Physiotherapy Plus Psychotherapy Improves Functional Movement Disorder Symptoms

Combined physiotherapy and psychotherapy improved symptoms and physical aspects of quality of life in patients with functional movement disorders more than psychological support alone, according to study results published in JAMA Neurology.

“[T]his improvement seems to be driven by changes in mobility and pain domains,” wrote a research team from Seville, Spain. “Results show that multidisciplinary treatment (physiotherapy plus cognitive behavioral therapy) effectively improves functional movement disorder symptoms and physical aspects of patients’ quality of life,” researchers wrote. “Further studies must be performed to evaluate the potential cost-effectiveness of this approach in functional movement disorder [care].”

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The study enrolled 40 adult patients from the movement disorders unit at the Hospital Universitario Virgen Rocio in Seville, Spain. Patients were randomly assigned to either multidisciplinary treatment consisting of physiotherapy and cognitive behavioral therapy or to a psychological support intervention used as a control. Follow-up visits were conducted at months 3 and 5.

Among participants, the mean age was 43.5 years and the mean age at functional movement disorder onset was 38.4 years. Eighty percent were female. The analysis for primary outcomes included 38 patients who completed all follow-up visits.

Multidisciplinary treatment improved scores on the 36-Item Short-Form Survey Physical Component Summary more than the control intervention, the study found. Mean between-group differences were 4.23 points at 3 months and a significant 5.62 points at 5 months.

Other quality-of-life outcomes, including 36-Item Short-Form Survey Mental Component Summary scores as well as EQ Index and EQ visual analog scale scores, did not differ significantly between interventions. 

At the 3-month follow-up, improved health per the EQ-5D system was reported by 42% of patients in the multidisciplinary treatment group compared with 26% of patients in the control group, according to the study. At 5 months, improved health was reported by 47% of patients in the multidisciplinary treatment group compared with 16% of patients in the control group.

Reference

Macías-García D, Méndez-Del Barrio M, Canal-Rivero M, et al. Combined physiotherapy and cognitive behavioral therapy for functional movement disorders: a randomized clinical trial. JAMA Neurol. Published online August 5, 2024. doi:10.1001/jamaneurol.2024.2393