Objective: To present six young athletes with functional movement disorder (FMD) engaged in competitive high school or college sports.

Background: FMD is defined by involuntary movements with high distractibility and variability, incongruent with other neurological disorders. Female gender and adverse childhood events are well known risk factors for FMD, and both physical and psychological stressors have been identified as common trigger factors¹. Little is known about FMD in competitive athletes, who are often exposed to physical injuries and a high stress environment. In this case series, we sought to describe the clinical presentation and treatment outcomes of young athletes with FMD undergoing a multidisciplinary rehabilitation program at our center².

Method: A retrospective case review was performed of patients with FMD undergoing an inpatient rehabilitation program at Frazier Rehab Institute in Louisville, KY, between January 2016 and December 2018. Patients were included if they were actively involved in competitive high school or college sports at the time of FMD symptom onset.

Results: We identified 6/73 patients with FMD involved in competitive high school or college sports. Patients were predominantly female (5F : 1M) and had an average age of 21 (SD 3.0). All patients were engaged in team sports and described either a physical (n=4) or psychological (n=2) stress factor before onset of FMD symptoms. Diagnostic delays were common, and 2/6 patients underwent surgeries including an intrathecal pain pump placement prior to diagnosis of FMD. Treatment outcomes were favorable in 5/6 patients, with complete remission in three and partial remission in two cases. One patient showed initial improvement but relapsed quickly.

Conclusion: Participating in sports has many advantages for young adults and not only improves physical health, but also carries psychological and social benefits. Competitive athletes are however also under a high amount of performance pressure and at increased risk for harassment and abuse, which is increasingly recognized by professional sports organizations. Both physical injuries and psychological stress factors are well recognized trigger factors for FMD and may be more prevalent in competitive athletes compared to their peers. Improved awareness of FMD in the public and among medical professionals involved in sports medicine may help to optimize recognition and treatment outcomes for young athletes with FMD.

References: 1. Parees I, Kojovic M, Pires C, Rubio-Agusti I, Saifee TA, Sadnicka A, et al. Physical precipitating factors in functional movement disorders. Journal of the neurological sciences. 2014;338(1-2):174-7. 2. Jacob AE, Kaelin DL, Roach AR, Ziegler CH, LaFaver K. Motor Retraining (MoRe) for Functional Movement Disorders: Outcomes From a 1-Week Multidisciplinary Rehabilitation Program. PM R. 2018;10(11):1164-72.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/functional-movement-disorder-in-young-athletes-a-retrospective-case-series/