What is FND?
FND or Functional Neurological Disorder is an umbrella term for any neurological symptoms that are caused by impairments in the functioning of the nervous system rather than any structural impairments. This means there can be a problem with how the nervous system functions, in the absence of any physical damage to any part of it. A good analogy is to think of the brain and nervous system as a computer – neurological insults such as strokes, MS, or spinal cord injuries are caused by physical damage to some part of the computer (i.e. the hardware), whereas FND is caused by a problem with the software of the computer. Since FND can affect any part of the “software” of the nervous system, one can experience symptoms that affect any part of it. This can include things like weakness, tremor, balance or walking problems, dystonia, myoclonus, and even speech or swallowing problems.
How does physiotherapy help?
A multi-disciplinary approach is often indicated when it comes to treatment, and physiotherapy is one of many interventions that can help FND. Here are some techniques that your physiotherapist may incorporate into your treatment:
Your physiotherapist can help you understand your condition and how/why symptoms may be triggered. Having a better understanding your condition is the first step into breaking down illness beliefs, patterns of learned movement/behaviours. Your physiotherapist is there to build trust with you, encourage you, and provide expert guidance on how to perform each exercise.
2) Diverting attention
Drawing your attention away from yourself can sometimes help to stimulate automatic movement patterns. Distractions can be used as a way to do this in order to retrain your brain to generate automatic movements.
Visualizing specific movement tasks or a pleasant scenario can help to retrain normalized movement in a similar way that diverting attention works.
4) Mirrors and video
These provide visual feedback on movement, task performance, or posture which often appear distorted in the individual’s perspective. With FND, individuals often feel that their motor impairments are much worse than they actually are, and visual feedback can help to correct that mis-match.
5) Graded exercise
An exercise program performed regularly helps to address fatigue and chronic pain symptoms. A graded or gradual approach to exercise is generally recommended. Your physiotherapist can help guide you and provide specific parameters to get the right level of intensity to prevent exacerbation of symptoms, but increase adherence to the program.
– Rebecca Chow, Registered Physiotherapist
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