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Peer-reviewedCC BY 4.0Frontiers in Neurology

A brief neuromotor-therapy-augmented pathway for pediatric functional movement disorders: a sequential historical cohort study

  • Baglioni Valentina1
  • Notaristefano Ilaria1
  • Maggiore Patrizia1
  • Romano Sara1
  • Galosi Serena1
  • Tinazzi Michele2
  • Geroin Christian3,4
  • Esposito Dario1
4 affiliations
  1. 1Department of Human Neuroscience, Sapienza University of Rome
  2. 2Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona
  3. 3Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona
  4. 4Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona
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Abstract

Background: Pediatric functional movement disorders (FMD) often improve, but access to specialized motor rehabilitation is heterogeneous. We compared two sequential, non-overlapping care periods within one clinical unit: usual care (UC) and a neuromotor-therapy-augmented pathway (NMT-A), which added brief hospital-based neuromotor therapy before community referral.

Methods: This retrospective, non-randomized historical cohort included 17 UC patients (June 2021–January 2023) and 29 NMT-A patients (February 2023–June 2025). The primary outcome was continuous S-FMDRS at 6 months; S-FMDRS-defined motor symptom-free status (score = 0) was secondary. Both were reassessed at 12 months, together with community-treatment engagement.

Results: At 6 months, the adjusted NMT-A-minus-UC S-FMDRS difference was −1.66 points (95% CI, −4.04 to 0.72). Motor symptom-free status occurred in 55.2% versus 5.9% (risk difference, 49.3 percentage points; 95% CI, 21.8 to 66.4), and in 86.2% versus 52.9% at 12 months (risk difference, 33.3 percentage points; 95% CI, 6.5 to 56.8). The pathway-by-time interaction was not significant. Sustained community physical and/or occupational therapy was documented in 75.0% versus 17.6% (RR, 4.25; 95% CI, 1.74–12.46).

Conclusion: The NMT-A pathway-period was associated with more frequent motor symptom-free status and greater continuity of community motor rehabilitation, although the adjusted mean S-FMDRS difference was not statistically significant. Because pathway and calendar period were inseparable, these findings should be interpreted as associations with the overall later care pathway rather than as an isolated effect of NMT.

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Cite

BibTeXRIS
BibTeX
@article{valentina2026brief,
  title = {{A brief neuromotor-therapy-augmented pathway for pediatric functional movement disorders: a sequential historical cohort study}},
  author = {Baglioni Valentina and Notaristefano Ilaria and Maggiore Patrizia and Romano Sara and Galosi Serena and Tinazzi Michele and Geroin Christian and Esposito Dario},
  journal = {Frontiers in Neurology},
  year = {2026},
  month = oct,
  doi = {10.3389/fneur.2026.1968237},
  url = {https://www.frontiersin.org/articles/10.3389/fneur.2026.1968237/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - A brief neuromotor-therapy-augmented pathway for pediatric functional movement disorders: a sequential historical cohort study
AU  - Baglioni Valentina
AU  - Notaristefano Ilaria
AU  - Maggiore Patrizia
AU  - Romano Sara
AU  - Galosi Serena
AU  - Tinazzi Michele
AU  - Geroin Christian
AU  - Esposito Dario
PY  - 2026
DA  - 2026/10/30
JO  - Frontiers in Neurology
DO  - 10.3389/fneur.2026.1968237
UR  - https://www.frontiersin.org/articles/10.3389/fneur.2026.1968237/full
AB  - Background: Pediatric functional movement disorders (FMD) often improve, but access to specialized motor rehabilitation is heterogeneous. We compared two sequential, non-overlapping care periods within one clinical unit: usual care (UC) and a neuromotor-therapy-augmented pathway (NMT-A), which added brief hospital-based neuromotor therapy before community referral.  Methods: This retrospective, non-randomized historical cohort included 17 UC patients (June 2021–January 2023) and 29 NMT-A patients (February 2023–June 2025). The primary outcome was continuous S-FMDRS at 6 months; S-FMDRS-defined motor symptom-free status (score = 0) was secondary. Both were reassessed at 12 months, together with community-treatment engagement.  Results: At 6 months, the adjusted NMT-A-minus-UC S-FMDRS difference was −1.66 points (95% CI, −4.04 to 0.72). Motor symptom-free status occurred in 55.2% versus 5.9% (risk difference, 49.3 percentage points; 95% CI, 21.8 to 66.4), and in 86.2% versus 52.9% at 12 months (risk difference, 33.3 percentage points; 95% CI, 6.5 to 56.8). The pathway-by-time interaction was not significant. Sustained community physical and/or occupational therapy was documented in 75.0% versus 17.6% (RR, 4.25; 95% CI, 1.74–12.46).  Conclusion: The NMT-A pathway-period was associated with more frequent motor symptom-free status and greater continuity of community motor rehabilitation, although the adjusted mean S-FMDRS difference was not statistically significant. Because pathway and calendar period were inseparable, these findings should be interpreted as associations with the overall later care pathway rather than as an isolated effect of NMT.
SN  - 1664-2295
ER  -