Functional movement disorders: Successful treatment with a physical therapy rehabilitation protocol

Kathrin Czarnecki, Jeffrey M. Thompson, Richard Seime, Yonas Endale Geda, Joseph R. Duffy, J. Eric Ahlskog

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

Background: Functional (" psychogenic" ) gait and other movement disorders have proven very difficult to treat. Objectives: Describe the Mayo Clinic functional movement disorder motor-reprogramming protocol conducted in the Department of Physical Medicine and Rehabilitation (PMR), and assess short-term and long-term outcomes. Design: Historical-cohort-study assessing non-randomized PMR intervention. Setting: Tertiary care center. Patients: Interventional group: 60 consecutive patients with a chronic functional movement disorder that underwent the PMR protocol between January 2005 and December 2008. Control group: age- and sex-matched patients with treatment-as-usual (n = 60). Interventions: An outpatient, one-week intensive rehabilitation program based on the concept of motor-reprogramming following a comprehensive diagnostic neurological evaluation, including psychiatric/psychological assessment. Main outcome measures: Improvement of the movement disorder by the end of the week-long program (patient- and physician-rated), plus the long-term outcome (patient-rated). Results: Patient demographics: median symptom duration, 17 months (range, 1-276); female predominance (76.7%); mean age 45 years (range, 17-79). Physician-rated outcomes after the one-week treatment program documented 73.5% were markedly improved, nearly normal or in remission, similar to the patient-ratings (68.8%). Long-term treatment outcomes (patient-rated; median follow-up, 25 months) revealed 60.4% were markedly improved or almost completely normal/in remission, compared to 21.9% of controls (p < 0.001). Conclusions: Short-term and long-term successful outcomes were documented in the treatment of patients with functional movement disorders by a rehabilitative, goal-oriented program with intense physical and occupational therapy. The rapid benefit, which was sustained in most patients, suggests substantial efficacy that should be further assessed in a prospective, controlled, clinical trial.

Original languageEnglish (US)
Pages (from-to)247-251
Number of pages5
JournalParkinsonism and Related Disorders
Volume18
Issue number3
DOIs
StatePublished - Mar 2012

Fingerprint

Movement Disorders
Rehabilitation
Physical and Rehabilitation Medicine
Therapeutics
Physicians
Occupational Therapy
Controlled Clinical Trials
Gait
Tertiary Care Centers
Psychiatry
Cohort Studies
Outpatients
Demography
Outcome Assessment (Health Care)
Psychology
Control Groups

Keywords

  • Conversion disorder
  • Functional movement disorder
  • Physical therapy
  • Psychogenic movement disorder

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Clinical Neurology
  • Neurology

Cite this

Functional movement disorders : Successful treatment with a physical therapy rehabilitation protocol. / Czarnecki, Kathrin; Thompson, Jeffrey M.; Seime, Richard; Geda, Yonas Endale; Duffy, Joseph R.; Ahlskog, J. Eric.

In: Parkinsonism and Related Disorders, Vol. 18, No. 3, 03.2012, p. 247-251.

Research output: Contribution to journalArticle

Czarnecki, Kathrin ; Thompson, Jeffrey M. ; Seime, Richard ; Geda, Yonas Endale ; Duffy, Joseph R. ; Ahlskog, J. Eric. / Functional movement disorders : Successful treatment with a physical therapy rehabilitation protocol. In: Parkinsonism and Related Disorders. 2012 ; Vol. 18, No. 3. pp. 247-251.
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