| Keywords [eng] |
functional movement disorder, functional neurological disorder, physiotherapy, psychological therapy, multidisciplinary treatment, quality of life, motor symptoms, systematic review / funkcinis judėjimo sutrikimas, funkcinis neurologinis sutrikimas, kineziterapija, psichologinė terapija, multidisciplininis gydymas, gyvenimo kokybė, motoriniai simptomai, sisteminė apžvalga |
| Abstract [eng] |
Background: Functional movement disorders (FMDs) are one of the most common subtypes of functional neurological disorders (FNDs). They are associated with involuntary motor symptoms causing significant impairment in the quality of life of patients. Despite the common use of non- pharmacological treatments, such as physiotherapy, psychological interventions, and multidisciplinary approaches, as effective strategies for managing the disease, there is still insufficient evidence regarding their efficacy in improving patient outcomes due to the limited literature available on this topic. Objectives: 1. To describe epidemiology, etiology, pathogenesis, diagnosis and treatment strategies of functional movement disorder. 2. To assess the effect of non-pharmacological treatments (physiotherapy, psychological interventions, and multidisciplinary treatment) in alleviating motor symptoms and improving functional status, psychological well-being, and quality of life of functional movement disorder patients. Methods: A non-systematic literature review was performed to overview epidemiology, etiology, pathogenesis, diagnosis, and treatment of functional movement disorder. A systematic literature review was performed in PubMed and Scopus for studies published between 2020 and 2025. Inclusion criteria (based on the PICO framework) focused on adults (>16 years) with functional movement disorder or predominant motor form of functional neurological disorders receiving physiotherapy, psychological interventions (e.g., cognitive behavioural therapy, hypnosis, compassion-focused therapy), or multidisciplinary approaches. All study designs were included because of the limited randomized controlled studies (RCTs) available. Study selection, data extraction, and narrative synthesis were performed systematically. Results: Thirteen studies (2 RCTs and 11 observational studies) involving a total number of 531 patients were included in this review. Both RCTs demonstrated the significant effect of specialized physiotherapy and multidisciplinary treatment (physiotherapy plus cognitive behavioural therapy) on motor symptom severity, physical functioning, and quality of life in patients with functional movement disorders. Observational studies (N = 244) demonstrated improvements across clinical and functional domains, with multidisciplinary therapies being particularly effective for motor symptom severity and mobility, while psychological monotherapies yielded more consistent benefits for mood and quality of life. Heterogeneity was high across the interventions, outcome measures, and overall study quality. Conclusions: Non-pharmacological interventions, particularly individualized physiotherapy and multidisciplinary approaches, have a moderate positive effect on improving motor symptoms, functional capacity, and quality of life in functional movement disorder. Psychological therapies provide additional benefits for emotional and psychological outcomes. However, due to methodological limitations, small sample sizes in observational studies, and high heterogeneity, it is necessary to have high-quality randomized controlled trials with standardized outcome measures and longer follow-up periods in the future to determine standardized therapeutic guidelines. |
