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J Neurol Neurosurg Psychiatry ; 88(6): 484-490, 2017 06.
Artículo en Inglés | MEDLINE | ID: mdl-27694498

RESUMEN

OBJECTIVE: To determine the feasibility of conducting a randomised controlled trial of a specialist physiotherapy intervention for functional motor symptoms (FMS). METHODS: A randomised feasibility study was conducted recruiting patients with a clinically established diagnosis of FMS from a tertiary neurology clinic in London, UK. Participants were randomised to the intervention or a treatment as usual control. Measures of feasibility and clinical outcome were collected and assessed at 6 months. RESULTS: 60 individuals were recruited over a 9-month period. Three withdrew, leaving 29 intervention and 28 controls participants in the final analysis. 32% of patients with FMS met the inclusion criteria, of which 90% enrolled. Acceptability of the intervention was high and there were no adverse events. At 6 months, 72% of the intervention group rated their symptoms as improved, compared to 18% in the control group. There was a moderate to large treatment effect across a range of outcomes, including three of eight Short Form 36 (SF36) domains (d=0.46-0.79). The SF36 Physical function was found to be a suitable primary outcome measure for a future trial; adjusted mean difference 19.8 (95% CI 10.2 to 29.5). The additional quality adjusted life years (QALY) with intervention was 0.08 (95% CI 0.03 to 0.13), the mean incremental cost per QALY gained was £12 087. CONCLUSIONS: This feasibility study demonstrated high rates of recruitment, retention and acceptability. Clinical effect size was moderate to large with high probability of being cost-effective. A randomised controlled trial is needed. TRIAL REGISTRATION NUMBER: NCT02275000; Results.


Asunto(s)
Trastornos de Conversión/rehabilitación , Trastornos Motores/rehabilitación , Modalidades de Fisioterapia , Adulto , Terapia Cognitivo-Conductual , Terapia Combinada , Trastornos de Conversión/diagnóstico , Trastornos de Conversión/psicología , Evaluación de la Discapacidad , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Humanos , Comunicación Interdisciplinaria , Colaboración Intersectorial , Masculino , Persona de Mediana Edad , Trastornos Motores/diagnóstico , Trastornos Motores/psicología , Evaluación de Resultado en la Atención de Salud , Aceptación de la Atención de Salud/psicología , Calidad de Vida/psicología , Años de Vida Ajustados por Calidad de Vida
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