Objective:

To evaluate the impact of demographics, clinical characteristics, and comorbidities on treatment engagement and outcomes in patients from an interdisciplinary FMD clinic, which offers tailored treatment plans including PT, CBT, and potentially inpatient rehabilitation.

Background:

Functional Movement Disorders (FMD) are common and treatable conditions. Interdisciplinary care, combining physical therapy (PT) and cognitive behavioral therapy (CBT), may be the optimal initial treatment approach for patients with FMD.

Design/Methods:

A retrospective analysis was conducted on 27 patients (59% female, 18.5% Hispanic) seen in our FMD interdisciplinary clinic (IDC). Statistical analyses, including Pearson correlations and t-tests were used to assess outcomes.

Results:

Women had higher confidence that therapy would improve their symptoms (P=0.05). Confidence in the FMD diagnosis correlated with confidence in symptom improvement (R=0.7). Of 27 patients at our IDC clinic, 18 attended follow-up care for their FMD, of which 15 attended PT, 12 CBT, 1 was admitted to inpatient rehabilitation, and 12 had follow-up with neurology. Among those with neurology follow-up, 7 showed improvement on PGI-I and 9 improved on CGI-I (scores <4). Patients with longer duration of symptoms (p=0.01), higher SCD (p=0.02), PHQ-9 (p=0.01), and GAD-7 (p=0.02) scores were more likely to attend CBT. None of our baseline demographics had significant associations with improvement in PGI-I or CGI-I scores.

Conclusions:

IDCs offering customized treatment plans can be effective for FMD patients, with the majority pursuing follow-up treatment and most experiencing improvement from the patient and clinician perspective. Perhaps the act of attending the IDC clinic itself, solidifying understanding, and/or formally establishing/accepting the diagnosis of FMD augments the improvement. Limited by small numbers, the demographics and characteristics analyzed did not reveal a significant impact on likelihood to improve. Tailored interventions based on patient characteristics may improve outcomes. Comparing this intervention to other modalities would be informative, especially for centers without IDC clinics.