Background and Purpose: 

Motor functional neurological disorder is a prevalent and costly condition at the intersection of neurology and psychiatry that is diagnosed using positive “rule-in” signs. Physical therapy is a first-line treatment and consensus recommendations exist to guide clinical care. Nonetheless, optimal outpatient treatment of adults with functional motor symptoms requires an expanded physical therapy tool kit to effectively guide care.

Summary of Key Points: 

In this article, lessons learned from a physical therapist practicing in a multidisciplinary and interdisciplinary outpatient functional neurological disorder clinic are highlighted. In doing so, we discuss how use of the biopsychosocial model and neuroscience constructs can inform physical therapy interventions. The importance of team-based care and the delivery of physical therapy through video telehealth services are also outlined.

Recommendations for Clinical Practice: 

Use of the biopsychosocial formulation to triage clinical challenges and guide longitudinal care, coupled with application of neuroscience to aid intervention selection, allows for patient-centered physical therapy treatment across the spectrum of functional motor symptoms.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: https://links.lww.com/JNPT/A400).

中文翻译：

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运动功能性神经障碍门诊物理治疗的经验教训

背景与目的： 

运动功能性神经障碍是神经病学和精神病学交叉领域的一种普遍且代价高昂的疾病，使用阳性“规则”标志进行诊断。物理治疗是一线治疗，并存在指导临床护理的共识建议。尽管如此，对具有功能性运动症状的成人进行最佳门诊治疗需要扩展的物理治疗工具包来有效地指导护理。

要点总结： 

在这篇文章中，强调了从在多学科和跨学科门诊功能性神经障碍诊所执业的物理治疗师的经验教训。在此过程中，我们讨论了生物心理社会模型和神经科学结构的使用如何为物理治疗干预提供信息。还概述了基于团队的护理和通过视频远程医疗服务提供物理治疗的重要性。

临床实践建议： 

使用生物心理社会公式对临床挑战进行分类并指导纵向护理，再加上应用神经科学来帮助选择干预措施，可以在功能性运动症状的范围内进行以患者为中心的物理治疗。

视频摘要可从作者那里获得更多见解（请参阅视频，补充数字内容 1，网址为：https ://links.lww.com/JNPT/A400 ）。