वीडियो “Breaking down functional movement disorders • 2025 MDS Congress” पर आधारित है। सबसे ज़्यादा दोहराए गए शब्द ये हैं: patient, functional, disorder, neurologist, symptom। इस वीडियो में शैडोइंग के लिए 123 वाक्य और 1585 शब्द हैं। बोला गया हिस्सा 11:00 लंबा है। वक्ता लगभग 144 शब्द प्रति मिनट की स्थिर गति से बोलता है, जो शैडोइंग के लिए आरामदायक है। 82% शब्द अंग्रेज़ी के 3,000 सबसे आम शब्दों में से हैं; बाकी शब्द अभ्यास से पहले देख लेना अच्छा रहेगा।
इस वीडियो की मुख्य शब्दावली
वीडियो के 15 सबसे कठिन शब्द, उच्चारण और अर्थ के साथ:
| शब्द | उच्चारण | अर्थ |
|---|---|---|
| neurologist संज्ञा | स्नायुशास्त्री | |
| symptom संज्ञा | /ˈsɪm(p)təm/ | लक्षण, अलामत |
| interdisciplinary विशेषण | अंतर्विषयक | |
| psychiatrist संज्ञा | /ˌsaɪˈkaɪ.ə.tɹɪst/ | मनश्चिकित्सक |
| epileptic विशेषण | /ˌɛpɪˈlɛptɪk/ | मिरगिया, अपस्मारी |
| postgraduate संज्ञा | /ˌpəʊstˈɡɹædju.ət/ | स्नातकोत्तर |
| reassure क्रिया | /ˌɹi.əˈʃʊɹ/ | आश्वासन |
| vertigo संज्ञा | /ˈvɝtɪɡoʊ/ | चक्कर |
| listener संज्ञा | /ˈlɪs(ə)nɚ/ | श्रोता |
| impatient विशेषण | /ɪmˈpeɪʃənt/ | आतुर |
| tailor संज्ञा | /ˈteɪlɚ/ | दर्ज़ी |
| seizure संज्ञा | /ˈsi.ʒɚ/ | अधिग्रहण |
| participant संज्ञा | /pɑːɹˈtɪsəpənt/ | भागी, भागिनी |
| hierarchy संज्ञा | /ˈhaɪ.ə.ɹɑː(ɹ).ki/ | पदानुक्रम, अनुक्रम |
| convey क्रिया | /kənˈveɪ/ | व्यक्त करना |
वीडियो में आने वाली फ़्रेज़ल वर्ब
| शब्द | अर्थ |
|---|---|
| go out क्रिया | बाहर निकलना, निकलना |
इस वीडियो का व्याकरण
वक्ता जिन संरचनाओं का सबसे अधिक प्रयोग करता है, वीडियो के असली शब्दों के साथ:
| संरचना | वीडियो में |
|---|---|
| Present perfect continuous have/has been + -ing — पहले शुरू हुआ काम जो अब भी जारी है | has been coming · I've been trying · that's been listening |
| Present perfect have/has + past participle — बीता हुआ काम जिसका असर अभी भी है | you've been · you've done · has been shown |
| Passive voice be + past participle — ज़ोर इस पर कि क्या होता है, न कि कौन करता है | be seen · has been shown · been estimated |
ध्यान देने योग्य उच्चारण
वक्ता 17 बार संक्षिप्त रूपों का प्रयोग करता है, जैसे don't, we're, I've। इन्हें वैसे ही छोटा बोलें जैसा आप सुनते हैं।
- “th” की ध्वनियाँ: thankful /ˈθæŋkfəl/, therapist /ˈθɛɹəpɪst/
- “sh” और “zh” की ध्वनियाँ: fascination /fæsɪˈneɪʃən/, outpatient /ˈaʊtˌpeɪʃ(ə)nt/, reassure /ˌɹi.əˈʃʊɹ/, impatient /ɪmˈpeɪʃənt/, occupational /ɑkjuˈpeɪʃənəl/
- लंबे शब्द — बलाघात सही रखें: neurological /nɝəˈlɑd͡ʒɪkəl/, psychiatrist /ˌsaɪˈkaɪ.ə.tɹɪst/, epileptic /ˌɛpɪˈlɛptɪk/, fascination /fæsɪˈneɪʃən/, perceptual /pə(ɹ)ˈsɛp.tʃ(u)əl/
हिंदी भाषियों के लिए मुश्किल ध्वनियाँ:
- /v/ और /w/ का फ़र्क़ — /v/ में ऊपर के दाँत निचले होंठ को छूते हैं, /w/ में होंठ गोल होते हैं: validate /ˈvæl.ɪ.deɪt/, vertigo /ˈvɝtɪɡoʊ/, descriptive /dəˈskɹɪptɪv/, convey /kənˈveɪ/
- /z/ — इसे “ज” (/dʒ/) न बनाएँ: coexist /ˌkoʊ.ɪɡˈzɪst/, oppose /əˈpoʊz/
- /æ/ — “ऐ” से ज़्यादा खुला: abnormal /ˌæbˈnɔɹ.ml̩/, amplitude /ˈæm.plɪ.tud/, fascinate /ˈfæsɪneɪt/, fascination /fæsɪˈneɪʃən/, postgraduate /ˌpəʊstˈɡɹædju.ət/
इस वीडियो से अभ्यास कैसे करें
- पहले बिना बोले पूरा वीडियो एक बार सुनें और जो शब्द नहीं आते उन्हें लिख लें।
- सामान्य गति पर एक-एक वाक्य की शैडोइंग करें और हर वाक्य तब तक दोहराएँ जब तक आपकी लय वक्ता से न मिल जाए।
- अपनी आवाज़ रिकॉर्ड करें और मूल से तुलना करें, ख़ासकर neurologist, symptom, interdisciplinary जैसे शब्दों पर ध्यान दें।
शैडोइंग तकनीक क्या है?
शैडोइंग (Shadowing) एक विज्ञान-समर्थित भाषा सीखने की तकनीक है जो मूल रूप से पेशेवर दुभाषिया प्रशिक्षण के लिए विकसित की गई थी। विधि सरल लेकिन शक्तिशाली है: आप मूल अंग्रेज़ी ऑडियो सुनते हैं और तुरंत इसे ज़ोर से दोहराते हैं — जैसे वक्ता की छाया 1-2 सेकंड की देरी से। शोध से पता चलता है कि यह उच्चारण सटीकता, स्वर, लय, जुड़ी हुई ध्वनियाँ, सुनने की समझ और बोलने की प्रवाहशीलता में काफ़ी सुधार करता है।