Objective: To evaluate the reliability of technological devices for phenotype definition and rehabilitative treatment tailoring of patients affected by Functional Movement Disorders (FMDs)

Background: FMDs may present with a combination of phenotypes such as tremor, dystonia, weakness or postural/ gait disorders; however, their characterization is still incomplete and difficult: we aimed to describe and cluster FMDs phenotypic patterns with the aid of a technological approach including augmented or immersive virtual reality (AR/IVR), in the setting of an intensive rehabilitation program

Method: A dynamic and comprehensive database of all FMD patients from our centers were set up. It uses multiple assessment tools, including the Simplified FMDs Rating Scale (S-FMDRS) and the Clinical Global Impression (CGI). We performed an individualized instrumental assessment in relation to the main patient’s disorder, including Kinematic Analysis of gait (optoelectronic systems, multi-sensor instrumented treadmill) or upper limbs function, Instrumental Analysis of the Articulation of the Voice, and Balance assessment through AR/IVR systems

Results: Starting from 2021, 64 patients have been recruited (74%F/26%M; mean age 46.7±15.5 Y), according to Gupta e Lang 2009 criteria. 7.8 % (n=5) had a neurological diagnosis (mainly parkinsonism or dystonia), while 92.2 % (n=59) had no neurological comorbidity. 39.1% (n=25) presented gait disorders (akinesia, ataxia or dyssynergia), 28.1% (n=18) fixed or mobile limb dystonia, 9.4% (n=6) oromandibular dystonia, 14.1% (n=9) hyposthenic/dysfunctional hemi-syndrome, 20.3% (n=13) mono- or para-paresis and 7.8% (n=5) tremor. 67.2 % of the patients (n=43) performed movement analysis. 14.1 % of the patients (n=9) did not obtain benefits from the rehabilitation, while 86.0 % (n=55) obtained a temporary or definitive benefit, 15 among them obtained a full recovery or a dramatic reduction of symptoms. Technical assessments strongly eased the clinical decoding of patients’ FMDs improving the individual rehabilitation project

Conclusion: Instrumental assessment and technological rehabilitation may pave the way to a deeper understanding of neural mechanisms behind FMDs, permitting also the identification of homogeneous groups of patients and of reliable predictors of outcome, in order to develop more specific rehabilitation programs

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MDS Abstracts - https://www.mdsabstracts.org/abstract/technological-approach-to-phenotypical-characterization-of-functional-movement-disorders/