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Motor Retraining (MoRe) for Functional Movement Disorders: Outcomes From a 1-Week Multidisciplinary Rehabilitation

Alexandra E Jacob1, Darryl L Kaelin2, Abbey R Roach3

  • 1Department of Neurology, University of Louisville, Louisville, KY(∗).

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Summary

Functional movement disorders (FMDs) improved significantly with a 1-week multidisciplinary inpatient program. Motor retraining (MoRe) strategies led to sustained symptom improvement, showing effectiveness regardless of symptom duration or psychiatric comorbidities.

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Area of Science:

  • Neurology
  • Psychiatry
  • Rehabilitation Medicine

Background:

  • Functional movement disorders (FMDs) are neurological conditions often linked to psychological factors with poor prognosis.
  • Current treatment guidelines are lacking, but multidisciplinary approaches combining physical and psychotherapy are gaining recognition.
  • This study evaluates patient outcomes from a specialized FMD treatment program utilizing motor retraining (MoRe) strategies.

Purpose of the Study:

  • To assess the effectiveness of a multidisciplinary FMD treatment program.
  • To identify predictors of successful treatment outcomes in FMD patients.

Main Methods:

  • A retrospective chart review of 32 consecutive FMD patients admitted to the MoRe program between July 2014 and July 2016.
  • Patients underwent a 1-week inpatient program including physical, occupational, speech therapy, and psychotherapy.
  • Outcomes were measured using the patient-rated Clinical Global Impression Scale (CGI) and physician-rated Psychogenic Movement Disorder Rating Scale (PMDRS).

Main Results:

  • The study included 32 patients (24 female, mean age 49.1 years) with a mean symptom duration of 7.4 years.
  • At discharge, 86.7% reported symptom improvement (CGI), maintained by 69.2% at 6-month follow-up.
  • Significant improvement was observed in PMDRS scores (59.1% from baseline to discharge), with no negative impact from longer symptom duration or psychiatric comorbidities.

Conclusions:

  • A 1-week multidisciplinary inpatient rehabilitation program using MoRe strategies is effective for the majority of FMD patients.
  • Treatment success was not adversely affected by longer disease duration or the presence of psychiatric comorbidities.
  • Further long-term, prospective randomized studies are warranted to confirm these encouraging findings.