Functional Neurological Disorder Responds Favorably to Interdisciplinary Rehabilitation Models

Abstract

Functional neurological disorder (FND) is difficult to treat and costly. Interdisciplinary chronic painrehabilitation programs (iCPRPs) are multidimensional functional restoration interventions for pain; their impact on FND specifically has not been assessed. The purpose of this study was to assess iCPRP's impact on functioning in FND. Data were examined retrospectively from anInstitutional Review Board-approved registry capturing admission and discharge data from patients participatingin an outpatient iCPRP. Subjective measures included pain-related disability, depression, anxiety, and stress scores, whereas objective measures included physical functioning measures (timed up and go, stair climbing test, and 6-min walk test). Pre-iCPRP and post-iCPRP measures were compared using a paired t-test approach. Forty-nine FND patients completed care and showed pre-measures and postmeasures. Statistically significant reductions in subjective measures of pain-related disability (46.40-20.91; P<0.001, d=1.92), depression (20.38-4.81; P<0.001, d=1.53), anxiety (15.09-6.29; P<0.001, d=1.18), and stress (21.96-9.70; P<0.001, d=1.21) scores were observed. Statistically significant changes in objective measures of mean timed up and go scores (decreased from 15.96 to 8.87 s), stair climbing test scores (increased from 40.98 to 71.93 steps), and mean 6-minute walk test scores (increased from 0.21 to 0.30 miles) were also observed across the group. While preliminary and based on a small patient sample, these findings support the use of interdisciplinary care models for FND treatment. Clinical and investigational implications are explored.