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Randomised feasibility study of physiotherapy for patients with functional motor symptoms.

Nielsen, G; Buszewicz, M; Stevenson, F; Hunter, R; Holt, K; Dudziec, M; Ricciardi, L; Marsden, J; Joyce, E; Edwards, MJ (2017) Randomised feasibility study of physiotherapy for patients with functional motor symptoms. J Neurol Neurosurg Psychiatry, 88 (6). pp. 484-490. ISSN 1468-330X https://doi.org/10.1136/jnnp-2016-314408
SGUL Authors: Nielsen, Glenn Ricciardi, Lucia Edwards, Mark John James

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Abstract

OBJECTIVE: To determine the feasibility of conducting a randomised controlled trial of a specialist physiotherapy intervention for functional motor symptoms (FMS). METHODS: A randomised feasibility study was conducted recruiting patients with a clinically established diagnosis of FMS from a tertiary neurology clinic in London, UK. Participants were randomised to the intervention or a treatment as usual control. Measures of feasibility and clinical outcome were collected and assessed at 6 months. RESULTS: 60 individuals were recruited over a 9-month period. Three withdrew, leaving 29 intervention and 28 controls participants in the final analysis. 32% of patients with FMS met the inclusion criteria, of which 90% enrolled. Acceptability of the intervention was high and there were no adverse events. At 6 months, 72% of the intervention group rated their symptoms as improved, compared to 18% in the control group. There was a moderate to large treatment effect across a range of outcomes, including three of eight Short Form 36 (SF36) domains (d=0.46-0.79). The SF36 Physical function was found to be a suitable primary outcome measure for a future trial; adjusted mean difference 19.8 (95% CI 10.2 to 29.5). The additional quality adjusted life years (QALY) with intervention was 0.08 (95% CI 0.03 to 0.13), the mean incremental cost per QALY gained was £12 087. CONCLUSIONS: This feasibility study demonstrated high rates of recruitment, retention and acceptability. Clinical effect size was moderate to large with high probability of being cost-effective. A randomised controlled trial is needed. TRIAL REGISTRATION NUMBER: NCT02275000; Results.

Item Type: Article
Additional Information: This article has been accepted for publication in Journal of Neurology, Neurosurgery and Psychiatry following peer review. The definitive copyedited, typeset version Nielsen G, Buszewicz M, Stevenson F, et al Randomised feasibility study of physiotherapy for patients with functional motor symptoms J Neurol Neurosurg Psychiatry 2017;88:484-490 is available online at: http://doi.org/10.1136/jnnp-2016-314408
Keywords: 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
6 September 2016Accepted
30 September 2016Published Online
1 June 2017Published
Publisher License: Publisher's own licence
Projects:
Project IDFunderFunder ID
CDRF-2013-04-034Department of HealthUNSPECIFIED
MR/M02363X/1Medical Research CouncilUNSPECIFIED
PubMed ID: 27694498
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/108601
Publisher's version: https://doi.org/10.1136/jnnp-2016-314408

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