Intensive rehabilitation for functional motor disorders (FMD) in the United States: A review, 2022, Polich et al

Abstract:

BACKGROUND:Higher levels of care in the form of intensive rehabilitation may be appropriate for select patients with a diagnosis of Functional Motor Disorder (FMD). Intensive rehabilitation, as delivered through an outpatient day program or through admission to an inpatient rehabilitation facility, can offer a greater frequency and variety of integrated clinical services than most lower levels of care.

OBJECTIVE:Higher levels of rehabilitation for FMD have not yet been well characterized in the literature. In this article, we will focus on the population of FMD patients who begin receiving care in the outpatient setting.

METHOD:In this review, we will describe a range of options for higher levels of FMD care, evaluate the supporting literature, and weigh the pros and cons of each approach. Several specific examples of intensive rehabilitation programs in the United States will be described. Finally, we will consider existing health systems barriers to each of these outpatient and inpatient higher levels of care.

RESULTS:Within a stepped model of care, intensive outpatient day-programs and inpatient rehabilitation may be considered for individuals who present with complex, refractory motor deficits from FMD. For appropriately selected patients, a growing body of literature suggests that time-limited, goal-oriented intensive rehabilitation may provide an effective treatment avenue.

CONCLUSION:It remains to be determined whether treatment in intensive care settings, while more costly in the short term, could lead to greater cost savings in the long term. The prospect of telemedicine rehabilitation for FND in terms of efficacy and cost also remains to be determined.

Paywall, https://content.iospress.com/articles/neurorehabilitation/nre228007

 

Whenever I see papers like this I wish that the authors would explain what tests were done to exclude non-functional problems before they went ahead and possibly tortured the patients that bio-medicine wouldn't or couldn't cure.

The way that the use of FND as a "real" diagnosis is expanding all the time just makes me think that medicine has permanently given up trying to cure people and is happier all the time to dismiss everything the patient says.

 

Intensive physiotherapy may well help people with movement disorders especially if they are caused by a single event such as a bang on the head. It would work the same way as stroke rehabilitation. There have been some videos going round of this.

But that does not prove it was ever a functional disease.