Multidisciplinary treatment works well for functional movement disorder

Combined physiotherapy and cognitive behavioural therapy (CBT) help produce improvements in functional movement disorder (FMD) symptoms and the physical aspects of the patients’ quality of life, as shown in a study.

Forty adults (mean age 43.5 years, 80 percent female, mean age at FMD onset 38.4 years) with FMD were randomly assigned to undergo a multidisciplinary treatment that combined physiotherapy with CBT or a control intervention that consisted of psychological support. Of these participants, 38 completed all the follow-up visits and were included in the analysis for primary outcomes.

The primary outcomes were between-group differences in changes from baseline to month 3 and month 5 in the patients’ quality of life, measured using the EQ-5D-5L score and the 36-Item Short-Form Survey Physical Component Summary (SF-36 PCS) and SF-36 Mental Component Summary (MCS) scores.

Compared with control, multidisciplinary treatment yielded improvements in SF-36 PCS, with a numerical mean between-group difference of 4.23 points (95 percent confidence interval [CI], −0.9 to 9.4; p=0.11) at 3 months and significant mean between-group difference of 5.62 points (95 percent CI, 2.3–8.9; p<0.001) at 5 months.

Multidisciplinary treatment had no significant effects on other quality-of-life outcomes such as SF-36 MCS (mean between-group difference, 0.72 points at 3 months and 0.69 points at 5 months; p=0.82 and p=0.83, respectively), EQ VAS (9.34 points at 3 months and 13.7 points at 5 months; p=0.07 and p=0.09, respectively), and EQ Index (0.001 point at 3 months and 0.08 points at 5 months; p=0.98 and p=0.13, respectively).

At months 3 and 5, 42 percent and 47 percent of patients, respectively, in the multidisciplinary group reported improved health using the EQ-5D system as opposed to only 26 percent and 16 percent of patients, respectively, in the control group.