title: Physiotherapy for functional motor disorders: a consensus recommendation.
abstract: BACKGROUND
  Patients with functional motor disorder (FMD) including weakness and paralysis are commonly referred to physiotherapists. There is growing evidence that physiotherapy is an effective treatment, but the existing literature has limited explanations of what physiotherapy should consist of and there are insufficient data to produce evidence-based guidelines. We aim to address this issue by presenting recommendations for physiotherapy treatment.
  
  
  METHODS
  A meeting was held between physiotherapists, neurologists and neuropsychiatrists, all with extensive experience in treating FMD. A set of consensus recommendations were produced based on existing evidence and experience.
  
  
  RESULTS
  We recommend that physiotherapy treatment is based on a biopsychosocial aetiological framework. Treatment should address illness beliefs, self-directed attention and abnormal habitual movement patterns through a process of education, movement retraining and self-management strategies within a positive and non-judgemental context. We provide specific examples of these strategies for different symptoms.
  
  
  CONCLUSIONS
  Physiotherapy has a key role in the multidisciplinary management of patients with FMD. There appear to be specific physiotherapy techniques which are useful in FMD and which are amenable to and require prospective evaluation. The processes involved in referral, treatment and discharge from physiotherapy should be considered carefully as a part of a treatment package.
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK Therapy Services, The National Hospital for Neurology and Neurosurgery, London, UK.
authors.forename: Glenn
authors.initials: G
authors.lastname: Nielsen
authors.affiliation: Department Clinical Neurosciences, Western General Hospital, Edinburgh, UK.
authors.forename: Jon
authors.initials: J
authors.lastname: Stone
authors.affiliation: Institute of Neurological Sciences, Southern General Hospital, Glasgow, UK.
authors.forename: Audrey
authors.initials: A
authors.lastname: Matthews
authors.affiliation: Institute of Neurological Sciences, Southern General Hospital, Glasgow, UK.
authors.forename: Melanie
authors.initials: M
authors.lastname: Brown
authors.affiliation: Therapy Services, The Ipswich Hospital NHS Trust, Ipswich, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Sparkes
authors.affiliation: South London & Maudsley NHS Foundation Trust, London, UK.
authors.forename: Ross
authors.initials: R
authors.lastname: Farmer
authors.affiliation: Community Rehabilitation and Brain Injury Service, West Lothian, UK.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Masterton
authors.affiliation: Community Rehabilitation and Brain Injury Service, West Lothian, UK.
authors.forename: Linsey
authors.initials: L
authors.lastname: Duncan
authors.affiliation: Department Clinical Neurosciences, Western General Hospital, Edinburgh, UK.
authors.forename: Alisa
authors.initials: A
authors.lastname: Winters
authors.affiliation: Department Clinical Neurosciences, Western General Hospital, Edinburgh, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Daniell
authors.affiliation: Community Rehabilitation and Brain Injury Service, West Lothian, UK.
authors.forename: Carrie
authors.initials: C
authors.lastname: Lumsden
authors.affiliation: Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, UK.
authors.forename: Alan
authors.initials: A
authors.lastname: Carson
authors.affiliation: Institute of Psychiatry, King's College London, London, UK National Institute of Health Research Biomedical Research Centre at the South London & Maudsley NHS Foundation Trust and Institute of Psychiatry KCL, London, UK.
authors.forename: Anthony S
authors.initials: AS
authors.lastname: David
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Edwards
mesh_terms: D019317:Evidence-Based Medicine; D017408:Guidelines as Topic; D006801:Humans; D001523:Mental Disorders / Q000150:complications; D009069:Movement Disorders / Q000175:diagnosis / Q000628:therapy*; D010351:Patient Discharge; D010353:Patient Education as Topic; D010806:Physical Education and Training; D026741:Physical Therapy Modalities; D012017:Referral and Consultation; D012648:Self Care
keywords: NEUROPSYCHIATRY; REHABILITATION; SOMATISATION DISORDER