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Physiotherapy for functional motor disorders: a consensus recommendation.

Nielsen, G; Stone, J; Matthews, A; Brown, M; Sparkes, C; Farmer, R; Masterton, L; Duncan, L; Winters, A; Daniell, L; et al. Nielsen, G; Stone, J; Matthews, A; Brown, M; Sparkes, C; Farmer, R; Masterton, L; Duncan, L; Winters, A; Daniell, L; Lumsden, C; Carson, A; David, AS; Edwards, M (2015) Physiotherapy for functional motor disorders: a consensus recommendation. J Neurol Neurosurg Psychiatry, 86 (10). pp. 1113-1119. ISSN 1468-330X https://doi.org/10.1136/jnnp-2014-309255
SGUL Authors: Edwards, Mark John James Nielsen, Glenn

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Abstract

BACKGROUND: Patients with functional motor disorder (FMD) including weakness and paralysis are commonly referred to physiotherapists. There is growing evidence that physiotherapy is an effective treatment, but the existing literature has limited explanations of what physiotherapy should consist of and there are insufficient data to produce evidence-based guidelines. We aim to address this issue by presenting recommendations for physiotherapy treatment. METHODS: A meeting was held between physiotherapists, neurologists and neuropsychiatrists, all with extensive experience in treating FMD. A set of consensus recommendations were produced based on existing evidence and experience. RESULTS: We recommend that physiotherapy treatment is based on a biopsychosocial aetiological framework. Treatment should address illness beliefs, self-directed attention and abnormal habitual movement patterns through a process of education, movement retraining and self-management strategies within a positive and non-judgemental context. We provide specific examples of these strategies for different symptoms. CONCLUSIONS: Physiotherapy has a key role in the multidisciplinary management of patients with FMD. There appear to be specific physiotherapy techniques which are useful in FMD and which are amenable to and require prospective evaluation. The processes involved in referral, treatment and discharge from physiotherapy should be considered carefully as a part of a treatment package.

Item Type: Article
Additional Information: Open Access This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Keywords: NEUROPSYCHIATRY, REHABILITATION, SOMATISATION DISORDER, Consensus, Evidence-Based Medicine, Guidelines as Topic, Humans, Mental Disorders, Movement Disorders, Patient Discharge, Patient Education as Topic, Physical Education and Training, Physical Therapy Modalities, Referral and Consultation, Self Care, Humans, Movement Disorders, Patient Discharge, Self Care, Consensus, Mental Disorders, Evidence-Based Medicine, Physical Education and Training, Referral and Consultation, Physical Therapy Modalities, Patient Education as Topic, Guidelines as Topic, Neurology & Neurosurgery, 11 Medical And Health Sciences, 17 Psychology And Cognitive Sciences
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Neuroscience (INCCNS)
Journal or Publication Title: J Neurol Neurosurg Psychiatry
ISSN: 1468-330X
Language: eng
Dates:
DateEvent
1 October 2015Published
13 September 2015Published Online
13 November 2014Accepted
Publisher License: Creative Commons: Attribution-Noncommercial 4.0
Projects:
Project IDFunderFunder ID
G0701055Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
PubMed ID: 25433033
Web of Science ID: WOS:000361154800011
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/109501
Publisher's version: https://doi.org/10.1136/jnnp-2014-309255

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