Background: Functional Neurological Disorders (FNDs) are common, comprising 10% to 30% of the Neurology caseload. Emerging evidence suggests that multidisciplinary rehabilitation is effective in FND, but actual gains in daily functioning are not clear from the current literature. Aims: To assess the outcomes of FND patients receiving inpatient rehabilitation in a specialist neurorehabilitation unit. Methods: Multidisciplinary (MDT) rehabilitation was provided by a multidisciplinary professional team led by consultants in Physical and Rehabilitation Medicine (PRM). Functional Outcomes such as Functional Independence Measure /Functional Assessment Measure, including motor and cognitive domains, were measured at 3 timepoints (admission, discharge and during post-discharge telephone appointments). Further data on demographics and disease presentation were collected by retrospective chart review. Results: Eighteen patients with FND were admitted to the unit over a 2-year period. The median length of stay for patients in the rehabilitation unit was 69 days (47-98 days) and the median post-discharge follow-up was 10 months (3,24 months). All outcome measures demonstrated improvement following rehabilitation. In particular, the median (IQR; FIM) score improved by 30 points (IQR 82-120) between admission and discharge, which exceeds the Minimal Clinically Important Difference (MCID) of 22 reported in the literature, indicating a clinically significant improvement. The improvements post-discharge plateaued but were maintained at follow-up. Qualitative feedback indicated high satisfaction with care in the rehabilitation unit and the improvements in daily functioning achieved. Conclusion: FND patients showed clinically significant improvements from inpatient specialist rehabilitation in this cohort. Further multi-site, larger-scale research is needed to determine whether certain types of FND patients have greater improvements than others from inpatient MDT rehabilitation.
Ibraheem et al. (Wed,) studied this question.