Recent trial study highlights positives of specialist physiotherapy for functional motor disorder

In the latest article from our Functional Neurological Disorder (FND) SIG, we take a look at the recent trial study conducted by Physio4FMD. The purpose of the study was to assess two types of physiotherapy and consider whether one of these is more effective than the other in cases of functional motor disorder (FMD).

FND is a condition that causes a range of symptoms including issues with movement such as tremors, weakness and difficulty walking, and sensations such as numbness and seizures. For more details make sure to download our recent handling guide.

FMD refers specifically to the symptoms that affect movement and is caused by a problem with how the brain and the body communicate.

The Physio4FMD trial

This randomised control trial was conducted at 11 sites across England and Scotland. Physio4FMD randomly allocated 247 people with FND either specialist physiotherapy for FMD or a referral for standard physiotherapy.

The programme for specialist physio focused on several key elements. Participants were provided with education around the causes of FMD, concentrating on how the brain’s spotlight interrupts movement. There was then a retraining of movement patterns by redirecting attention away from the body.

All candidates were asked to complete a questionnaire to measure their physical function when involved in:

• Vigorous activities
• Moderate activities
• Climbing the stairs
• Walking various distances
• Carrying groceries
• Walking
• Shopping

At 12 months post-commencement of physio, both groups reported improved physical function difference but those within the specialist physiotherapy programme reported that their movement problem had improved when compared with those who had completed the usual physiotherapy. Satisfaction levels were also greater for those participating in the specialist programme.

Physio4FMD candidates reported

• Better mental health
• Better understanding of their symptoms
• Greater sense of control over symptoms

Trial outcome

Physiotherapy provided by clinicians experienced in seeing people with neurological symptoms appears to be a valuable treatment for people with FMD.

However, more people who received specialist physiotherapy felt their movement problem had improved compared to those who received usual physiotherapy. There may also be other benefits to specialist physiotherapy, for example in helping people to understand their symptoms.

Treatment costs

The cost of private specialist neurological physiotherapy is in the region of £130 for an assessment and approximately £100 for a follow up session. Non–specialist treatment, for example MSK physio, is likely to be around £50 per session.

Comment

This trial reaffirms the importance of ensuring that patients suffering from functional disorders receive the appropriate treatment from practitioners who understand the aetiology of these conditions and have direct experience in treating them.

In a personal injury claim, rehabilitation with properly qualified practitioners can be beneficial and reduce the ultimate damages award. Our special interest group members are happy to discuss individual cases and advise on appropriate treatment and rehabilitation.