A physical therapy programme for functional motor symptoms: A telemedicine pilot study

Demartini, Benedetta; Bombieri, Federica; Goeta, Diana; Gambini, Orsola; Ricciardi, Lucia; Tinazzi, Michèle

doi:10.1016/j.parkreldis.2019.05.004

Cited by 34 publications

(26 citation statements)

References 14 publications

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“…25 Several studies have explored a variety of management strategies for FMD with growing evidence for the use of physical therapy, cognitive behaivoral therapy, psychotherapy, medical management, and interdiscplinary care. [26][27][28][29][30] Of these, physical therapy, in the form of motor reprogramming, shows great promise for FMD patients, both with and without psychiatric comorbidities, and has the potential to improve both movement and mood symptoms. 25,[31][32][33] Conversely, monotherapy with psychotherapy alone may be insufficient for managing FMD, with one study of psychodynamic psychotherapy for a small cohort of FMD patients with comorbid psychiatric conditions showing no significant improvements in psychiatric nor motor symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have explored a variety of management strategies for FMD with growing evidence for the use of physical therapy, cognitive behaivoral therapy, psychotherapy, medical management, and interdiscplinary care 26–30 . Of these, physical therapy, in the form of motor reprogramming, shows great promise for FMD patients, both with and without psychiatric comorbidities, and has the potential to improve both movement and mood symptoms 25,31–33 .…”

Section: Discussionmentioning

confidence: 99%

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Psychiatric Comorbidities in Functional Movement Disorders: A Retrospective Cohort Study

Macchi

Kletenik

Olvera

et al. 2021

Movement Disord Clin Pract

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BackgroundBackground: Functional movement disorders (FMD) are characterized by abnormal movements and motor symptoms incongruent with a known structural neurologic cause. While psychological stressors have long been considered an important risk factor for developing FMD, little is known about the impact of psychiatric comorbidities on disease manifestations or complexity. Objectives Objectives: To compare characteristics of FMD patients with co-occurring mood and trauma-related psychiatric conditions to FMD patients without psychiatric conditions. Methods Methods: We performed a retrospective cohort study of patients seen in the University of Colorado Health system between January 1, 2015 and December 31, 2019. Patients were included if they had a diagnosis of FMD, determined by ICD-10 coding and ≥1 phenomenology-related diagnostic code (tremor, gait disturbances, ataxia, spasms, and weakness), and at least one encounter with a neurology specialist. Fisher's exact and unpaired t-tests were used to compare demographics, healthcare utilization, and phenomenologies of patients with psychiatric conditions to those with none. Results Results: Our review identified 551 patients with a diagnosis of FMD who met inclusion criteria. Patients with psychiatric conditions (N = 417, 75.7%) had increased five-year healthcare utilization (mean emergency room encounters 9.9 vs. 3.5, P = 0.0001) and more prevalent non-epileptic seizures (18.2% vs. 7.5%, P = 0.001). Suicidal ideation (8.4%) and self-harm (4.1%) were only observed amongst patients with comorbid psychiatric conditions. Conclusions Conclusions: Patients with FMD and comorbid psychiatric conditions require more healthcare resources and have greater disease complexity than patients without psychiatric illness. This may have implications for treatment of patients without comorbid psychiatric conditions who may benefit from targeted physiotherapy alone.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Psychiatric Comorbidities in Functional Movement Disorders: A Retrospective Cohort Study

Macchi

Kletenik

Olvera

et al. 2021

Movement Disord Clin Pract

View full text Add to dashboard Cite

show abstract

“…As motor and non-motor components are involved in the neural control of PA, three main elements are fundamental for effective rehabilitation: active self-correction techniques, stabilization exercises, and functional tasks. Based on this, Tinazzi and collaborators (16,17,118) have found that a 4-week trunk-specific rehabilitation program improved passive and active control of the trunk and was maintained at 1-month post-treatment. The benefits of training were evident even when PA were assessed through the Unified Parkinson Disease Rating Scale-motor subscale (122,124).…”

Section: Motor Abnormalities and Physical Activitymentioning

confidence: 95%

“…Finally, clinical evaluations found rehabilitation strategies, such as a promising non-drug-based approach able to influence the progression of PD lasting long after the program break, therefore suggesting the involvement of the anatomical substrate accompanying the disease (16,17).…”

Section: Introductionmentioning

confidence: 99%

From the Gut to the Brain and Back: Therapeutic Approaches for the Treatment of Network Dysfunction in Parkinson's Disease

Paolone

2020

Front. Neurol.

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Parkinson's disease (PD) is a complex, multisystem, progressive, degenerative disorder characterized by severe, debilitating motor dysfunction, cognitive impairments, and mood disorders. Although preclinical research has traditionally focused on the motor deficits resulting from the loss of nigrostriatal dopaminergic neurons, up to two thirds of PD patients present separate and distinct behavioral changes. Loss of basal forebrain cholinergic neurons occurs as early as the loss of dopaminergic cells and contributes to the cognitive decline in PD. In addition, attentional deficits can limit posture control and movement efficacy caused by dopaminergic cell loss. Complicating the picture further is intracellular α-synuclein accumulation beginning in the enteric nervous system and diffusing to the substantia nigra through the dorsal motor neurons of the vagus nerve. It seems that α-synuclein's role is that of mediating dopamine synthesis, storage, and release, and its function has not been completely understood. Treating a complex, multistage network disorder, such as PD, likely requires a multipronged approach. Here, we describe a few approaches that could be used alone or perhaps in combination to achieve a greater mosaic of behavioral benefit. These include (1) using encapsulated, genetically modified cells as delivery vehicles for administering neuroprotective trophic factors, such as GDNF, in a direct and sustained means to the brain; (2) immunotherapeutic interventions, such as vaccination or the use of monoclonal antibodies against aggregated, pathological α-synuclein; (3) the continuous infusion of levodopa-carbidopa through an intestinal gel pad to attenuate the loss of dopaminergic function and manage the motor and non-motor complications in PD patients; and (4) specific rehabilitation treatment programs for drug-refractory motor complications.

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“…Psychiatric support for patients with movement disorders by telemedicine showed to have satisfactory evaluations 108 . The telemedicine rehabilitation program for functional disorders seems to improve quality of life as assessed by scales 109 . In addition, a telephone support program appears to improve apathy in patients with PD when compared to controls without a support program 110 .…”

Section: Movement Disordersmentioning

confidence: 99%

Telemedicine in neurology: current evidence

Domingues¹,

Mantese²,

Aquino

et al. 2020

Arq. Neuro-Psiquiatr.

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Background: Telemedicine was first introduced in Neurology as a tool to facilitate access to acute stroke treatment. More recently, evidence has emerged of the use of telemedicine in several other areas of Neurology. With the advent of the COVID-19 pandemic and the need for social isolation, Brazilian authorities have expanded the regulation of the use of telemedicine, thus allowing the treatment of many patients with neurological diseases to be conducted with less risk of SARS-CoV-2 contamination. Objective: This study aimed to critically review the current evidence of the use, efficacy, safety, and usefulness of telemedicine in Neurology. Methods: A review of PubMed indexed articles was carried out by searching for the terms “telemedicine AND”: “headache”, “multiple sclerosis”, “vestibular disorders”, “cerebrovascular diseases”, “epilepsy”, “neuromuscular diseases”, “dementia”, and “movement disorders”. The more relevant studies in each of these areas were critically analyzed. Results: Several articles were found and analyzed in each of these areas of Neurology. The main described contributions of telemedicine in the diagnosis and treatment of such neurological conditions were presented, indicating a great potential of use of this type of assistance in all these fields. Conclusion: Current evidence supports that teleneurology can be a tool to increase care for patients suffering from neurological diseases.

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A physical therapy programme for functional motor symptoms: A telemedicine pilot study

Cited by 34 publications

References 14 publications

Psychiatric Comorbidities in Functional Movement Disorders: A Retrospective Cohort Study

Psychiatric Comorbidities in Functional Movement Disorders: A Retrospective Cohort Study

From the Gut to the Brain and Back: Therapeutic Approaches for the Treatment of Network Dysfunction in Parkinson's Disease

Telemedicine in neurology: current evidence

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