{"id":14401,"date":"2024-03-05T06:55:30","date_gmt":"2024-03-05T06:55:30","guid":{"rendered":"https:\/\/pre-prod.neurosymptoms.org\/?page_id=14401"},"modified":"2024-03-05T06:55:30","modified_gmt":"2024-03-05T06:55:30","slug":"fnd-physiotherapy-treatment-in-new-york","status":"publish","type":"page","link":"https:\/\/neurosymptoms.org\/en\/media\/fnd-videos\/fnd-physiotherapy-treatment-in-new-york\/","title":{"rendered":"FND physiotherapy treatment in New York"},"content":{"rendered":"\n

Zachary Grin – physical therapist in New York shared this video of treatment on social media<\/a>. <\/p>\n\n\n\n

I have reproduced his summary below as I think it provides a good insight into successful elements of physio treatment for a functional movement disorder. Thank you Zachary for permission to post on this site as well.<\/p>\n\n\n\n

I’m so excited to share this patient’s FND treatment plan & outcome! Background: Dog bite to the R thigh 3 yrs ago, R leg heaviness, severe R leg tremor & gait problems. She had some fluctuating improvement with “traditional” physical therapy but felt that her progress plateaued. <\/p>\n\n\n\n

Treatment began with showing her the leg heaviness was due to significant muscle tension throughout the leg when walking.<\/p>\n\n\n\n

Once aware, she learned how to relax the leg when she felt the heaviness by using her hands on the muscle for feedback. <\/p>\n\n\n\n

Movement pattern changes with an external focus of attention: hopscotch, skipping, crab walk, agility ladder, obstacle courses, kicking a soccer ball to access automatic movements that were not “corrupted” by FND. <\/p>\n\n\n\n

Dual-tasks: Learning to allocate less attention toward walking. Bop-It is my fav due to the high attentional demand. Gait may initially worsen but improve as they learn to balance attention allocation to the tasks! <\/p>\n\n\n\n

Behavioral: Prevent reinforcement of motor symptom – If trunk hyperextension was triggered when stepping over an object she would repeat it until it stopped. <\/p>\n\n\n\n

Sensory: Weighted vest – easier to relax her leg & raised her triggering threshold. Desensitizing the right leg to vibration allowed her to kick a firm soccer ball without triggering a leg tremor. <\/p>\n\n\n\n

Autonomic: Diaphragmatic breathing with extended exhale – sympathetic activity to raise the triggering threshold. <\/p>\n\n\n\n

Variability: People with FND may learn a motor skill very well but symptoms may reoccur by slight modification to the task. Variability helps to learn how to adapt motor responses to meet new task demands. <\/p>\n\n\n\n

Outcome: After 4-months, she returned to work part-time (gradually increasing to full-time), rejoined her soccer league for the upcoming season, and could run without motor symptoms!! <\/p>\n\n\n\n

FND is a complex condition. It demands clinicians be curious, creative, comprehensive, and comfortable with the grey. I hope this post provides clinicians with some out-of-the-box treatment ideas and provides patients with hope.<\/p>\n","protected":false},"excerpt":{"rendered":"

https:\/\/www.youtube.com\/watch?v=KLc6Ug62t3c<\/p>\n","protected":false},"author":7,"featured_media":0,"parent":1220,"menu_order":183,"comment_status":"closed","ping_status":"closed","template":"page-template\/media-details-template.php","meta":[],"_links":{"self":[{"href":"https:\/\/neurosymptoms.org\/en\/wp-json\/wp\/v2\/pages\/14401"}],"collection":[{"href":"https:\/\/neurosymptoms.org\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/neurosymptoms.org\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/neurosymptoms.org\/en\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/neurosymptoms.org\/en\/wp-json\/wp\/v2\/comments?post=14401"}],"version-history":[{"count":2,"href":"https:\/\/neurosymptoms.org\/en\/wp-json\/wp\/v2\/pages\/14401\/revisions"}],"predecessor-version":[{"id":14403,"href":"https:\/\/neurosymptoms.org\/en\/wp-json\/wp\/v2\/pages\/14401\/revisions\/14403"}],"up":[{"embeddable":true,"href":"https:\/\/neurosymptoms.org\/en\/wp-json\/wp\/v2\/pages\/1220"}],"wp:attachment":[{"href":"https:\/\/neurosymptoms.org\/en\/wp-json\/wp\/v2\/media?parent=14401"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}