This module sets the stage for the Rehab 101 course. A brief introduction covers the rationale for the program and what to expect, followed by a dedicated talk on the crucial role of education in treating FND. We cover illness models, communicating how and why FND symptoms occur, and how important it is to have the treating team on the same page as the patient during the course of therapy.
4 Minutes
1.1 Welcome and Introduction to FND Rehabilitation 101
Sarah Lidstone, MD, PhD Director of the Integrated Movement Disorders Program
Toronto Rehabilitation Institute
Assistant Professor of Neurology, University of Toronto
Glenn Nielsen, PhD Senior Lecturer in Neurological Physiotherapy
St George’s University of London
UK AHP FND Network Co-Lead
35 Minutes
1.2. Education as a Rehabilitation Tool
Sarah Lidstone, MD, PhD Director of the Integrated Movement Disorders Program
Toronto Rehabilitation Institute
Assistant Professor of Neurology, University of Toronto
Glenn Nielsen, PhD Senior Lecturer in Neurological Physiotherapy
St George’s University of London
UK AHP FND Network Co-Lead
2. Rehabilitation Assessment, Common Themes Across Disciplines
Lecture Description
This module covers the common basics of an FND rehab assessment used by all disciplines. We explore structuring a history and building an understanding of the patient perspective that will form the basis for the therapy plan, both in the in-person and virtual settings.
Identify key information that is important to gather during an initial patient interview
Describe recommended interview strategies and questions
Discuss methods that rehab professionals may use to consider biopsychosocial factors in case formulation and treatment planning
13 Minutes
2.2 Delivering an Effective Virtual Assessment
Haseel Bhatt, MSc, MScPT Physiotherapy Lead
Integrated Movement Disorders Program
University Health Network
Learning Objectives 2.2
Understand the evidence and feasibility of virtual assessments for FND
Describe practical strategies for preparing and delivering an effective virtual FND assessment.
Apply a 3-step framework for virtual FND assessments: before, during, and after the session.
3. Therapy Role and Techniques (including assessment when needed)
Lecture Description
Now we are getting to the meat of it! This module takes a tour through the specific tools and strategies used in FND rehab across all rehab specialties: physiotherapy, occupational therapy, and speech and language pathology (voice, speech, and swallow). We cover evidence-based techniques used in everyday practice in a series of practical, bite-sized talks. These are followed by a dedicated talk about dealing with pain, fatigue, and cognitive symptoms, the most common non-motor symptoms that arise in FND, and when present, can act as barriers to engagement. Rounding out the module, we cover the important roles of social work and nursing in the care of people with FND, and finish with a conversation exploring how to conclude therapy and prepare patients for self-management.
20 Minutes
3.1 Therapeutic Neurobiological Mechanisms
David L. Perez MD, MMSc Associate Professor of Neurology and Psychiatry
Mass General Brigham
Harvard Medical School
Learning Objectives 3.1
Identify neuropsychological constructs implicated in the pathophysiology of functional neurological disorder
Identify how functional neurological symptoms, neuropsychological constructs, and brain networks relate to one another in the pathophysiology of functional neurological disorder
Identify primary resting state brain networks implicated in the pathophysiology of functional neurological disorder
24 Minutes
3.2 Movement Retraining Physiotherapy
Julie Maggio, PT, DPT, NCS Clinical Specialist
Massachusetts General Hospital Outpatient PT
MGH FND Unit Affiliated Researcher
Learning Objectives 3.2
Participants will be able to assess movement patterns and recognize opportunities to enhance motor control utilizing external focus
Participants will be able to identify key factors contributing to movement dysfunction, including altered attentional focus, fear, pain, and nervous system dysregulation
Participants will develop a more comprehensive understanding of how FND impacts movement and motor control
23 Minutes
3.3 Occupational Therapy, Including Provision of Aids and Adaptations
Clare Nicholson, OT Clinical Specialist Occupational Therapist, Neurosciences / Functional Neurological Disorders Rehabilitation Team
The National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London
Doctoral Clinical Practitioner Academic Fellowship (DCAF) candidate
University College London (UCL), Centre for Behaviour Change
Learning Objectives 3.3
To describe overarching principles of Occupational Therapy interventions for Functional Neurological Disorder
To provide examples of Occupational Therapy interventions for specific functional neurological symptoms.
To illustrate how symptom management strategies can be integrated into daily activities and routines.
19 Minutes
3.4 Voice Disorders
Janet Baker, LACST, MsC, PhD Speech Pathologist & Family Therapist
Clinical Consultant in Voice & Counselling
Supervision & Reflective Practice for Clinicians and Academics
Adjunct Associate Professor, Flinders University, SA
Honorary Clinical Fellow, UTS NSW
Learning Objectives 3.4
Provide an overview of biopsychosocial conceptual understandings underpinning the nature and patterns of onset of FNVD
Describe the positive clinical signs that contribute to the differential diagnosis of FNVD
Present the general principles of management that include practical strategies to facilitate the resolution of vocal symptoms, and generalisation beyond the clinical setting
Highlight ways in which counselling by the SLP is integral to this process, with attention to predisposing, precipitating, and perpetuating factors
Identify possible ‘red flags’ that may indicate the need for deeper levels of counselling and/or collaboration with mental health professionals in the multidisciplinary team
Know the positive signs for functional neurological dysphagia
Know the DEEEP principles of treatment of functional neurological dysphagia
Understand how treatment for clients with chronic/complex FND differs
18 Minutes
3.7 Pain, fatigue, and cognition
Cameron Moss Principal Physiotherapist, Functional Movement Disorders
St George’s University Hospitals NHS Foundation Trust
Honorary Contract: City St George’s University of London
Learning Objectives 3.7
To identify wider symptoms of pain, fatigue, and cognition that commonly co-exist with FND.
To demonstrate examples of education regarding these complex, co-existing symptoms.
To describe strategies that support self-management of these co-existing symptoms.
26 Minutes
3.8 The Role of Social Work
Najda Robinson-Mayer, LMSW Licensed Master Social Worker (LMSW)
University of Michigan Health System, Michigan Medicine
Adult Neurology Clinic, Department of Social Work
Social Worker MSW Senior
Learning Objectives 3.8
Explain the multifaceted role of social work in treating patients who have functional neurologic disorders, including providing therapy, identifying needs, and collaborating with local agencies.
Illustrate case management techniques to reduce barriers in access to healthcare and other resources.
Demonstrate how prognostic signs are used to personalize psychotherapy treatment and maximize treatment success.
10 Minutes
3.9 The Role of Nursing
Kate Kain, RN Registered Nurse
Ambulatory Neurosciences
South Health Campus / Alberta Health Services (Calgary AB)
Learning Objectives 3.9
Explain the RN role for patients with FND within various care settings.
Explore the nursing role in the assessment of FND symptomology and patterns.
Differentiate between the necessity of time spent with patients and setting boundaries to promote agency and avoid dependence.
35 Minutes
3.10 Concluding treatment and supporting self-management
Glenn Nielsen, PhD Senior Lecturer in Neurological Physiotherapy
St George’s University of London
UK AHP FND Network Co-Lead
Mark J Edwards, MBBS, BSc, FRCP, PhD Professor of Neurology and Interface Disorders
Department of Basic and Clinical Neuroscience
Institute of Psychiatry, Psychology and Neuroscience
King’s College London
Learning Objectives 3.10
To recognize the importance of planning for discharge from day one of treatment
To be able to include strategies in your treatment that will help to create a good discharge experience
To be able to approach treatment in ways that support the patient to develop self-management skills
4. Adapting Treatment for Paediatrics and Young People
Lecture Description
This module builds on the previous content to add the unique considerations when working with the pediatric population. Children and adolescents have unique predisposing, precipitating, and perpetuating factors associated with their symptoms, and can benefit from some special therapy strategies and care models, summarized over 3 brief talks.
20 Minutes
4.1 Paediatric predisposing, precipitating, and perpetuating factors
Kristen Trott, PhD Pediatric Psychologist
Nationwide Children's Hospital
Clinical Associate Professor
The Ohio State University in Columbus
Learning Objectives 4.1
Identify typical FND symptomology in youth
Define risk factors in the development of FND in youth
Recognize complicating factors in recovery
22 Minutes
4.2 Paediatric multidisciplinary teams
Dara Albert, DO, MEd, FAAN, FAES Associate Professor
Department of Pediatrics
Division of Child Neurology
Nationwide Children’s Hospital/The Ohio State University
Learning Objectives 4.2
Define why there is a need for multidisciplinary care for patients with FND
Highlight the benefits of multidisciplinary care
Provide an example of a multidisciplinary Pediatric Functional Seizure Clinic
16 Minutes
4.3 Rehabilitation for Young People
Jason Kreuzman MOT, OTR/L Occupational Therapist
St. Louis Children's Hospital
Therapy and Audiology Services
Learning Objectives 4.3
Define the roles of OT, PT, and ST in the treatment of young people with FND
Explain the importance of developmental skills in the FND treatment of young people
Explain the Bio-Psycho-Social factors unique to young people with FND
5. Integrating Mind and Body
Lecture Description
This module begins with a moderated 30-minute panel discussion between an FND expert physiotherapist, occupational therapist, and psychotherapist that delves into the concept of “psychologically-informed therapy.” We blur the boundaries between physical rehabilitation and psychotherapy and discuss the benefits and challenges in pulling together these different approaches. The following talk addresses psychological safety in rehab, covering practical tips about how to handle challenging mental health situations that sometimes may arise in therapy.
31 Minutes
5.1 Unravelling psychologically-informed rehab: strategies and tools
Sarah Lidstone, MD, PhD Director of the Integrated Movement Disorders Program
Toronto Rehabilitation Institute
Assistant Professor of Neurology, University of Toronto
Kate Holt Clinical Physiotherapist
Research Physiotherapist
City St George's University of London
Helen Jinadu Clinical Specialist Occupational Therapist
Lishman Unit
South London and Maudsley NHS Foundation Trust
30 Minutes
5.2 Psychological safety in rehabilitation
Gaston Baslet, MD Neuropsychiatrist
Bruce W Carter VA Medical Center, Miami, FL
Associate Professor of Psychiatry
Harvard Medical School, Boston, MA
Learning Objectives 5.2
Identify the psychological safety concerns that may arise during rehabilitation therapy and have a plan on how to address them.
Create a therapeutic, safe environment during rehabilitation therapy that will facilitate clinical progress of functional neurological symptoms and will allow psychological symptoms to be discussed.
Recognize psychiatric and psychosocial factors that may interfere with rehabilitation therapy and may need to be prioritized.
6. The Lived Experience
Lecture Description
The final module of the course is a collection of the reflections and lived experiences shared by three people who received rehabilitation for FND. They discuss what was helpful and not helpful to their recovery, what made a difference, and their messages for health care providers.
20 Minutes
6. The Lived Experience
Caoimhe McLoughlin Research Fellow
University of Edinburgh
Consultant Liaison Psychiatrist
Sligo University Hospital, Ireland
Learning Objectives 6.1
Hear advice (do and don’ts) for healthcare professionals from the patient perspective
Use language that is helpful and non-stigmatising when working with patients
Develop a more empathic understanding of what the patient goes through on their FND journey
Cookie Notice
This website uses cookies to deliver to you the best experience possible on our website. By continuing to use this site, you are providing us with your consent to ensure you receive such an experience. View our privacy notice to learn more.
Janet Baker, LACST, MsC, PhD
