The work is held at the Municipal Health Department in São Gonçalo/RJ through physical education assessments by the Center of Family Health Support, Brazil
Healthcare institutions and colleges have long prioritized, through the media, studies and interviews, that quality of life and health of patients has to only be associated with the management of arterial hypertension, weight loss, diabetes, prescription of controlled medications, whether or not towards certain comorbidities, dieting, and regular physical activities thus often forgetting that the individual is whole, biopsychosocial and, that the body is much more than a deposit of synthetic substances and “natural” pharmaceuticals to replace chemical deficiencies or to anesthetize moral sufferings accruing for a lifetime in the form of depression and auto-immune diseases.
However, psychosomatic illnesses affect emotions and consequentially cause mismanagement of blood pressure, diabetes, increase of adipose tissue (body fat), bad eating habits (anxieties), heart disease, amongst other comorbidities. It is not useful to treat, attempt to prevent or give attention to a single part of the body and not care for other corporal features as we have to take heed of patients in respect to their integrality (condition of what is whole, complete).
Such integrality, is associated with the following aspects: affective-relational, cognitive-intellectual and, physical-motor. As an education and health professional, when making observations in caring for patients and upon investigational studies tailored to applying psychomotricity in patients, I notice that a group of scientific literatures back up psychomotricity as an important science to develop the human being towards his wholesomeness.
According to ISPE-GAE (2007) “Psychomotricity is the neuroscience that turns the thought into a harmonious motor act. It is the fine tuning which coordinates and organizes the actions managed by the brain and manifests them in knowledge and learning”.
According to the Brazilian Association of Psychomotricity (2003), “it is the science that has as its subject of study the man through his body while in movement and in relation to his internal and external world, as well as his possibilities to be aware, behave, and take action towards the other, with objects, and with himself. It is related to the process of maturation (maturity) where the body is the origin of cognitive, affective, and organic aquisitions”. Hence, “Psychomotricity is a term employed within the concept of organized movement (coordinated) and integrated (steps that function in a complete fashion), according to the experiences lived by the subject whose actions are a result of his individuality (cultural identity), language (mode of self-expression – whether or not via behaviors and attitudes), as well as his socialization (development of social consciousness)”.
However, when following the racionalization of some health researchers as to the psychomotricity and education fields, we base their research on this study. As we affirm the importance of psychomotricity when caring for patients with comorbidities, we ascertain the significance of its basic aspects, the first we will focus on is the cognitive aspect related to healthcare studies.
As to cognition within neural adaptation, according to Maior and Alves (2003), when the subject presents with motor coordination difficulties in the beginning of the stimulation of a given exercise, it is due to the brain not being ready for the movement. In other words, the brain does not recognize the proposed exercise and the movement itself is not well coordinated. When the patient succeeds in the movement and exercise, his brain is thus adapted to the movement and is able to execute it thanks to neural adaptation. According to study findings, they take place in a period of 4 to 8 weeks. (O’Bryant et al., 1998; Hickson et al., 1994)
The Intellectual, in its studies of learning as related to motor function and memory, according to Gallardo (1998), in order to execute a series of movements, human beings need to memorize the format of how they have to be accomplished. For that to happen, it is crucial that the healthcare provider or the instructor correctly assists the patient with the storage of the information related to the movement while tending to the following: not giving excessive information at once, and not too rapidly.
According to Janet Spence (1971) we must observe the patients’ anxiety levels, if it is significant: as a predisposition from the individual to see a situation as threatening or not, or that of a state-of-being anxiety: indicative of how someone responds to a situation in particular as it may affect learning and performance in relation to the anxiety level and the task complexity.
Diewert and Stelmach (1978) approach the aspects of memory under the direct control of the subject. There are three processes: storage, organization, and the reuptake of information towards a positive and conscious assimilation. When furthering the study, Adams and Dijkstra (1966) refer to short and long-term memory as a storage stage of twenty to thirty seconds with a limited capacity of five to nine items for the short-tem memory, and a characteristic of unlimited capacity through repetition of information, or conditioning, for the long-tem.
The aforementioned researchers brought valuable contributions about the recording of serial information following a standard upon which the beginning parts and the most recent ones are better remembered while the parts in the middle are more poorly retrieved. It is paramount to teach coherently the very content of the information with care and affect in a positive way so that patients can have proper understanding and comprehension.
As to the affective aspect, in education, Wallon (1975), values the importance of affect as it relates the being with the environment, intelligence, emotion, and the movement. Affect greatly contributes to development and learning.
Said affect in human development involves giving credit that the subject is capable of becoming more autonomous in solving life issues and being socially interactive within his reality. Believing in the science of affect is key in order to discuss how the strengthening of affect-filled relationships in caring contributes to the whole health of the subject (Vasconcelos, 2004).
According to Wallon (2006), it is through culture immersion that men develop themselves as human beings and thus what were biological effects become more complex as affect and intelligence bond throughout the human development.
According to Almeida (2012), it is in the sociocultural context that healthcare professionals and instructors serve as stewards for both patients and students within the culture – given that such mediation are affective in nature and determine the relationship between those who give and those who receive care.
However, Leite (2016) writes that affect-related phenomena are intimately linked with the quality of the interactions between subjects and their life experiences, therefore, affect is construed and is a byproduct of the relationships established by the patients.
Hence, the attitude of the healthcare professional towards a practice oriented by affect, allows the patient to reach an intellectual development that is more effective since it comprehends how relationships with affect within public units of care have an influence in the process of teaching and learning; consequently upon trust, self-esteem, and a positive cognitive development of patients as the instructor plays an influential role in the lives of students. (Bezerra, 2016)
We then have the aspect of movement, of psychomotricity, within motricity. According to Quiros (1983), motricity is the faculty of performing movements, and psychomotricity is the education by means of the movements in search of a better utilization of the psych capacities. Thus, psychomotricity, as a health and psychomotor-related science of education, seeks to both educate and develop the functions of intelligence and that of affect within the subject.
In considering the role of the Physical Education professional involving motor-related abilities and movements, he predominantly works towards obtaining motor control. According to Gallhue and Osmum (2011) movement, psychomotricity, and motor-related learning entail the gradual improvement of a given motor-dependent behavior as observed as an outcome in practice. Learning is then a continuous process of lived and stored experiences which, in and out of themselves, are not noticeable to us. It is then externalized through human movement. When such learning involve movements, there is motor learning.
This is the reason Goretti (2010) states that “Psychomotricity is the field that focus on the body while in movement. However, we should not forget that the body is one of the most powerful tools people have in order to express knowledge, ideas, feelings and emotions. It is the body that unites the individual with the world which in turn gives back to him the necessary features so that he may constitute himself as an individual”.
Psychomotricity acts as it allows environments that stimulate body-related experiences through the psychomotor elements of the subjects during therapy. They are: body diagram, body image, muscle tone, global coordination/widespread motricity, fine motricity/fine motor coordination, organization of time and space, rhythm, laterality, lower limb and visual perception, walking, and static and dynamic balance (Goretti, 2010).
We conclude that the patient who is well cared for, oriented, and welcomed performs better in his integrality and is able to succeed in controlling blood pressure, diabetes, anxiety, and other comorbities. But in some particular situations, drug prescriptions, dieting, and regular physical activities are very useful for the health of the frail who only should diminish, stop taking, or increase prescriptions with the direction of competent physicians who are good stewards towards the other.
We intend to demonstrate with this study that psychomotricity and its cognitive/intellectual, affective/social, and movement/motricity aspects are important fields to be stimulated by capable professionals in order to assist patients in their rehabilitation as well as in their gradual improvement of quality of living and health.
It is noticeable that health is to be employed wholesomely, as explained by Nahas and Totaro (2010), as a crucial health concept “of balanced condition of physical, emotional, spiritual, and social well-being without illness, handicaps, and dysfunctions” and “of health promotion as an art to assist people with lifestyle changes towards optimum health”.
In sum, this theoretical and practical study is of paramount importance to orient healthcare professionals within an affective and effective approach. I would like to thank the patients involved in the study for their kindness, perseverance, availability, their fight in regards to the many public-health challenges (resources, physical spaces, hostile environments, and structures), their dedication, attention, as well as for believing in the physical education psychomotor therapy which allowed us outstanding results as published in articles, and seen in photos and videos taken throughout our daily practice at the Health Family Units, RJ, Brazil.
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Marcelo Bittencourt Jardim
Physical Education Instructor for the Municipal Department of Public Health by the NASF, SG, RJ, Brasil; Member of the Editorial/Scientific Committee for the Observatorio del Deportes da Universidad de Los Lagos, Santiago campus, Chile; Psychomotricity professional and writer of books regarding Psychomotricity/Affect, Motor-related Learning, Special Education, Physical Education and Education. Researcher recognized by the Federal Council of Physical Education, the Brazilian Association of Psychomotricity and Public Education/Brazil.