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功能性运动障碍患者康复计划后的运动和非运动结局:一项前瞻性观察性队列研究。

Motor and non-motor outcomes after a rehabilitation program for patients with Functional Motor Disorders: A prospective, observational cohort study.

作者信息

Gandolfi Marialuisa, Riello Marianna, Bellamoli Veronica, Bombieri Federica, Geroin Christian, Di Vico Ilaria A, Tinazzi Michele

机构信息

Department of Neuroscience, Biomedicine and Movement, University of Verona, Italy.

出版信息

NeuroRehabilitation. 2021;48(3):305-314. doi: 10.3233/NRE-201617.

Abstract

BACKGROUND

Rehabilitation has proven effective in improving motor symptoms (i.e., weakness, tremor, gait and balance disorders) in patients with Functional Motor Disorders (FMDs). Its effects on non-motor symptoms (NMSs) such as fatigue, pain, depression, anxiety and alexithymia, have not been explored yet.

OBJECTIVE

To explore the effects of a validated inpatient 5-day rehabilitation program, followed by a home-based self-management plan on functional motor symptoms, NMSs, self-rated perception of change, and quality of life (QoL).

METHODS

33 FMD patients were enrolled. Measures for motor symptoms and NMSs were primary outcomes. Secondary outcomes included measures of self-perception of change and QoL. Patients were evaluated pre-treatment (T0), post-treatment (T1), and 3-month follow-up (T2).

RESULTS

There was an overall significant decrease in functional motor symptoms, general, physical, and reduced-activity fatigue (for all, p < 0.001). Post hoc comparison showed significant improvements at T1, whereas effects remained significant at T2 for motor symptoms and physical fatigue. Gait and balance, alexithymia, and physical functioning (QoL) significantly improved at T2. More than 50% of patients reported marked improvement at T1 and T2.

CONCLUSIONS

Our study suggests the benefits of rehabilitation and self-management plan on functional motor symptoms and physical fatigue in the medium-term. More actions are needed for the management of pain and other distressing NMSs in FMDs.

摘要

背景

康复已被证明对改善功能性运动障碍(FMD)患者的运动症状(即虚弱、震颤、步态和平衡障碍)有效。但其对疲劳、疼痛、抑郁、焦虑和述情障碍等非运动症状(NMS)的影响尚未得到探讨。

目的

探讨一项经过验证的为期5天的住院康复计划,随后进行家庭自我管理计划对功能性运动症状、NMS、自我评定的变化感知和生活质量(QoL)的影响。

方法

招募了33名FMD患者。运动症状和NMS的测量为主要结局。次要结局包括变化感知和QoL的测量。在治疗前(T0)、治疗后(T1)和3个月随访(T2)时对患者进行评估。

结果

功能性运动症状、一般疲劳、身体疲劳和活动减少性疲劳总体上有显著下降(所有p<0.001)。事后比较显示在T1时有显著改善,而在T2时运动症状和身体疲劳的影响仍然显著。步态和平衡、述情障碍以及身体功能(QoL)在T2时显著改善。超过50%的患者在T1和T2时报告有明显改善。

结论

我们的研究表明康复和自我管理计划在中期对功能性运动症状和身体疲劳有益。对于FMD中疼痛和其他令人痛苦的NMS的管理,还需要采取更多行动。

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