Motor Retraining (MoRe) for Functional Movement Disorders: Outcomes From a 1-Week Multidisciplinary Rehabilitation Program
| Autor: | Darryl L. Kaelin, Abbey R. Roach, Craig Ziegler, Kathrin LaFaver, Alexandra E. Jacob |
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| Rok vydání: | 2017 |
| Předmět: |
Occupational therapy
Adult Male 030506 rehabilitation medicine.medical_specialty medicine.medical_treatment Psychological intervention Physical Therapy Sports Therapy and Rehabilitation Motor Activity Speech Therapy 03 medical and health sciences 0302 clinical medicine Occupational Therapy Rating scale medicine Psychogenic disease Humans Physical Therapy Modalities Retrospective Studies Rehabilitation Movement Disorders business.industry Retrospective cohort study Evidence-based medicine Middle Aged Psychotherapy Treatment Outcome Neurology Clinical Global Impression Physical therapy Female Neurology (clinical) 0305 other medical science business 030217 neurology & neurosurgery |
| Zdroj: | PMR : the journal of injury, function, and rehabilitation. 10(11) |
| ISSN: | 1934-1563 |
| Popis: | Background Functional movement disorders (FMDs) are conditions of abnormal motor control thought to be caused by psychological factors. These disorders are commonly seen in neurologic practice, and prognosis is often poor. No consensus treatment guidelines have been established; however, the role of physical therapy in addition to psychotherapy has increasingly been recognized. This study reports patient outcomes from a multidisciplinary FMD treatment program using motor retraining (MoRe) strategies. Objective To assess outcomes of FMD patients undergoing a multidisciplinary treatment program and determine factors predictive of treatment success. Design Retrospective chart review. Setting University-affiliated rehabilitation institute. Patients Thirty-two consecutive FMD patients admitted to the MoRe program from July 2014–July 2016. Intervention Patients participated in a 1-week, multidisciplinary inpatient treatment program with daily physical, occupational, speech therapy, and psychotherapy interventions. Main Outcome Measurements Primary outcome measures were changes in the patient-rated Clinical Global Impression Scale (CGI) and the physician-rated Psychogenic Movement Disorder Rating Scale (PMDRS) based on review of standardized patient videos. Measurements were taken as part of the clinical evaluation of the program. Results Twenty-four of the 32 patients were female with a mean age of 49.1 (±14.2) years and mean symptom duration of 7.4 (±10.8) years. Most common movement phenomenologies were abnormal gait (31.2%), hyperkinetic movements (31.2%), and dystonia (31.2%). At discharge, 86.7% of patients reported symptom improvement on the CGI, and self-reported improvement was maintained in 69.2% at the 6-month follow-up. PMDRS scores improved by 59.1% from baseline to discharge. Longer duration of symptoms, history of abuse, and comorbid psychiatric disorders were not significant predictors of treatment outcomes. Conclusions The majority of FMD patients experienced improvement from a 1-week multidisciplinary inpatient rehabilitation program. Treatment outcomes were not negatively correlated with longer disease duration or psychiatric comorbidities. The results from our study are encouraging, although further long-term prospective randomized studies are needed. Level of Evidence III |
| Databáze: | OpenAIRE |
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