Inpatient Neurorehabilitation Benefits Patients with Functional Neurological Disorder: A Single Centre Study

Functional Neurological Disorders (FNDs) are common, comprising 10% to 30% of the Neurology caseload. Emerging evidence suggests that multidisciplinary rehabilitation is effective in FND, but actual gains in daily functioning are not clear from the current literature.

To assess the outcomes of FND patients receiving inpatient rehabilitation in a specialist neurorehabilitation unit.

Multidisciplinary (MDT) rehabilitation was provided by a multidisciplinary professional team led by consultants in Physical and Rehabilitation Medicine (PRM). Functional Outcomes such as Functional Independence Measure /Functional Assessment Measure, including motor and cognitive domains, were measured at 3 timepoints (admission, discharge and during post-discharge telephone appointments). Further data on demographics and disease presentation were collected by retrospective chart review.

Eighteen patients with FND were admitted to the unit over a 2-year period. The median length of stay for patients in the rehabilitation unit was 69 days (47-98 days) and the median post-discharge follow-up was 10 months (3,24 months). All outcome measures demonstrated improvement following rehabilitation. In particular, the median (IQR; FIM) score improved by 30 points (IQR 82-120) between admission and discharge, which exceeds the Minimal Clinically Important Difference (MCID) of 22 reported in the literature, indicating a clinically significant improvement. The improvements post-discharge plateaued but were maintained at follow-up. Qualitative feedback indicated high satisfaction with care in the rehabilitation unit and the improvements in daily functioning achieved.

FND patients showed clinically significant improvements from inpatient specialist rehabilitation in this cohort. Further multi-site, larger-scale research is needed to determine whether certain types of FND patients have greater improvements than others from inpatient MDT rehabilitation.