MDS Abstracts

Abstracts from the International Congress of Parkinson’s and Movement Disorders.

MENU 
  • Home
  • Meetings Archive
    • 2024 International Congress
    • 2023 International Congress
    • 2022 International Congress
    • MDS Virtual Congress 2021
    • MDS Virtual Congress 2020
    • 2019 International Congress
    • 2018 International Congress
    • 2017 International Congress
    • 2016 International Congress
  • Keyword Index
  • Resources
  • Advanced Search

Virtual Rehabilitation for Functional Movement Disorder

H. Bhatt, L. Macgillivray, K. Marcelle, S. Lidstone (Toronto, Canada)

Meeting: MDS Virtual Congress 2021

Abstract Number: 197

Keywords: Psychogenic movement disorders(PMD): Treatment

Category: Functional Movement Disorders / Psychogenic Movement Disorders

Objective: We describe initial experiences using virtual rehabilitation in a specialized outpatient functional movement disorder (FMD) clinic.

Background: Specialized rehabilitation programs have been shown to be an effective treatment option for patients with FMD. Access to such programs is limited due to a scarcity of specialized FMD centres. The Covid-19 pandemic has forced neurorehabilitation programs to deliver care in novel ways. While telerehabilitation has been used in other neurological conditions, virtual rehabilitation for FMD has not been well explored, presenting an opportunity to bridge this service delivery gap.

Method: Between March 2020-2021 FMD patients seen in our virtual integrated clinic were triaged to receive either integrated therapy (IT) or physiotherapy alone (PT). Patients received 6-10, biweekly 45-minute therapy sessions over 3 months. Therapy was delivered using a hybrid model of in-person and virtual sessions. The IT intervention was delivered by a neurologist, neuropsychiatrist and physiotherapist simultaneously and all patients received hybrid therapy (4 in-person and 2 virtual sessions). The PT intervention consisted of motor retraining delivered by a physiotherapist. 6 patients received hybrid therapy and 6 were treated entirely virtually.

Results: Twenty-two patients (14 women; mean age 46.6±17.4 years, mean symptom duration 6.1±6.7 years) were enrolled into a treatment stream (IT, n=10; PT, n=12). Two-thirds of patients (59%) had a mixed phenotype with >1 functional movement symptom. The most common phenotypes were gait disorder (50%), tremor (36%) and weakness (27%). Pre-morbid psychiatric diagnoses were present in 73% (9/10 in IT, 7/12 in PT). 41% were unable to work due to their symptoms. The most common therapeutic strategies in both IT and PT included FMD education (100%) and breathing exercises (86%). Gait retraining was used in 10 patients (IT, PT). Integrative psychotherapy was most commonly used in the IT intervention and task-specific motor retraining was most commonly used in the PT intervention. Upon program completion, 12/19 (63%) patients had “much” or “very much” improved on the clinical global impression scale.

Conclusion: Virtual rehabilitation is a feasible treatment option for patients with FMD and offers additional benefits to traditional in-person care. Challenges include lack of appropriate equipment, safety concerns and the “digital divide.” Future research aims to better capture patient outcomes.

References: [1] Lidstone, S., MacGillivray, L., & Lang, A. Integrated Therapy for Functional Movement Disorders: Time for a Change. Mov Disord Clin Pract 2020; 7. [2] Nielsen G, Stone J, Matthews A, et al. Physiotherapy for functional motor disorders: a consensus recommendation. J Neurol Neurosurg Psychiatry 2015; 10:1113–1119. [3] Aybek S, Lidstone SC, Nielsen G, MacGillivray L, Bassetti CL, Lang AE, Edwards MJ. What Is the Role of a Specialist Assessment Clinic for FND? Lessons From Three National Referral Centers. J Neuropsychiatry Clin Neurosci. 2020;32(1):79-84.

To cite this abstract in AMA style:

H. Bhatt, L. Macgillivray, K. Marcelle, S. Lidstone. Virtual Rehabilitation for Functional Movement Disorder [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/virtual-rehabilitation-for-functional-movement-disorder/. Accessed July 10, 2025.
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to MDS Virtual Congress 2021

MDS Abstracts - https://www.mdsabstracts.org/abstract/virtual-rehabilitation-for-functional-movement-disorder/

Most Viewed Abstracts

  • This Week
  • This Month
  • All Time
  • What is the appropriate sleep position for Parkinson's disease patients with orthostatic hypotension in the morning?
  • Covid vaccine induced parkinsonism and cognitive dysfunction
  • Life expectancy with and without Parkinson’s disease in the general population
  • To be or not to bupropion: a drug-induced parkinsonism?
  • Estimation of the 2020 Global Population of Parkinson’s Disease (PD)
      • Help & Support
      • About Us
      • Cookies & Privacy
      • Wiley Job Network
      • Terms & Conditions
      • Advertisers & Agents
      Copyright © 2025 International Parkinson and Movement Disorder Society. All Rights Reserved.
      Wiley