The effect of individualized sensory retraining on the rehabilitation of adults with functional neurological disorders: An unexplored field in physical therapy practice

Abstract

The purpose of this article is to introduce a new integrated model of physical therapy in managing adults with Functional Neurological Disorder (FND), which is a disabling, common health issue with no form of standardized treatment. The approach includes integrating incongruent lines of evidence through adopting a complete synthesis of the qualitative research of the lived experience of the patient, neurobiological research on sensory perception, and clinical research regarding physical and mental therapy. The primary results of this synthesis argument lead to a paradigm shift towards the participatory model of sensory retraining that rejects pure motor-based rehabilitation. This model is constructed on the base of co-creation, in which the patient-narrative construction and subjective state are the central sequences in creating a treatment alliance and the improvement of treatment compliance. The main ones are the introduction of affordably individualized classical sensory retraining focused on retraining the central nervous system-interpretation, the use of a personalized dental, or sensory diet to enhance self-regulation, and the introduction of what we call the sensory mindfulness to uncouple painful sensations with maladaptive/ unresponsive movements/dissociation reactions.