Outpatient Occupational Therapy,Physiotherapy,and Speech Language Pathology Interventions for People with Functional Neurologic Disorder: A Scoping Review

Abstract

Background

Functional neurologic disorder (FND) is a disabling condition commonly managed by occupational therapists (OT), physiotherapists (PT), and speech-language pathologists (SLP). While consensus recommendations for OT, PT, and SLP provide general principles for assessment and treatment, there is limited understanding of how interventions are delivered or how outcomes are measured, particularly in the outpatient setting.

Purpose

This scoping review describes the characteristics (mode, frequency, duration) of outpatient OT, PT, and SLP interventions for individuals with FND, assesses their alignment with consensus FND recommendations, and maps outcome measures to the International Classification of Functioning (ICF) model.

Methods

Three electronic databases (Medline, Embase, and CINAHL) were searched for articles that included individuals diagnosed with FND, reported characteristics of outpatient OT, PT, or SLP interventions, and were published in English.

Results

Thirty-one studies were included (PT, n = 14, SLP, n = 8, multidisciplinary n = 6, and OT, n = 3). Most studies (n = 22, 71%) included interventions that aligned with FND recommendations and commonly consisted of education, movement retraining with diverted attention, and symptom management plans. Intervention frequency ranged from daily sessions over one week to twice-monthly sessions across three months. The outcome measures were primarily patient-rated, and most frequently mapped to the body structure and function domain of the ICF.

Conclusions

Outpatient OT, PT, and SLP interventions predominantly included components of FND recommendations yet varied in mode, frequency, and outcome measure selection. Future research is needed to examine the optimal parameters and modes, compare specific interventions, and identify outcomes that encompass all ICF domains.