쉐도잉 연습: Breaking down functional movement disorders • 2025 MDS Congress - 영상으로 영어 말하기 배우기
레슨 만드는 중...
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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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이 레슨의 어휘와 말하기 포인트
이 C1 수준 말하기 레슨은 영상 “Breaking down functional movement disorders • 2025 MDS Congress”을(를) 바탕으로 합니다. 가장 자주 반복되는 단어는 다음과 같습니다: patient, functional, disorder, neurologist, symptom. 이 영상에는 섀도잉할 문장 123개와 단어 1585개가 있습니다. 말하는 구간의 길이는 11:00입니다. 화자는 분당 약 144단어의 일정한 속도로 말해서 섀도잉하기에 편한 속도입니다. 단어의 82%가 영어에서 가장 많이 쓰이는 3,000단어에 속합니다. 나머지는 연습 전에 미리 확인해 두세요.
이 영상의 핵심 어휘
영상에서 가장 어려운 단어 15개를 발음, 뜻과 함께 정리했습니다.
| 단어 | 발음 | 뜻 |
|---|---|---|
| symptom 명사 | /ˈsɪm(p)təm/ | 증상, 증후 |
| diagnose 동사 | /ˈdaɪ.əɡˌnoʊs/ | 진단 |
| tremor 명사 | /ˈtɹɛmɚ/ | 떨림 |
| psychiatrist 명사 | /ˌsaɪˈkaɪ.ə.tɹɪst/ | 정신과의 |
| certify 동사 | /ˈsɜː.tɪ.faɪ/ | 인증하다 |
| coexist 동사 | /ˌkoʊ.ɪɡˈzɪst/ | 공존하다 |
| postgraduate 명사 | /ˌpəʊstˈɡɹædju.ət/ | 원생 |
| reassure 동사 | /ˌɹi.əˈʃʊɹ/ | 안심시키다 |
| teamwork 명사 | 팀워크 | |
| vertigo 명사 | /ˈvɝtɪɡoʊ/ | 현기증 |
| listener 명사 | /ˈlɪs(ə)nɚ/ | 경청자, 청취자 |
| tailor 명사 | /ˈteɪlɚ/ | 재단사 |
| participant 명사 | /pɑːɹˈtɪsəpənt/ | 참가자 |
| hierarchy 명사 | /ˈhaɪ.ə.ɹɑː(ɹ).ki/ | 계층 |
| psychologist 명사 | /ˌsaɪˈkɑl.ə.d͡ʒɪst/ | 심리학자 |
영상에 나오는 구동사
| 단어 | 발음 | 뜻 |
|---|---|---|
| come out 동사 | /ˌkʌm ˈaʊt/ | 나오다 |
| go out 동사 | 나가다 |
이 영상의 문법
화자가 가장 많이 쓰는 문형을 영상 속 실제 표현과 함께 정리했습니다.
| 문형 | 영상 속 표현 |
|---|---|
| 현재완료진행 have/has been + -ing — 전에 시작해 지금도 계속되는 동작 | has been coming · I've been trying |
| 수동태 be + 과거분사 — 누가 하는지보다 무슨 일이 일어나는지에 초점 | be seen · has been shown · been estimated |
| 현재완료 have/has + 과거분사 — 과거의 일이 지금도 관련이 있을 때 | you've been · you've done · has been shown |
주의할 발음
화자는 don't, we're, I've 같은 축약형과 약화된 형태를 17번 사용합니다. 들리는 대로 짧게 발음하세요.
- “th” 소리: thankful /ˈθæŋkfəl/, therapist /ˈθɛɹəpɪst/
- “sh”와 “zh” 소리: fascination /fæsɪˈneɪʃən/, outpatient /ˈaʊtˌpeɪʃ(ə)nt/, reassure /ˌɹi.əˈʃʊɹ/, impatient /ɪmˈpeɪʃənt/, occupational /ɑkjuˈpeɪʃənəl/
- 긴 단어 — 강세 위치에 주의: neurological /nɝəˈlɑd͡ʒɪkəl/, psychiatrist /ˌsaɪˈkaɪ.ə.tɹɪst/, epileptic /ˌɛpɪˈlɛptɪk/, fascination /fæsɪˈneɪʃən/, perceptual /pə(ɹ)ˈsɛp.tʃ(u)əl/
한국어 화자가 어려워하는 소리:
- /f/ — ㅍ(/p/)으로 바꾸지 말고 윗니를 아랫입술에 대기: certify /ˈsɜː.tɪ.faɪ/, fascinate /ˈfæsɪneɪt/, fascination /fæsɪˈneɪʃən/, specificity /spɛsɪˈfɪsɪti/, thankful /ˈθæŋkfəl/
- /v/ — ㅂ(/b/)과 구별하기: validate /ˈvæl.ɪ.deɪt/, vertigo /ˈvɝtɪɡoʊ/, descriptive /dəˈskɹɪptɪv/, convey /kənˈveɪ/
- /z/ — ㅈ이 아니라 성대를 울리는 /s/: coexist /ˌkoʊ.ɪɡˈzɪst/, oppose /əˈpoʊz/
이 영상으로 연습하는 방법
- 먼저 말하지 않고 영상을 끝까지 듣고 모르는 단어를 적어 둡니다.
- 보통 속도로 한 문장씩 섀도잉하고, 화자의 리듬과 맞을 때까지 반복합니다.
- 자신의 목소리를 녹음해 원본과 비교하고, symptom, diagnose, tremor 같은 단어에 특히 주의합니다.
쉐도잉이란? 영어 실력을 빠르게 키우는 과학적 방법
쉐도잉(Shadowing)은 원래 전문 통역사 훈련을 위해 개발된 언어 학습 기법으로, 다언어 학자인 Dr. Alexander Arguelles에 의해 대중화된 방법입니다. 핵심 원리는 간단하지만 매우 강력합니다: 원어민의 영어를 들으면서 1~2초의 짧은 지연으로 즉시 소리 내어 따라 말하는 것——마치 '그림자(shadow)'처럼 화자를 따라가는 것입니다. 문법 공부나 수동적인 청취와 달리, 쉐도잉은 뇌와 입 근육이 동시에 실시간으로 영어를 처리하고 재현하도록 훈련합니다. 연구에 따르면 이 방법은 발음 정확도, 억양, 리듬, 연음, 청취력, 말하기 유창성을 크게 향상시킵니다. IELTS 스피킹 준비와 자연스러운 영어 소통을 원하는 분들에게 특히 효과적입니다.