900 Section - Breaking The Myth: Do FND patients Benefit Equally from Inpatient Neurorehabilitation

Functional Neurological Disorders (FNDs) are common, comprising up to 30% of the Neurology caseload. Current evidence suggests multidisciplinary rehabilitation is effective in FND, but the actual functional gains are not clear from the current literature. 

Aims: To assess the outcomes of FND patients who received inpatient rehabilitation in a specialist rehabilitation unit to inform clinical practice and guide future research in this field.

Design:

A service evaluation of admission, discharge and final follow-up (three timepoints) functional ability using Functional Independence Measure (FIM), Functional Assessment Measure (FAM), Activities of Daily Living (ADL), and Rehabilitation Complexity Scale (RCS) data from 18 FND patients over two years. Patient satisfaction, their perception of recovery and information regarding their return to work or education was also collected. 

Results: The mean length of stay for patients in the rehabilitation unit was 80 days (11-162 days). The final follow up was at median of 10 months post-discharge (3-24 months). The FIM score increased from a median 84.5 (IQR 58, 93) at admission to 114.5 (82, 120) at discharge, and maintained at 111.5 (77.5, 119) at final follow-up. The FIM + FAM scores increased from 152.5 (119.5, 159.5) at admission to 188.5 (163.25, 200.5) at discharge, and at final follow-up it was 187 (135.25, 196). The ADL score has improved on discharge, and maintained at follow-up.Given that the literature suggests the Minimal Clinically Important Difference value for FIM is 22, these scores demonstrated a clinically significant improvement in functional outcomes at discharge, which were maintained at follow-up. Qualitative feedback indicated that most patients were satisfied with their stay in the rehabilitation unit.

Conclusion:

Individuals with FND achieved clinically significant and sustained functional improvements from inpatient neurorehabilitation programmes. Rehabilitation units must accept FND patients for inpatient rehabilitation similar to other neurological conditions.