Margaret A MoutvicMayo Clinic, USA
Title: Treatment of functional movement disorders: The best approach
Functional movement disorder (FMD) is a subtype of functional neurologic symptom disorder in which the presenting symptom may be tremor, dystonia, weakness, gait disorder, or other abnormal movement. Functional movement disorders are increasingly being diagnosed secondary to awareness of this condition. Behavioral Shaping Therapy (BeST) is a rehabilitative/retraining, goal-oriented program with intensive physical and occupational therapy developed to treat functional movement disorders.
This is an outpatient rehabilitation program based on the concept of motor-reprogramming and it is provided to appropriate patients following a comprehensive, diagnostic neurological evaluation, including psychiatric/psychological assessment.
Therapeutic interventions include diaphragmatic breathing, muscle relaxation techniques, purposeful motor tasks, stop and reset, body scanning, proprioception training, among others. These strategies serve to interrupt maladaptive motor habits and habituate normal muscle control for correcting gait abnormalities and reducing extraneous movements.
In this presentation, we will discuss functional movement disorders and the BeST program including, comprehensive evaluation and diagnosis, program structure, participation criteria, role of physiatrist, physical, occupational and speech therapy, specific interventions and follow up, and patients outcomes.
Margaret Moutvic, M.D., is an Assistant Professor of Physical Medicine and Rehabilitation. She divides her time between the Neurology and PM&R clinics at the Mayo Clinic. She is Medical Director of the Neurologic Disease Rehabilitation subsection of the department. Her clinical interest include Neurologic Disorders, Motor Neuron Disease, Arthritis, and Geriatrics.
In addition to her clinical practice, Dr. Moutvic is an accomplished leader, actively participating in the PM&R Residency and Fellowship training program. She provides valuable one-on-one education for the next generation of PM&R physicians by allowing them crucial insight into the daily duties of a Physiatrist. She has extensive history as a mentor and is the recipient of several awards including:
- Mayo Medical School for Excellence in Teaching
- Department of Physical Medicine and Rehabilitation Excellence in Clinical Care Award
- Department of Physical Medicine and Rehabilitation Teacher of the Year Award
- Patient Experience Provider Recognition Award
Dr. Moutvic has presented across the United States, most recently presenting on the topics of Shoulder Pain and Weakness, Severe Copper Deficiency, Functional Movement Disorders, and Rehabilitation for Multiple Sclerosis and ALS.