Functional neurological symptom disorder: Preliminary findings of factors associated with walking ability post integrative pediatric rehabilitation

PURPOSE: The current study's aims were to (1) examine long-distance walking ability (6-minute walking test [6MWT]) and walking hemodynamic responses (i.e., heart rate) among youth with functional neurological symptom disorder (FNSD) before and after an integrative pediatric rehabilitation (IPR) program; and (2) explore factors predicting improvement in walking ability. METHODS: Thirty-one youth with FNSD participating in an IPR program were recruited. The IPR program was activated biweekly in an ambulatory format. Study measures included the 6MWT, hemodynamic characteristics, rate of perceived exertion (RPE), pain-intensity perception, and Child's Somatization Inventory-24 (CSI-24). All measures were conducted upon admission to the IPR and discharge. RESULTS: Findings indicated a significant increase in 6MWT distance, as well as decreases in heart rate, RPE, and pain-intensity perception from admission to discharge. At admission, CSI-24 and pain intensity predicted 6MWT distance (adjusted R-2 = 0.68). Pain intensity predicted discharge 6MWT distance (adjusted R-2 = 0.18). Initial 6MWT predicted changes in 6MWT distance from admission to discharge (adjusted R-2 = 0.33). CONCLUSION: Using an integrative rehabilitation approach increases walking distance and decreases pain-related symptoms in youth with FNSD, emphasizing the need for collaboration between physical therapists and pediatric psychologists. Moreover, changes in walking ability may increase participation and thus should be the focus of IPR.

Automated summary

The purpose of this study was to examine long-distance walking ability and walking hemodynamic responses among youth with functional neurological symptom disorder (FNSD) before and after an integrative pediatric rehabilitation program. The study found that using an integrative rehabilitation approach increased walking distance and decreased pain-related symptoms in youth with FNSD.