• Glenn Nielsen, Jon Stone, Audrey Matthews, Melanie Brown, Chris Sparkes, Ross Farmer, Lindsay Masterton, Linsey Duncan, Alisa Winters, Laura Daniell, Carrie Lumsden, Alan Carson, Anthony S David, and Mark Edwards.
• Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK Therapy Services, The National Hospital for Neurology and Neurosurgery, London, UK.
• J. Neurol. Neurosurg. Psychiatr. 2015 Oct 1;86(10):1113-9.

BackgroundPatients with functional motor disorder (FMD) including weakness and paralysis are commonly referred to physiotherapists. There is growing evidence that physiotherapy is an effective treatment, but the existing literature has limited explanations of what physiotherapy should consist of and there are insufficient data to produce evidence-based guidelines. We aim to address this issue by presenting recommendations for physiotherapy treatment.MethodsA meeting was held between physiotherapists, neurologists and neuropsychiatrists, all with extensive experience in treating FMD. A set of consensus recommendations were produced based on existing evidence and experience.ResultsWe recommend that physiotherapy treatment is based on a biopsychosocial aetiological framework. Treatment should address illness beliefs, self-directed attention and abnormal habitual movement patterns through a process of education, movement retraining and self-management strategies within a positive and non-judgemental context. We provide specific examples of these strategies for different symptoms.ConclusionsPhysiotherapy has a key role in the multidisciplinary management of patients with FMD. There appear to be specific physiotherapy techniques which are useful in FMD and which are amenable to and require prospective evaluation. The processes involved in referral, treatment and discharge from physiotherapy should be considered carefully as a part of a treatment package.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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