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I have been waiting for this article all year!
So I was super excited to talk about it today.
And here are the major take homes from the study:
- A large RCT on FMD was finally done-yay! Over 300 people
- People overall improved over the course of 12 months
- The SF-36 physical functioning report was not statistically different at 12 months between specialist physio and standard physio
- People with specialist physio had more sessions, reported greater improvement overall, had greater mental health improvement, and were more satisfied with their care.
Hear me out-this happens in large randomized clinical trials-where the main outcome measure does not reflect a statically significant difference. And it definitely shows the many challenges of a large RCT in a very heterogenous population. Particularly it reflects the difficulty in outcome measurement in this group.
Another limitation is that this was only PT and only addressing motor system with movement, attention and expectation(without addressing sensory, autonomic, physical impairment or lifestyle factors)
Compared to when this trial was designed and started, what we have learned about the pathophysiology and treatment of FND has really evolved-particularly in understanding the non-motor components (thank you to our OT colleagues bringing sensory to the forefront).
But overall-a great start to us continuing to understand what is beneficial for FMD-and bottom line-physio helps!I am curious to hear from you-what do you think of the outcome of this trial?
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