Publication details
Fyzioterapie u funkčních neurologických poruch hybnosti – principy v kazuistice
| Title in English | Physiotherapy in functional neurological disorders – principles in case studie |
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| Authors | |
| Year of publication | 2023 |
| Type | Conference abstract |
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| Description | Functional neurological disorders (FND), are neurological disorders, characterized by almost any type of neurological symptoms, caused by brain network dysfunction that does not exclude the possibility of normal function, sometimes partially caused by a psychological cause and unexplained by other neurological pathology that may or may not be present. Symptoms are inconsistent or incompatible with other known neurological disorders or human anatomy and physiology, i.e. incongruention. According to the current neurobiological model, these diseases are characterized by abnormal attention associated with a disorder of explicit motor control and alteration of the perception of voluntary control of momentum. The mechanism assumes the participation of abnormal predictions of motor and sensory states represented at the intermediate level of the motor and sensory system. The incidence of FND is 4-12/100 000/year, and the prevalence is 50/100 000. It affects more women, at a ratio of 4:1, and can develop at any age. Studies report that this is 5% of patients presenting for a neurological examination. The most common occurrence in functional tremor, functional abnormal gait disorders, and functional weakness is published, which is also confirmed by our practice. Comorbidities are very common, namely non-specific multisegmental pain, fatigue and headaches. The record of this disease has experienced rapid and dynamic development in the last 15 years. Part of the multidisciplinary approach is physiotherapy, which according to recent studies is the most effective therapy with effectiveness in 60-70% of patients lasting 1-2 years. Despite the fact that it is a difficult and frequent disease, there are few centers in the Czech Republic that focus on it. One of them is the Outpatient ward of the Department of Sport Medicine and Rehabilitation of the St´ Annes University Hospital in Brno, where 58 patients attended targeted physiotherapy from 11/2020 to 8/2023. The aim of the work is to present the principles and mechanisms of FND and recommended procedures for physiotherapy, which differ from routine procedures, using the example of a case study of a patient with functional motor symptoms. The effect of physiotherapy is evaluated through self-assessment scales and the use of video-analysis of movement according to the Hinson protocol and the so-called "Simplified Functional Movement Disorders Rating Scale - SFMDRS". The contribution thus aims to spread awareness about the correct procedure of physiotherapy and the treatment of this frequent and difficult-to-grasp diagnosis both from the point of view of assessment and the actual therapy, which is still met with misunderstanding and myths even in the professional society. |