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Why do we need physiotherapy for FND?

jnnp · 2025-09-15 · canonical JSON source

11 visible annotations · policy: published · automated confidence ≥ 75.00%

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I am a clinical academic neurological physiotherapist at St George’s University of London and St George’s University Hospital where I lead a specialist NHS physiotherapy service for functional motor disorder.I began my career at Sir Charles Gairdner Hospital in Perth Western Australia before moving to London and starting work at the National Hospital for Neurology and Neurosurgery in 2007.I was awarded an NIHR Clinical Doctoral Research Fellowship in 2014 and while working at the National Hospital I completed my PhD at the UCL Institute of Neurology on the topic of physiotherapy for functional neurological disorder (FND).I am currently leading a multicenter, single-blind, randomised controlled trial of specialist physiotherapy for functional motor disorder (physio4FMD.org) and an NIHR-funded observational study on functional somatosensory symptoms.In recent years, psychologically informed physiotherapy approaches for Functional Neurological Disorder (FND) have gained significant attention from clinicians, researchers, and patients. Is this attention justified? Given that FND often presents with physical symptoms and impaired mobility, there is a strong rationale for physical rehabilitation, including physiotherapy and occupational therapy. Secondary complications such as disuse weakness, joint contractures, and pain from altered movement patterns further highlight the need for targeted physiotherapy. Additionally, physical rehabilitation can have positive psychological consequences, which may improve treatment outcome as well as contributing to overall well-being. This talk will explore a specialist physiotherapy approach for FND motor symptoms through case studies. It will examine the potential benefits, including improved quality of life, reduced iatrogenic harm, and cost-effectiveness. The discussion will also address the limitations of physiotherapy, the necessity of multidisciplinary care, and the current evidence supporting its efficacy.