Improvement in motor symptoms, physical fatigue, and self-rated change perception in functional motor disorders: a prospective cohort study of a 12-week telemedicine program

Marialuisa Gandolfi, Angela Sandri, Christian Geroin, Federica Bombieri, Marianna Riello, Zoe Menaspà, Chiara Bonetto, Nicola Smania, Michele Tinazzi, Marialuisa Gandolfi, Angela Sandri, Christian Geroin, Federica Bombieri, Marianna Riello, Zoe Menaspà, Chiara Bonetto, Nicola Smania, Michele Tinazzi

Abstract

Background: Functional motor disorders (FMDs) are highly disabling conditions associated with long-term disability, poor quality of life, and economic burden on health and social care. While multidisciplinary 5-days rehabilitation programs have been shown to reduce motor and non-motor symptoms, long-term management and monitoring in FMDs remain an unmet need.

Aim: To compare a 12-weeks telemedicine program against a 12-weeks self-management program after a 5-days rehabilitation program for improving motor, non-motor symptoms, quality of life, and perception of change in patients with FMDs.

Methods: The study population was 64 consecutive patients with a definite diagnosis of FMDs who underwent a 5-days in-person rehabilitation program followed by either a self-management (the first 32 patients) or a telemedicine program (the latter 32 patients). Validated measures of motor and non-motor symptoms such as fatigue and pain, quality of life, perception of change, gait, and postural control were recorded before (T0), after completion of rehabilitation (T1), and then again at 3 months (T2).

Results: Improvement at 3-month follow-up assessment of motor symptoms (p < 0.001), physical fatigue (p = 0.028), and self-rated change perception (p = 0.043) was greater in the telemedicine group. No different between-groups effect was found on other dimensions of fatigue, pain, physical and mental health, and gait and postural control.

Conclusions: Long-term management and expert monitoring of patients with FMDs via telemedicine may enhance long-term outcomes in motor symptoms and physical fatigue, with a positive long-term impact on self-rated health perception of change.

Keywords: Anxiety; Depression; Gait disorders; Motor symptoms; Physical fatigue; Quality of life; Telemedicine.

Conflict of interest statement

The authors declare no conflict of interest.

Ethical standards

All human and animal studies have been approved by the appropriate ethics committee (Project Number. 1757CESC) and have been performed in accordance with the ethical standards set in the 1964 Declaration of Helsinki and its later amendments. All patients gave their informed consent prior to inclusion in the study.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Study design and measures. S-FMDRS Simplified Functional Movement Disorders Rating Scale, MFI-20 Multidimensional Fatigue Inventory scale, BPI Brief Pain Inventory, SF-12 12-Item Short-Form Health survey, BAI Beck Anxiety Inventory, BDI-II Beck Depression Inventory-II, TAS-20 Toronto Alexithymia Scale, CGI Clinical Global Impression scale
Fig. 2
Fig. 2
Motor and NMSs symptom severity in the telemedicine and the control group before, at completion of the 5-days in-person rehabilitation program, and at the 3-months follow-up. T0 before initiating the 5-days in-person rehabilitation; T1 at completion of the 5-days in-person rehabilitation; T2 at the 3-months follow-up. *Statistically significant. p value was corrected for multiple comparisons. S-FMDRS Simplified Functional Movement Disorders Rating Scale; Physical Fatigue, a subscale of the MFI-20 (Multidimensional Fatigue Inventory-20)

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