Evidence-Based Practice: Physiotherapy for Children and Adolescents with Motor Symptoms of Conversion Disorder.

Abstract

Clinical Case: A boy aged 14 years with conversion disorder who presented with an ataxic gait pattern experienced complete symptom resolution after engaging in physiotherapy (PT) as part of interdisciplinary treatment. Clinical Question: Is there evidence to support the use of PT in children and adolescents with motor symptoms of conversion disorder? Evidence: All the extant paediatric literature consists of case studies and case series. Some exciting research has been published in the adult literature that suggests the potential positive benefits of PT. Limitation of the Evidence and Future Research: The paediatric literature is limited in quantity and quality. In the adult literature, most studies are limited in that they do not control for the type of motor symptoms and do not evaluate PT independent of interdisciplinary treatment. In future research, it would be pertinent to (1) evaluate PT independent of interdisciplinary treatment, (2) control for the type of motor symptoms, and (3) describe theoretical models. Recommendation for Clinical Question: Expert consensus and emerging evidence suggest that PT may be beneficial in adults with conversion disorder, but the evidence in the paediatric population is insufficient.