Physiotherapists’ management of paediatric patients with Functional Neurological Disorder (FND): A scoping review

OBJECTIVES: Functional Neurological Disorder (FND) involves neurological symptoms, such as movement disorders and seizures, that are not explained by known pathophysiological disease. Physiotherapy may improve outcomes for children with FND; however, intervention reporting is often limited, and relevant studies may be excluded from systematic reviews. Outcome measures used to evaluate effectiveness also remain unclear. This review aimed to: (1) map existing evidence for physiotherapy interventions in paediatric FND, and (2) identify outcome measures used by physiotherapists. DESIGN: This scoping review followed PRISMA-ScR guidelines. Databases searched included MEDLINE, CINAHL Plus, Cochrane Library, PEDro, APA PsycInfo, SCOPUS, Child Development and Adolescent Studies, and PTSDpubs. Studies were included if they involved paediatric patients with FND, described physiotherapy interventions and/or outcome measures, were published in English, and dated from 2014 onwards. Screening and data extraction were conducted by two researchers. Analysis used the PAGER framework to enhance clinical relevance. RESULTS: 26 papers were included. Reporting of interventions and outcome measures was limited. Therapeutic alliance, particularly building trust, was consistently highlighted as essential. Play-based approaches supported symptom redirection. Consistency within the multidisciplinary team (MDT), including shared outcome measures and unified patient/family education, was also important. Limited research addressed patient and family perspectives. CONCLUSIONS: Physiotherapy for paediatric FND lacks detailed reporting and is delivered within an MDT context rather than in isolation. Future research should explore MDT collaboration, incorporate patient and family perspectives, and support development of appropriate outcome measures. CONTRIBUTION OF THE PAPER.