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Published on: February 13, 2020
Combined Physiotherapy and Cognitive Behavioral Therapy for Functional Movement Disorders: A Randomized Clinical
Daniel Macías-García1,2, Marta Méndez-Del Barrio1,2, Manuel Canal-Rivero3,4
1Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/Universidad de Sevilla/CSIC/CIBERNED, Sevilla, Spain.
Functional movement disorders (FMDs) are effectively treated with multidisciplinary therapy combining physiotherapy and cognitive behavioral therapy. This approach significantly improves patients' quality of life, particularly physical aspects, offering a promising treatment for FMDs.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Psychiatry
Background:
- Functional movement disorders (FMDs) are prevalent and disabling neurological conditions with significant socioeconomic consequences.
- Limited randomized trials have explored the effectiveness of combined physiotherapy and psychotherapy for improving FMD patients' quality of life.
Purpose of the Study:
- To evaluate the efficacy of a multidisciplinary treatment approach, integrating physiotherapy and cognitive behavioral therapy (CBT), for patients diagnosed with FMDs.
Main Methods:
- A parallel-group, rater-blinded, single-center randomized clinical trial was conducted.
- Participants (n=40) with confirmed FMD diagnosis were randomized 1:1 to receive either multidisciplinary treatment (physiotherapy + CBT) or a control intervention (psychological support).
- Quality of life was assessed using EQ-5D-5L and SF-36 surveys at baseline, 3 months, and 5 months, with analysis using linear mixed models.
Main Results:
- Multidisciplinary treatment led to a significant improvement in the SF-36 Physical Component Summary (PCS) at 5 months (mean difference 5.62 points, P < .001).
- While not statistically significant at 3 months for PCS, improvements were observed.
- No significant differences were found in SF-36 Mental Component Summary (MCS), EQ VAS, or EQ Index between groups at either time point.
- Higher self-reported health improvements were noted in the multidisciplinary group at 3 and 5 months compared to the control group.
Conclusions:
- Multidisciplinary treatment combining physiotherapy and CBT demonstrates effectiveness in improving the physical aspects of quality of life for patients with FMDs.
- The study highlights the potential of this integrated approach for managing FMD symptoms and enhancing patient well-being.
- Further research is warranted to explore the cost-effectiveness of this intervention for FMD management.
