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In Patients With Functional Movement Disorders, Is Specialized Physical Therapy Effective in Improving Motor

Marcus N Callister1, Cynthia B Stonnington2, Andrea Cuc2

  • 1Departments of Neurology.

The Neurologist
|January 20, 2022
PubMed
Summary

Specialized physical therapy (PT) significantly improves motor symptoms in functional movement disorders (FMD). This evidence-based approach offers sustained, cost-effective relief for disabling FMD symptoms.

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Area of Science:

  • Neurology
  • Physical Therapy
  • Rehabilitation Medicine

Background:

  • Functional movement disorders (FMD), also known as psychogenic movement disorders, are common, chronic, and disabling conditions.
  • There is a lack of evidence-based treatments for managing FMD motor symptoms.
  • Specialized physical therapy (PT) shows promise for alleviating motor symptoms through motor relearning and attention redirection.

Purpose of the Study:

  • To critically evaluate the evidence comparing specialized PT with usual care for improving motor symptoms in FMD patients.
  • To develop a structured critically appraised topic to assess current evidence.

Main Methods:

  • A randomized controlled feasibility trial was critically appraised.
  • 60 FMD patients were randomized to a 5-day specialized outpatient PT program or general PT referral.
  • Outcomes were measured using patient-reported and clinician-assessed scales, including the SF36.

Main Results:

  • 72% of patients in the specialized PT group achieved good outcomes at 6 months, versus 18% in the control group.
  • Specialized PT significantly improved physical and social function across multiple scales (SF36 domains d=0.46 to 0.79).
  • The intervention was cost-effective, yielding 0.08 additional quality-adjusted life years.

Conclusions:

  • Specialized PT offers clinically significant, sustained, and cost-effective improvement in motor symptoms for FMD patients.
  • This intervention demonstrates considerable promise and warrants further research and replication.