Which factors predict outcome from specialist physiotherapy for functional motor disorder? Prognostic modelling of the Physio4FMD intervention

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research Pub Date : 2025-02-10 DOI:10.1016/j.jpsychores.2025.112056

Glenn Nielsen , Teresa C. Lee , Louise Marston , Alan Carson , Mark J. Edwards , Laura H. Goldstein , Rachael Maree Hunter , Kate Holt , Jon Marsden , Markus Reuber , Jon Stone , Irwin Nazareth

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引用次数: 0

Abstract

Objectives

Physiotherapy is considered part of first line treatment for functional motor disorder (FMD) although not all patients benefit. Predictors of treatment outcome may help to inform triage decisions. We aimed to determine which baseline variables predicted treatment outcome in the pragmatic multicentre Physio4FMD randomised controlled trial of specialist physiotherapy for FMD.

Methods

Participants randomised to the specialist physiotherapy arm of the trial were included in the analysis. Treatment outcome was dichotomised into improvement vs no improvement, based on two measures, Short Form 36 Physical Functioning (SF36 PF) and participant-rated Clinical Global Impression Scale of Improvement (CGI-I). Predictors of outcome were selected from baseline variables. Univariate logistic regression was used to calculate the odds ratio of improvement for each variable. Variables associated with improvement at p < 0.1 were considered for inclusion in a multiple logistic regression model.

Results

A greater perception of having control over recovery predicted improvement on the CGI-I (OR 1.18, 95 % CI 1.07, 1.31). Predictors of lack of improvement were an increased perception of the permanence of symptoms, predicting lack of improvement on the SF36 PF (OR 0.91, 95 % CI 0.84, 0.99) and older age, predicting lack of improvement on the CGI-I (OR 0.97, 95 % CI 0.95, 0.998).

Conclusions

Age and perceptions of symptom control were weak predictors of outcome from specialist physiotherapy. In contrast, a number of factors commonly believed to predict poorer treatment response, including illness duration and levels of pain and fatigue, were not related to the outcomes measured in this study.

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哪些因素可以预测功能性运动障碍专科物理治疗的结果？Physio4FMD干预的预后模型

物理治疗被认为是功能性运动障碍（FMD）一线治疗的一部分，尽管并非所有患者都受益。治疗结果的预测因子可能有助于告知分诊决定。我们的目的是确定哪些基线变量可以预测FMD专科物理治疗的多中心Physio4FMD随机对照试验的治疗结果。方法随机分配到该试验的专业物理治疗组的参与者纳入分析。治疗结果分为改善和无改善，基于两项测量，短表36身体功能（SF36 PF）和参与者评定的临床总体印象改善量表（CGI-I）。结果的预测因子从基线变量中选择。采用单变量logistic回归计算各变量改善的优势比。与p <改善相关的变量；0.1被考虑纳入多元逻辑回归模型。结果更强的康复控制感预示着CGI-I的改善（OR 1.18, 95% CI 1.07, 1.31）。缺乏改善的预测因子是对症状持久性的认知增加，预测SF36 PF缺乏改善（OR 0.91, 95% CI 0.84, 0.99）和年龄的增加，预测CGI-I缺乏改善（OR 0.97, 95% CI 0.95, 0.998）。结论sage和症状控制感知是专科物理治疗预后的弱预测因子。相比之下，许多通常被认为预测较差治疗反应的因素，包括疾病持续时间、疼痛和疲劳程度，与本研究中测量的结果无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Psychosomatic Research 医学-精神病学

CiteScore

7.40

自引率

6.40%

发文量

314

审稿时长

6.2 weeks

期刊介绍： The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.