Outcomes of specialist physiotherapy for functional motor disorder: the Physio4FMD RCT

Area of Science:

• Neurology
• Rehabilitation Medicine
• Health Economics

Background:

• Functional motor disorder presents persistent, disabling symptoms and incurs high healthcare costs.
• Specialist physiotherapy is a promising treatment, but large-scale evidence is lacking.

Purpose of the Study:

• To compare the effectiveness and cost-effectiveness of specialist physiotherapy versus treatment as usual for functional motor disorder.

Main Methods:

• A pragmatic, multicentre, randomised controlled trial involving 355 adults.
• Primary outcome: Short Form questionnaire-36 items Physical Functioning domain at 12 months.
• Secondary outcomes included patient perception, quality of life, and health economics.

Main Results:

• No significant difference in the primary physical functioning outcome at 12 months.
• Specialist physiotherapy improved secondary outcomes like mental health and patient perception at 6 and 12 months.
• Health economic analysis indicated a high probability of cost-effectiveness (£4133 per QALY).

Conclusions:

• Specialist physiotherapy is not superior for physical functioning but offers benefits in other areas.
• The treatment demonstrates a high likelihood of being cost-effective.
• Further research is needed to refine outcome measures and identify optimal patient groups.