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Inpatient Rehabilitation for Acute Presentations of Motor Functional Neurological Disorder: A Retrospective Cohort
Ginger Polich1, Stacey Zalanowski, Julie Maney Lewis
1From the Spaulding Rehabilitation Hospital, Boston, Massachusetts (GP, SZ, JML, SS, KC, CH, PS); Brigham and Women's Hospital, Boston, Massachusetts (GP, GB); MedRhythms, Inc, Boston, Massachusetts (CH); Massachusetts General Hospital, Boston, Massachusetts (DLP); and California Rehabilitation Institute, Cedars Sinai Medical Center, Los Angeles, California (SH).
Objective:
Patients with functional neurological disorder involving the motor system (eg, functional weakness, functional gait) may acutely present to the hospital for new-onset symptoms. For some, symptoms may remain severe enough at the time of hospital discharge to qualify for an inpatient rehabilitation facility stay.
Design:
Data were extracted via retrospective chart review on functional neurological disorder patients ( N = 22) admitted to an inpatient rehabilitation facility between September 2019 and May 2022. Demographic and clinical data, including admission and discharge physical and occupational therapy measurements on the Inpatient Rehabilitation Facility Patient Assessment Instrument, were recorded and analyzed.
Results:
Symptom duration was less than 1 wk for nearly two thirds of the cohort. After an approximately 2-wk length of stay, patients showed statistically significant changes in admission to discharge measures of self-care, transfers, ambulation, and balance. More than 95% of patients were able to be discharged home. The presence or absence of comorbid depression, anxiety, or posttraumatic stress disorder did not impact outcomes.
Conclusions:
For a subset of patients with persistent motor symptoms after an acute hospital admission for a new diagnosis of functional neurological disorder, a relatively short inpatient rehabilitation facility stay was associated with significant clinical gains.
