Telerehabilitation for functional neurological disorders: A scoping review

Functional neurological disorder (FND) is a prevalent condition requiring various rehabilitation needs. Telerehabilitation may be a promising solution. This scoping review explored how telerehabilitation is used for FND and identified gaps.

A systematic search was performed from May 18 to June 3, 2024, using MEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane Central, PsycINFO, CINAHL, and clinicaltrials.gov. Ongoing research (protocols and conference abstracts) was included. Citation screening was done for reviews and narrative articles to identify missing articles. Screening and data extraction were conducted in duplicate. Data were analyzed both quantitatively and qualitatively.

We identified 180 records, and 26 met inclusion criteria (six were reviews or narratives). We identified 11 completed primary studies (one from citation tracing), seven protocols, and three abstracts. Telerehabilitation was predominantly delivered one-on-one, often using synchronous or hybrid formats. The most common form of therapy was cognitive behavioural therapy. Most completed studies involved a small number of participants, and all were conducted in high-income countries. Identified gaps included disparities in telerehabilitation access and limited completed studies for some subtypes (e.g., functional cognitive and speech disorders) or forms of therapy (e.g., physical therapy, etc.).

Telerehabilitation as a viable approach to management for some FND patients has been primarily described in the literature in one-on-one and synchronous/hybrid formats, providing insights for future research and clinical practices. Emerging trends explore understudied subtypes, other remotely deliverable therapies, and the use of innovative technologies such as wearable sensors and a Tremor Retrainer smartphone application.