シャドーイング練習: Breaking down functional movement disorders • 2025 MDS Congress - 動画で英語スピーキングを学ぶ
レッスンを作成中...
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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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このレッスンの語彙とスピーキングのポイント
このC1レベルのスピーキングレッスンは、動画「Breaking down functional movement disorders • 2025 MDS Congress」を教材にしています。 繰り返し出てくる語は次のとおりです：patient, functional, disorder, neurologist, symptom。 この動画には、シャドーイング用の文が123文、単語が1585語あります。 音声の長さは11:00です。 話す速さは1分あたり約144語で安定しており、シャドーイングしやすいペースです。 単語の82%は英語の頻出3,000語に含まれます。残りは練習の前に確認しておきましょう。
この動画の重要語彙
動画の中で特に難しい単語15語を、発音と意味つきで紹介します。
| 単語 | 発音 | 意味 |
|---|---|---|
| symptom 名詞 | /ˈsɪm(p)təm/ | 症状, 症候 |
| diagnose 動詞 | /ˈdaɪ.əɡˌnoʊs/ | 診断する |
| tremor 名詞 | /ˈtɹɛmɚ/ | 震え, 揺れ |
| psychiatrist 名詞 | /ˌsaɪˈkaɪ.ə.tɹɪst/ | 精神科医 |
| abnormal 形容詞 | /ˌæbˈnɔɹ.ml̩/ | 不自然, 異常 |
| amplitude 名詞 | /ˈæm.plɪ.tud/ | 広さ |
| certify 動詞 | /ˈsɜː.tɪ.faɪ/ | 認証する |
| coexist 動詞 | /ˌkoʊ.ɪɡˈzɪst/ | 共存する |
| dizziness 名詞 | 目眩, くらくら | |
| fascinate 動詞 | /ˈfæsɪneɪt/ | 魅惑する |
| pathophysiology 名詞 | 病態生理学 | |
| postgraduate 名詞 | /ˌpəʊstˈɡɹædju.ət/ | 院生, 研究生 |
| slowness 名詞 | 遅さ, 遅慢 | |
| subgroup 名詞 | /ˈsʌbˌɡɹuːp/ | 部分群, 亜群 |
| teamwork 名詞 | チームワーク |
動画に出てくる句動詞
| 単語 | 発音 | 意味 |
|---|---|---|
| come out 動詞 | /ˌkʌm ˈaʊt/ | 出る |
| go out 動詞 | 出る |
この動画の文法
話し手がよく使っている文型を、動画の実際の表現とともに紹介します。
| 文型 | 動画での表現 |
|---|---|
| 現在完了進行形 have/has been + -ing — 以前に始まり今も続いている動作 | has been coming · I've been trying · that's been listening |
| 現在完了形 have/has + 過去分詞 — 過去の出来事が今も関係している | you've been · you've done · has been shown |
| 受動態 be + 過去分詞 — 誰がするかより、何が起きるかに焦点を当てる | be seen · has been shown · been estimated |
注意したい発音
話し手はdon't, we're, I'veなど、短縮形や弱形を17回使っています。聞こえたとおりの短い形で発音しましょう。
- 「th」の音: thankful /ˈθæŋkfəl/, therapist /ˈθɛɹəpɪst/
- 「sh」と「zh」の音: fascination /fæsɪˈneɪʃən/, outpatient /ˈaʊtˌpeɪʃ(ə)nt/, reassure /ˌɹi.əˈʃʊɹ/, impatient /ɪmˈpeɪʃənt/, occupational /ɑkjuˈpeɪʃənəl/
- 長い単語（アクセントの位置に注意）: neurological /nɝəˈlɑd͡ʒɪkəl/, psychiatrist /ˌsaɪˈkaɪ.ə.tɹɪst/, epileptic /ˌɛpɪˈlɛptɪk/, fascination /fæsɪˈneɪʃən/, perceptual /pə(ɹ)ˈsɛp.tʃ(u)əl/
日本語話者が苦手な音：
- /r/ と /l/ の区別 — /l/ は舌先を歯茎につけ、/r/ はどこにもつけない: abnormal /ˌæbˈnɔɹ.ml̩/, perceptual /pə(ɹ)ˈsɛp.tʃ(u)əl/, postural /ˈpɑst͡ʃəɹəl/, disclosure /dɪsˈkləʊʒə(ɹ)/
- /v/ — /b/ にならないように、上の歯を下唇に当てる: validate /ˈvæl.ɪ.deɪt/, vertigo /ˈvɝtɪɡoʊ/, descriptive /dəˈskɹɪptɪv/, convey /kənˈveɪ/
- /f/ — 「フ」ではなく、上の歯と下唇で出す: certify /ˈsɜː.tɪ.faɪ/, fascinate /ˈfæsɪneɪt/, fascination /fæsɪˈneɪʃən/, specificity /spɛsɪˈfɪsɪti/, thankful /ˈθæŋkfəl/
この動画での練習方法
- まず声を出さずに動画を最後まで聞き、知らない単語をメモします。
- 通常の速度で一文ずつシャドーイングし、話し手のリズムに合うまで繰り返します。
- 自分の声を録音して元の音声と比べます。symptom, diagnose, tremorなどの単語に特に注意しましょう。
シャドーイングとは？英語上達に効果的な理由
シャドーイング（Shadowing）は、もともとプロの通訳者養成プログラムで開発された言語学習法で、多言語習得者として知られるDr. Alexander Arguelles によって広く普及されました。方法はシンプルですが非常に効果的：ネイティブスピーカーの英語を聞きながら、1〜2秒の遅延で声に出してすぐに繰り返す——まるで「影（shadow）」のように話者を追いかけます。文法ドリルや受動的なリスニングと異なり、シャドーイングは脳と口の筋肉が同時にリアルタイムで英語を処理・再現することを強制します。研究により、発音精度、抑揚、リズム、連音、リスニング力、そして会話の流暢さが大幅に向上することが確認されています。IELTSスピーキング対策や自然な英語コミュニケーションを目指す方に特におすすめです。