Adding physiotherapy to mental health support such as cognitive-behavioral therapy (CBT) may improve the quality of life for people with functional movement disorders, a study in JAMA Neurology has found. Functional movement disorders are a subset of functional neurologic disorder (conversion disorder) and include unusual, involuntary movements or body positions caused by a problem with the way signals are sent throughout the brain.
Daniel Macías-García, M.D., Ph.D., of the University of Seville, and colleagues analyzed data from 38 patients with functional movement disorders who were randomized to receive either physiotherapy plus CBT (the treatment group) or psychological support only (the control group). The treatment group participated in four successive, weekly, one-hour group sessions of CBT and 12 one-hour individualized physiotherapy sessions delivered three times a week. The control group participated in four weekly one-hour group sessions of supportive psychotherapy that included discussion about life stressors.
The researchers measured the patients’ perceived mental and physical quality of life using various surveys at baseline, three months, and five months. At five months, patients in the treatment group reported significantly greater improvements in physical measures of quality of life such as severity of motor symptoms, pain, and perception of overall health compared with the control group.
Also at the fifth month, 47% of patients in the treatment group reported improvement in at least one aspect of quality of life and no worsening in others compared with 16% of patients in the control group.
“[The] effect [of multidisciplinary care] on the physical aspects of quality of life is superior to a comprehensive diagnosis followed by psychoeducation and psychological support, and it seems to be driven by improvements in mobility and pain,” the researchers wrote. “Multidisciplinary treatment may also improve social functioning and may be cost effective regarding return to work; however, further studies with larger cohorts and longer follow-up periods must clarify these aspects.”
For related information, see the Journal of Neuropsychiatry and Clinical Neurosciences article “A Review and Expert Opinion on the Neuropsychiatric Assessment of Motor Functional Neurological Disorders.”
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