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Review article
Physiotherapy for patients with functional movement disorder: a systematic review
Tratamiento fisioterápico del paciente con trastorno del movimiento funcional: una revisión sistemática
P. Molero-Mateoa,b, F. Molina-Ruedac,
Corresponding author
Francisco.molina@urjc.es

Corresponding author.
a Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, Móstoles, Madrid, Spain
b Centro Lescer (rehabilitación neurológica), Madrid, Spain
c Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
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including paralysis&#44; tremor&#44; dystonia&#44; sensory alterations&#44; speech alterations&#44; and seizures&#46; Patients with FND present positive clinical symptoms&#44; which are not correlated with a pathophysiological cause&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> The term &#8220;functional&#44;&#8221; replacing the former term &#8220;psychogenic&#44;&#8221; is more neutral in its reference to the aetiology of the condition&#44; improving understanding and acceptance by patients&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> To achieve adequate communication&#44; it is vital that diagnostic labels are useful and are accepted by physicians and patients alike&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Additional changes to the definition of FND were introduced in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders &#40;DSM-5&#41;&#46; In this latest edition of the DSM&#44; diagnosis of FND is based on the positive identification of physical symptoms that are not correlated with neurological disease&#59; psychiatric comorbidities are not a necessary condition for diagnosis&#46; Diagnosis of FND does not exclude other conditions&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">From an epidemiological viewpoint&#44; FND is one of the most frequent causes of neurological disability&#46; It has an incidence of 4&#8211;12 cases per 100 000 person-years&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;9</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">In a study published in 2018&#44; Espay et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> established several types of FND&#58; motor FND&#44; FND with sensory manifestations&#44; axial FND &#40;disorders of gait and posture&#41;&#44; speech FND&#44; and paroxysmal FND&#46; Within the spectrum of motor FNDs&#44; the term functional movement disorder &#40;FMD&#41; is used in reference to such symptoms as weakness&#44; paralysis&#44; tremor&#44; and dystonia&#44; which are not caused by a typical neurological disease&#46; FMD is generally associated with a high degree of disability and poor prognosis&#44; and has a great economic burden&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#8211;13</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Clinical features suggestive of FMD include sudden disease onset&#44; disappearance of symptoms with distraction and exacerbation with attention&#44; and excessive fatigue&#46; Diagnosis is based on detection during the neurological examination of typical features of FMD that are incongruous with an organic disorder and inconsistent over time and between tasks&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Several sets of diagnostic criteria have been proposed&#44; but they present low inter-rater reliability when applied to movement disorders with nonspecific symptoms&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> Among the most widely used criteria&#44; we should mention those proposed by Gupta and Lang&#44;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> who introduce the diagnostic category of laboratory-supported definite FMD based on electrophysiological findings of psychogenic myoclonus&#59; the authors use electromyography and electroencephalography to evaluate premovement potentials and psychogenic tremor&#46; These criteria have recently been updated by Espay et al&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">In recent years&#44; neuroimaging studies have revealed alterations in brain network function and metabolic demands during task execution&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> Furthermore&#44; in patients with FMD&#44; abnormal differential weighting of ascending and descending sensory data leads to prediction errors about sensory data&#44; which&#44; together with body-focused attention&#44; generates abnormal perceptions or movements&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Another differential feature of these patients is a reduced sense of agency&#44; a process of retrospective assessment of an action and its expected and actual sensory outcomes&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> In this sense&#44; patients with FMD perceive their movements&#44; or lack thereof&#44; as involuntary&#46; Furthermore&#44; several major predisposing and reinforcing factors have been described&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Prognosis of FMD is usually poor due to under-recognition of this condition among healthcare professionals&#46; Another relevant factor is health status before treatment&#46; It is widely known that long-standing symptoms are associated with poor prognosis&#44; whereas young age and early diagnosis are indicators of favourable prognosis&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">There is growing evidence of the effectiveness of physical therapy &#40;movement retraining&#41; and cognitive-behavioural therapy&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21&#44;22</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">In 2013&#44; Nielsen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> published a systematic review of physical therapy interventions for the management of functional motor symptoms&#46; Despite its great value&#44; the study has several methodological limitations&#46; Firstly&#44; the studies reviewed presented significant methodological differences&#58; except for one retrospective&#44; controlled study&#44;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> all studies were case reports or case series&#44; and no prospective study was included&#46; Secondly&#44; none of the studies was randomised&#44; and most included small samples &#40;only 7 of the 29 studies included samples of more than 10 patients&#41;&#46; Lastly&#44; most of the studies were performed in hospital settings&#59; therefore&#44; their results cannot be extrapolated to the outpatient setting&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">In the light of the above&#44; we conducted a systematic literature search of studies published after the publication of the review by Nielsen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">The purpose of this study is to analyse the available evidence on the effects of physical therapy on motor symptoms&#44; activity &#40;gait&#44; mobility&#44; balance&#41;&#44; perceived health status&#44; quality of life&#44; and cognitive and emotional status in patients with FMD&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Databases and search strategy</span><p id="par0075" class="elsevierStylePara elsevierViewall">In March 2021&#44; we consulted the following databases&#58; Web of Science&#44; PubMed&#44; Scopus&#44; and the BRAIN resource search engine of Universidad Rey Juan Carlos &#40;Madrid&#41;&#46; The following keywords were used&#58; &#8220;physical therapy&#44;&#8221; &#8220;physiotherapy&#44;&#8221; &#8220;rehabilitation&#44;&#8221; &#8220;functional movement disorders&#44;&#8221; &#8220;functional motor symptoms&#44;&#8221; and &#8220;psychogenic motor symptoms&#44;&#8221; combined with the Boolean operator AND &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; We considered protocols published in registries and manually searched the references cited in the studies gathered in our literature search to identify relevant studies&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Eligibility criteria</span><p id="par0080" class="elsevierStylePara elsevierViewall">We established the following inclusion criteria&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#8226;</span><p id="par0085" class="elsevierStylePara elsevierViewall">Study type&#58; randomised&#44; controlled trials written in English or Spanish and published since 2013</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#8226;</span><p id="par0090" class="elsevierStylePara elsevierViewall">Participants&#58; studies including patients with a diagnosis of FMD</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#8226;</span><p id="par0095" class="elsevierStylePara elsevierViewall">Type of intervention&#58; studies analysing the effect of specialised physical therapy interventions&#44; alone or combined with other therapies in a multidisciplinary approach&#44; and comparing the effects of a specialised physical therapy intervention against those of standard physical therapy</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">&#8226;</span><p id="par0100" class="elsevierStylePara elsevierViewall">Outcome measures&#58; studies evaluating changes in motor symptoms&#44; activity &#40;gait&#44; mobility&#44; balance&#41;&#44; perceived health status&#44; quality of life&#44; or cognitive or emotional status&#46;</p></li></ul></p><p id="par0105" class="elsevierStylePara elsevierViewall">We excluded articles whose design was incomplete or that did not describe the outcome of the intervention&#44; as well as those including heterogeneous samples or patients with different types of FND&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Study selection and data extraction</span><p id="par0110" class="elsevierStylePara elsevierViewall">We gathered data on the sample included in each study&#44; applied the inclusion and exclusion criteria&#44; gathered outcome measures&#44; described interventions&#44; and collected data on the outcome of the intervention&#46; One of the authors of this study reviewed the titles and abstracts to determine whether the articles gathered met the inclusion criteria&#46; The full texts of articles potentially meeting all inclusion criteria was examined in greater detail&#46; The final selection of studies was performed by the author and another researcher&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Evaluation of methodological quality and risk of bias</span><p id="par0115" class="elsevierStylePara elsevierViewall">The Oxford Quality Scoring System<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> was used to assess the methodological quality and objectiveness of the studies included&#58; scores &#60;&#8239;3 indicate poor methodological quality&#44; scores of 3&#8211;4 indicate moderate methodological quality&#44; and a score of 5 indicates high methodological quality&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">To evaluate the risk of bias of each trial&#44; we used the Cochrane risk of bias tool&#44; which assesses random sequence generation&#44; allocation concealment&#44; blinding of participants and personnel&#44; blinding of outcome assessment&#44; incomplete outcome data&#44; selective outcome reporting&#44; and other potential sources of bias&#46; Each domain is rated as presenting low&#44; high&#44; or unclear risk of bias&#46; The literature review was conducted following the recommendations of the PRISMA statement&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> Methodological quality and risk of bias were evaluated by the lead author&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Results</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Study selection</span><p id="par0125" class="elsevierStylePara elsevierViewall">A total of 360 articles were retrieved&#59; after excluding duplicate articles&#44; 186 original articles were included for review&#46; We read the abstracts of potentially eligible articles to determine whether they were relevant for our review and met the inclusion criteria&#46; We finally included 4 studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">26&#8211;29</span></a> reporting data from a total of 188 participants&#46; The study selection process is described in the flow chart in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Study characteristics and synthesis of results</span><p id="par0130" class="elsevierStylePara elsevierViewall">All 4 studies used physical therapy as part of the therapeutic intervention&#46; Two studies applied a specialised education-based physical therapy programme&#44; movement retraining &#40;to restore normal function redirecting the attentional focus&#41;&#44; and self-management plan using a workbook&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">27&#44;28</span></a> One study proposed combining physical therapy with cognitive-behavioural therapy using distraction techniques&#44; motor strategies to reduce tremor&#44; and low&#47;moderate-intensity walking&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> The remaining study developed a programme of adapted physical activity within a multidisciplinary cognitive-behavioural framework &#40;the 3 main elements of the intervention were explaining symptoms&#44; positively reinforcing normal function&#44; and not positively reinforcing dysfunction&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">Control groups generally received standard medical care<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> or standard physical therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> In one of the studies&#44; the control group did not receive physical therapy&#44;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> and in the remaining study&#44; controls received the same treatment as the intervention group but started 4 weeks later&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">In 2 studies&#44; the intervention took place on an outpatient basis&#44;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">26&#44;27</span></a> whereas the remaining 2 studies used inpatient programmes&#46;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">28&#44;29</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">Session duration ranged from 45 to 90&#8239;minutes per day<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">26&#8211;28</span></a>&#59; this information is not reported in the study by Jordbru et al&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> The duration of the intervention varied greatly&#58; in one study&#44;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> participants underwent intensive treatment for 5 consecutive days&#59; in another&#44;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> the intervention lasted 3 weeks&#59; another study<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> designed a 12-week intervention &#40;2 weekly sessions&#41;&#59; whereas in the study by Teodoro et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> the duration of the intervention is not specified&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">In all studies&#44; participants were followed up after the intervention&#59; follow-up time ranged from 4 weeks to one year&#46; In 2 studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">26&#44;27</span></a> participants attended a single follow-up consultation&#44; whereas in the remaining 2&#44;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">28&#44;29</span></a> they were assessed at 2 different time points&#58; one at 1&#47;3 months postintervention and the second at 6&#47;12 months postintervention&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">According to the results of these studies&#44; physical therapy improves motor symptoms&#44; activity&#44; quality of life&#44; and perceived health status&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Motor symptoms and activity</span><p id="par0160" class="elsevierStylePara elsevierViewall">Outcome measures evaluating motor function varied between studies&#46; Teodoro et al&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> used surface electroencephalography to analyse motor performance&#44; reaction time&#44; and beta-frequency cortical oscillations during reaction time tasks with predictive and nonpredictive cues&#46; They found that reaction times did not improve in patients with FMD when the cue was predictive of the upcoming movement&#46; These patients displayed persistent beta synchronisation and lack of lateralised beta desynchronisation during motor preparation&#59; this is explained by the abnormal explicit movement control observed in these patients as a result of excessive self-directed attention&#46; This points to impaired motor performance&#44; as event-related beta desynchronisation indicates movement preplanning and preparation&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">After the intervention&#44; Nielsen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> observed improved performance in the Berg Balance Scale&#59; Timed 10-Meter Walk Test&#59; Functional Mobility Scale&#59; Disabilities of the Arm&#44; Shoulder&#44; and Hand questionnaire&#59; and Brief Illness Perception Questionnaire&#46; Perception of motor symptoms improved in 72&#37; of patients in the intervention group&#44; as compared to only 18&#37; in the control group&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Jordbru et al&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> reported significant improvements in gait and functional independence&#44; as measured with the Functional Mobility Scale and the Functional Independence Measure&#46; These improvements remained at one month and one year of follow-up&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Quality of life and perceived health status</span><p id="par0175" class="elsevierStylePara elsevierViewall">After the physical therapy programme&#44; Teodoro et al&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> observed higher scores on the physical function domain of the Short Form-36 Health Survey &#40;SF-36&#41;&#46; Similarly&#44; Nielsen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> observed significant increases in 3 domains of the SF-36&#58; physical function&#44; physical role&#44; and social function&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Jordbru et al&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> reported significant improvements in the physical and mental domains of the SF-12 after treatment&#46; However&#44; at the follow-up consultation&#44; these improvements remained significant only in the physical domain&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">In the study by Dallocchio et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> controls displayed improvements in the severity and functional impact subscales of the Psychogenic Movement Disorders Rating Scale after treatment&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Cognitive and emotional status</span><p id="par0190" class="elsevierStylePara elsevierViewall">Several studies evaluated depression and anxiety&#46; Nielsen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> used the Hospital Anxiety and Depression Scale&#44; finding no significant differences between groups&#46; In the study by Dallocchio et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> Hamilton Depression Rating Scale and Beck Anxiety Inventory scores were used as secondary outcome measures&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Study characteristics are summarised in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Assessment of methodological quality</span><p id="par0200" class="elsevierStylePara elsevierViewall">According to the Oxford Quality Scoring System&#44; 3 studies presented moderate to high methodological quality<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">26&#44;28&#44;29</span></a> and one presented poor methodological quality&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> Given the nature of the intervention&#44; participants were not blind to the treatment in any study&#59; neither were the raters&#44; in some cases&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Assessment of risk of bias</span><p id="par0205" class="elsevierStylePara elsevierViewall">Two studies<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">26&#44;27</span></a> presented an unclear risk of bias arising from the randomisation process&#59; risk of bias was low in the remaining 2&#46; All studies presented a low risk of bias due to deviations from the intended interventions&#46; All studies presented a low risk of bias due to missing outcome data&#46; Two studies<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">28&#44;29</span></a> presented a high risk of bias in measurement of the outcome&#59; risk of bias was low in the remaining 2&#46; Risk of bias due to selective outcome reporting was low in all 4 studies&#46; Overall risk of bias was unclear in all studies &#40;<a class="elsevierStyleCrossRefs" href="#fig0010">Figs&#46; 2 and 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Discussion</span><p id="par0210" class="elsevierStylePara elsevierViewall">In recent years&#44; there has been growing clinical and research interest in FMD&#59; this can be seen in the large number of studies on the topic published in the last decade&#46; FMD may be identified with the current diagnostic criteria&#59; however&#44; diagnosis is not based on exclusion&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> Much remains to be known about the pathophysiological and neurobiological causes of the disorder&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0215" class="elsevierStylePara elsevierViewall">Neuroimaging has played a pivotal role in identifying and reshaping our understanding of FMD&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17&#44;18&#44;30</span></a> These studies have identified structural and functional abnormalities in the central nervous system that involve hypoactivation of cortical and subcortical motor pathways&#44; as well as increased modulation by the limbic system&#46; Neurobiological theories point to impaired regulation of motor movement and abnormal emotional processing in these patients&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">There is broad consensus that treatment for FMD should be provided by specialised multidisciplinary units&#46; Treatment focuses on retraining activity&#44; with physiotherapists playing an essential role&#46; According to the paradigm of the International Classification of Functioning&#44; Disability and Health &#40;ICF&#41;&#44; patients are diagnosed based on the presence of certain deficits&#59; however&#44; specific tools must subsequently be used to evaluate activity limitation and participation restriction&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a></p><p id="par0225" class="elsevierStylePara elsevierViewall">This review analyses the most recent scientific evidence on physical therapy for FMD&#46; Treatment must be multidisciplinary&#44; aiming to educate patients about their disease&#44; achieve motor retraining&#44; and provide self-care strategies&#46; Specialised physical therapy programmes improve motor symptoms and activity&#44; which in turn improves perceived health status and quality of life&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">All the studies included in our review analysed specialised physical therapy interventions&#46; Only one combined physical therapy with cognitive-behavioural therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> As mentioned previously&#44; physical therapy is based on 3 pillars&#58; education&#44; movement retraining&#44; and a self-management plan&#46; Education is essential for patients to understand their diagnosis and symptoms and actively participate in treatment&#46; Movement retraining shows patients that normal movement is possible in the context of routine daily activities&#46; The key to retraining is to minimise self-directed attention through distraction &#40;music&#44; changes in rhythm&#44; tapping&#41;&#59; this reduces cognitive control of movement&#44; which becomes more automatic&#46; To retrain movement&#44; movements are broken down into elementary asymptomatic motor components&#44; which are subsequently rearranged to reconstruct a normal movement pattern&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> In this process&#44; neurorehabilitation uses the general principles of movement retraining<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a>&#58; repetition of task-oriented exercises&#44; gradually increasing task difficulty&#44; and feedback &#40;mirror training&#44; videos&#44; EMG&#44; etc&#46;&#41;&#46; Lastly&#44; a self-management plan is essential&#59; this is usually based on the use of a workbook&#46; The contents of the workbook include strategies aimed at normalising movement&#44; a list of precipitating and perpetuating factors&#44; markers of progress&#44; and future goals&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">33</span></a></p><p id="par0235" class="elsevierStylePara elsevierViewall">The studies included in our review used highly variable programmes&#44; both in terms of number of sessions and in the duration of each session and the overall intervention&#46; Interventions took place on an outpatient basis in 2 studies and with inpatient programmes in the remaining 2&#46; Broadly speaking&#44; inpatient treatment programmes are more intensive&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> However&#44; in other studies not included in our review &#40;both prospective and retrospective&#41;&#44; interventions were predominantly inpatient programmes&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">34&#8211;40</span></a> However&#44; studies of outpatient interventions have been published that include large samples and report favourable results<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">41</span></a>&#59; some studies employ a mixed design&#44; where patients complete an inpatient rehabilitation programme followed by a supervised&#44; home-based self-management plan&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">42</span></a></p><p id="par0240" class="elsevierStylePara elsevierViewall">Most studies used pre-established similar inclusion criteria for selection of participants&#44; such as those proposed by Gupta and Lang&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a></p><p id="par0245" class="elsevierStylePara elsevierViewall">All studies included long follow-up times&#44; with patients being monitored in the medium and long term&#46; This seems reasonable due to the chronic nature of the disease and the need to evaluate whether the benefits of the intervention are persistent&#46;</p><p id="par0250" class="elsevierStylePara elsevierViewall">The outcome measures used to evaluate changes varied according to the factor analysed&#58; motor symptoms&#44; activity and quality of life&#44; perceived health status&#44; and cognitive and emotional status&#46; In all studies&#44; the physical therapy intervention resulted in improvements in scale scores&#46; Some researchers have focused on the development of assessment tools specifically designed for FMD&#44; such as the Psychogenic Movement Disorders Rating Scale<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">43</span></a> and the more recent Simplified Functional Movement Disorders Rating Scale&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">44</span></a> Several authors<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">31&#44;45</span></a> have reviewed these scales and issued recommendations on the most appropriate outcome measures&#46; Although standardisation of specialised physical therapy for FMD is currently underway&#44; the approaches proposed by different authors continue to present discrepancies&#46; The multicentre study by Nielsen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">46</span></a> may shed some light onto some of these questions&#44; given the large population included and the fact that it mixes both inpatient and outpatient interventions&#46;</p><p id="par0255" class="elsevierStylePara elsevierViewall">Telerehabilitation programmes have recently been introduced in clinical practice&#44; such as those developed by Gelauff et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">47</span></a> in which patients had access to a non-guided education and self-help website in addition to standard care&#44; and by Demartini et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">48</span></a> who combined in-person sessions and telemedicine sessions&#46; It remains to be determined whether telerehabilitation alone is sufficient or whether it should be applied in the context of a multidisciplinary in-person treatment programme&#46; There can be no doubt that new technologies enable more fluent patient-therapist communication&#44; improving patients&#8217; access to relevant information on their condition&#46;</p><p id="par0260" class="elsevierStylePara elsevierViewall">This systematic review presents a number of limitations&#46; Firstly&#44; it includes a limited number of studies&#44; which resulted in a small sample of patients&#46; Secondly&#44; the intervention varied between studies&#46; Furthermore&#44; the number and duration of the sessions varied between studies&#44; preventing us from objectively comparing their results&#46; Lastly&#44; as we only included studies published in English or Spanish&#44; we may have missed relevant studies in other languages&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Conclusions</span><p id="par0265" class="elsevierStylePara elsevierViewall">Physical therapy for patients with FMD improves motor symptoms&#44; activity&#44; perceived health&#44; and quality of life&#46; However&#44; there is a need for further well-designed studies to evaluate the effects of this type of intervention in different contexts and establish the most appropriate dose and treatment approach for each patient&#44; as well as reliable outcome measures&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conflicts of interest</span><p id="par0270" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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    "fechaRecibido" => "2021-07-23"
    "fechaAceptado" => "2022-01-15"
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            0 => "Physiotherapy"
            1 => "Neurorehabilitation"
            2 => "Physical therapy"
            3 => "Motor retraining"
            4 => "Functional movement disorder"
            5 => "Functional neurological disorder"
            6 => "Functional motor symptoms"
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            0 => "Fisioterapia"
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            2 => "Terapia f&#237;sica"
            3 => "Reentrenamiento motor"
            4 => "Trastorno del movimiento funcional"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Functional movement disorder &#40;FMD&#41;&#44; a type of functional neurological disorder&#44; is a common reason for consultation with the neurology department&#46; The efficacy of physiotherapy for motor rehabilitation of these patients has been widely studied&#46; The aim of this review is to analyse the available evidence on the effects of physiotherapy on motor symptoms&#44; activity &#40;gait&#44; mobility&#44; balance&#41;&#44; perceived health&#44; quality of life&#44; and the cognitive&#47;emotional state of patients with FMD&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">This review follows the PRISMA recommendations&#46; Four electronic databases were searched for relevant articles&#46; Our review included randomised controlled trials investigating the effects of a specialised physiotherapy intervention alone or in combination with other therapies as part of a multidisciplinary approach&#44; with results compared against standard physiotherapy&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">We reviewed 4 studies&#44; including a total of 188 patients&#46; We gathered data on the study population&#44; outcome measures&#44; protocols&#44; and results&#46; According to the Oxford quality scoring system&#44; 3 studies had moderate methodological quality &#40;3&#8211;4&#47;5&#41; and the remaining study presented poor methodological quality &#40;&#60;&#8239;3&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Physiotherapy improves motor symptoms&#44; activity&#44; perceived health&#44; and quality of life in patients with FMD&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">El trastorno del movimiento funcional &#40;TMF&#41; se engloba dentro de los trastornos neurol&#243;gicos funcionales &#40;TNF&#41;&#46; Este constituye un motivo de consulta habitual en el &#225;mbito de la neurolog&#237;a&#46; La eficacia del tratamiento de fisioterapia en la rehabilitaci&#243;n motora de estos pacientes es un campo ampliamente estudiado&#46; El objetivo de esta revisi&#243;n es analizar la evidencia cient&#237;fica existente sobre los efectos del tratamiento fisioter&#225;pico en las manifestaciones motoras&#44; la actividad &#40;marcha&#44; movilidad&#44; equilibrio&#41;&#44; la percepci&#243;n de salud&#44; la calidad de vida o el estado cognitivo-emocional de las personas con TMF&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Esta revisi&#243;n se llev&#243; a cabo siguiendo las recomendaciones de la declaraci&#243;n PRISMA&#46; Se realizaron b&#250;squedas sistem&#225;ticas en 4 bases de datos electr&#243;nicas para localizar resultados pertinentes&#46; Se incluyeron ensayos controlados aleatorizados que investigasen los efectos de una intervenci&#243;n de fisioterapia especializada&#44; de manera aislada o combinada con otras terapias dentro de un marco multidisciplinar&#59; comparando su aplicaci&#243;n con el tratamiento fisioter&#225;pico est&#225;ndar&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 4 estudios con un total de 188 sujetos&#46; Se extrajeron datos sobre la poblaci&#243;n&#44; las medidas de resultado&#44; los protocolos y los resultados&#46; Se aplic&#243; el sistema de puntuaci&#243;n de calidad de Oxford&#44; obteni&#233;ndose 3 estudios con una calidad metodol&#243;gica moderada &#40;3-4&#47;5&#41; y un estudio con calidad metodol&#243;gica baja &#40;&#60;3&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">El tratamiento de fisioterapia en personas diagnosticadas con TMF genera cambios positivos en su sintomatolog&#237;a motora&#44; actividad&#44; percepci&#243;n de salud y calidad de vida&#46;</p></span>"
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                  \t\t\t\t">Physical Therapy AND Functional Movement Disorders&nbsp;\t\t\t\t\t\t\n
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          "leyenda" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">10MWT&#58; Timed 10-Meter Walk Test&#59; APA&#58; adjunctive physical therapy&#59; BAI&#58; Beck Anxiety Inventory&#59; BBS&#58; Berg Balance Scale&#59; B-IPQ&#58; Brief Illness Perception Questionnaire&#59; CBT&#58; cognitive-behavioural therapy&#59; CGI&#58; Clinical Global Impression scale&#59; DASH&#58; Disabilities of the Arm&#44; Shoulder and Hand questionnaire&#59; EEG&#58; electroencephalography&#59; EQ-5D-5L&#58; European Quality of Life 5 Dimensions 5 Level version&#59; FIM&#58; Functional Independence Measure&#59; FMS&#58; Functional Mobility Scale&#59; CG&#58; control group&#59; IG&#58; intervention group&#59; HADS&#58; Hospital Anxiety and Depression Scale&#59; HDS&#58; Hamilton Depression Scale&#59; M&#58; men&#59; PHQ-15&#58; Patient Health Questionnaire-15&#59; PMDRS&#58; Psychogenic Movement Disorders Rating Scale&#59; QALY&#58; quality-adjusted life year&#59; SD&#58; standard deviation&#59; SF-12&#58; 12-Item Short Form Survey&#59; SF-36&#58; Short Form-36 Health Survey&#59; FMD&#58; functional movement disorder&#59; W&#58; women&#59; WSAS&#58; Work and Social Adjustment Scale&#46;</p>"
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                  \t\t\t\t">Dallocchio et al&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">IG<span class="elsevierStyleInf">1</span>&#58; n&#8239;&#61;&#8239;11&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">IG<span class="elsevierStyleInf">1</span>&#58; CBT&#44; 90&#8239;min &#40;1 session&#47;week&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">Primary&#58; PMDRS at T0 and T1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">The total PMDRS score &#40;severity&#8239;&#43;&#8239;functional impact&#41; represented the primary outcome&#44; whereas the 2 PMDRS subscores and HDS&#44; BAI&#44; and PHQ-15 scores represented secondary outcomes&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age&#58; 34&#46;7 years &#40;SD&#58; 10&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IG<span class="elsevierStyleInf">2</span>&#58; CBT&#8239;&#43;&#8239;APA &#40;distraction techniques&#44; motor strategies to reduce tremor and gait impairment&#41;&#44; 2 60-min sessions&#47;week&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sex&#58; 2 M&#47;9 W&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CG&#58; standard care&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Secondary&#58;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Improvements were observed between baseline &#40;T0&#41; and postintervention scores &#40;T1&#41; in primary and secondary outcomes in both IGs &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#60;&#8239;&#46;001&#41;&#46; No changes were observed in the CG &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#62;&#8239;&#46;05&#41;&#46; No significant differences were observed between the 2 IGs &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#62;&#8239;&#46;05&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Symptom duration&#58; 17&#46;1 months &#40;SD&#58; 12&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">- HDS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Treatment&#58; 12 weeks &#40;outpatient&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">- BAI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IG<span class="elsevierStyleInf">2</span>&#58; n&#8239;&#61;&#8239;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Follow-up&#58; after 12 weeks in IG&#44; or after 9 weeks in CG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">- PHQ-15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age&#58; 33&#46;7 years &#40;SD&#58; 7&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sex&#58; 4 M&#47;6 W&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Symptom duration&#58; 20&#46;7 months &#40;SD&#58; 10&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CG&#58; n&#8239;&#61;&#8239;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age&#58; 32&#46;9 years &#40;SD&#58; 9&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sex&#58; 2 M&#47;6 W&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Symptom duration&#58; 9&#46;8 months &#40;SD&#58; 7&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Teodoro et al&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IG&#58; n&#8239;&#61;&#8239;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IG&#58; EEG analysis of motor performance and beta-frequency cortical oscillations during a reaction time task&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SF-36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Reaction times were similar between patients receiving predictive and nonpredictive cues&#44; both at baseline &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#61;&#8239;&#46;430&#41; and after the intervention &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#61;&#8239;&#46;203&#41;&#46; However&#44; in the IG&#44; predictive cues showed a trend toward a lower beta power in the contralateral hemisphere &#40;mean of &#8211;0&#46;068 &#91;95&#37; CI&#44; &#8211;0&#46;313 to 0&#46;176&#93; vs 0&#46;146 &#91;95&#37; CI&#44; &#8211;0&#46;1 to 0&#46;390&#93;&#59; <span class="elsevierStyleItalic">P</span>&#8239;&#61;&#8239;&#46;065&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age&#58; 42&#46;7 &#40;SD&#58; 12&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 patients received specialised physical therapy &#40;education&#44; movement retraining&#44; and self-management plan&#41; and 12 patients received standard physical therapy&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EEG&#44; reaction time&#44; and beta power&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sex&#58; 4 M&#47;17 W&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CG&#58; no intervention&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">After treatment&#44; the IG showed higher scores on the physical function domain of the SF-36 &#40;mean &#91;SD&#93; of 30 &#91;21&#46;6&#93; at onset vs 40 &#91;30&#93; at follow-up&#59; <span class="elsevierStyleItalic">P</span>&#8239;&#61;&#8239;&#46;029&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diagnosis of FMD&#59; main symptoms were weakness &#40;n&#8239;&#61;&#8239;11&#41; and tremor &#40;n&#8239;&#61;&#8239;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Treatment&#58; not described &#40;outpatient&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CG&#58; n&#8239;&#61;&#8239;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Follow-up&#58; after a mean of 4&#46;7 weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age&#58; 41&#46;2 &#40;SD&#58; 14&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sex&#58; 4 M&#47;9 W&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Healthy individuals&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nielsen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IG&#58; n&#8239;&#61;&#8239;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IG&#58; 8 sessions &#40;45&#8211;90&#8239;min&#41; of specialised physical therapy &#40;education&#44; movement retraining&#44; and a self-management plan&#41; for 5 consecutive days&#46; Explanation of diagnosis before the intervention&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SF-36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">At 6 months&#44; the IG showed higher scores on 3 domains of the SF-36&#58; physical function &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#60;&#8239;&#46;01&#41;&#44; physical role &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#61;&#8239;&#46;037&#41;&#44; and social function &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#61;&#8239;&#46;007&#41;&#46; They also performed better on the BBS &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#61;&#8239;&#46;003&#41;&#44; 10MWT &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#61;&#8239;&#46;001&#41;&#44; FMS &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#60;&#8239;&#46;001&#41;&#44; DASH &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#61;&#8239;&#46;031&#41;&#44; and B-IPQ &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#61;&#8239;&#46;015&#41;&#46; No significant differences were observed in the remaining scales&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age&#58; 44 years &#40;SD&#58; 13&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sex&#58; 8 M&#47;22 W&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CG&#58; standard physical therapy &#40;1-17 sessions&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">QALY&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Motor symptoms improved in 72&#37; of individuals in the IG&#44; vs 18&#37; in the CG&#46; Symptoms worsened as compared to baseline in 32&#37; of individuals in the CG&#44; vs 3&#37; in the IG&#46; QALY in IG&#58; 0&#46;34&#59; QALY in CG&#58; 0&#46;26&#46; Mean gain of 0&#46;08 QALY per patient &#40;the intervention was cost-effective&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Symptom duration&#58; 5&#46;9 years &#40;SD&#58; 8&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HADS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Treatment&#58; 5 consecutive days &#40;inpatient&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EQ-5D-5L&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CG&#58; n&#8239;&#61;&#8239;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Follow-up&#58; at 4 weeks and at 6 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">WSAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age&#58; 41 years &#40;SD&#58; 13&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CGI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sex&#58; 9 M&#47;21 W&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DASH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Symptom duration&#58; 5&#46;6 years &#40;SD&#58; 6&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">FMS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BBS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B-IPQ&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10MWT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Jordbru et al&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IG&#58; n&#8239;&#61;&#8239;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IG&#58; immediate intervention for 3 weeks &#40;inpatient&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">FIM&#58; motor and cognitive domains&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">The IG showed significant improvements in gait and quality of life as compared to the CG&#46; These improvements remained at 1 month and 1 year of follow-up&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age&#58; 38&#46;8 &#40;12&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">FMS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">FMS&#58; mean difference of 6&#46;9 units &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#60;&#8239;&#46;001&#59; 95&#37; CI&#44; 5&#46;5&#8211;8&#46;3&#41; after treatment&#46; At follow-up&#58; 8&#46;1 units &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#60;&#8239;&#46;001&#59; 95&#37; CI&#44; 5&#46;9&#8211;10&#46;3&#41;&#46; FIM&#58; mean difference of 8&#46;4 units &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#60;&#8239;&#46;001&#59; 95&#37; CI&#44; 5&#46;2&#8211;11&#46;7&#41;&#46; At follow-up&#58; 9&#46;2 units &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#60;&#8239;&#46;001&#59; 95&#37; CI&#44; 5&#46;4&#8211;13&#46;1&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sex&#58; 6&#8239;M&#47;25 W&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CG&#58; same intervention after a waiting time of 4 weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SF-12&#58; physical and mental health domains&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">The SF-12 revealed significant treatment effects&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Symptom duration&#58; 8&#46;3 months &#40;SD&#58; 10&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intervention&#58; adapted physical activity with an educational and cognitive-behavioural frame of reference by a multidisciplinary team&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Physical domain&#58; mean difference of 11&#46;7 units between groups &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#60;&#8239;&#46;001&#59; 95&#37; CI&#44; 7&#46;2&#8211;16&#46;1&#41; and of 14&#46;1 between baseline and follow-up &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#60;&#8239;&#46;001&#59; 95&#37; CI&#44; 5&#46;9&#8211;22&#46;2&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CG&#58; n&#8239;&#61;&#8239;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mental domain&#58; mean difference of 6&#46;9 units between groups &#40;<span class="elsevierStyleItalic">P</span>&#8239;&#60;&#8239;&#46;01&#59; 95&#37; CI&#44; 2&#46;1&#8211;11&#46;8&#41;&#59; differences were not significant at follow-up&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age&#58; 36&#46;3 &#40;SD&#58; 9&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Treatment&#58; 3 weeks &#40;outpatient&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sex&#58; 6 M&#47;23 W&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Follow-up&#58; at 1 month and at 1 year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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Article information
ISSN: 21735808
Original language: English
DOI:10.1016/j.nrleng.2022.01.008
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