Motor retraining (MoRe) for functional movement disorders: Outcomes from a one-week multidisciplinary rehabilitation program (S4.007)

Objective: To assess outcomes of patients with functional movement disorders (FMD) who underwent a one-week, inpatient motor retraining (MoRe) program.

Background: FMD are characterized by abnormal, involuntary movements that cannot be attributed to an organic cause. Patients present with a variety of symptoms including tremor, dystonia, weakness, gait or speech disturbances. These disorders are commonly seen in neurological practice and prognosis is often poor. The MoRe program is a multidisciplinary rehabilitation program with daily physical, occupational and speech therapy as well as cognitive behavioral therapy. Normal motor patterns are “relearned” by breaking down abnormal movements into individual components and gradually reconstructing normal patterns.

Design/Methods: Retrospective chart review of 32 consecutive patients admitted to the MoRe program between July 2014 to July 2016. Before and after treatment, patients were given questionnaires and were recorded on video to evaluate symptoms.

Results: 75% of patients were female and the average age was 49.1 years (SD 14.0). Average symptom duration was 7.4 years (SD 10.8). 56.0% were on disability. Patients scored 16.6 (SD 10.4) on the Becks depression inventory (BDI) and 44.1 (SD 13.9) on State-Trait Anxiety Inventory. 53.3% of patients reported PTSD symptoms and 50.0% reported a history of physical or sexual abuse. 86.5% reported improvement after the program and 69.2% maintained improvement at 6-month follow-up. Patient videos before and after the program were assessed by a Movement disorder specialist with the PMD rating scale, scores improved on average by 59.2% (p<0.05). Self-rated disability scores improved for work, social and family life related responsibilities. The program was well received by patients and 96.6% indicated they would do it again if given the opportunity.

Conclusions: Patients with FMD can be successfully treated with a one-week multidisciplinary rehabilitation program. The majority of patients maintained a meaningful improvement of symptoms at 6 months follow-up.

Disclosure: Dr. Jacob has nothing to disclose. Dr. Kaelin has received research support from Allergan and PCORI. Dr. Smith has nothing to disclose. Dr. Jablonski has nothing to disclose. Dr. Roach has nothing to disclose. Dr. LaFaver has nothing to disclose.