Pediatric Functional Neurological Symptoms Disorder: Walking Ability and Perceived Exertion Post-Pediatric Rehabilitation

Jana Landa, Maya Gerner, Etzyona Eisenstein and Sharon Barak ()
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Jana Landa: Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children’s Hospital, The Chaim Sheba Medical Center, Ramat Gan 5265601, Israel
Maya Gerner: Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children’s Hospital, The Chaim Sheba Medical Center, Ramat Gan 5265601, Israel
Etzyona Eisenstein: Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children’s Hospital, The Chaim Sheba Medical Center, Ramat Gan 5265601, Israel
Sharon Barak: Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children’s Hospital, The Chaim Sheba Medical Center, Ramat Gan 5265601, Israel

IJERPH, 2023, vol. 20, issue 2, 1-14

Abstract: Background: Adolescents with functional neurological symptoms disorder (FNSD) commonly present walking abnormalities. Walking is influenced by ‘objective’ (e.g., fitness) and ‘subjective’ (e.g., fear) components. Rate of perceived exertion (RPE) reflects the interaction between these two components. This study compared the walking ability and RPE before and after rehabilitation of adolescents with FNSD to adolescents with moderate-to-severe traumatic brain injury (TBI). Factors predicting walking and RPE were also examined. Methods: Adolescents with FNSD ( n = 31) and adolescents with moderate-to-severe TBI ( n = 28) aged 6 to 18 years participated in the study. Participants received a multidisciplinary rehabilitation program. Six-minute walk test (6MWT) and RPE were assessed before and after rehabilitation. Results: At pre-test, the TBI group presented lower RPE than the FNSD group (3.38 ± 2.49 and 6.25 ± 2.71, respectively). In the FNSD group, pre-test 6MWT was a significant predictor of post-test 6MWT (adjusted R 2 = 0.17; p = 0.01). In the TBI group, post-test 6MWT was significantly predicted by both the pre-test 6MWT and age (adjusted R 2 = 0.16; p = 0.04). Conclusions: Prior to the intervention, adolescents with FNSD perceived walking as a more difficult activity than adolescents with TBI. Post-intervention, although the intervention was effective in terms of changes in 6MWT and RPE, the ‘subjective’ component still contributed to the elevated RPE of the FNSD group.

Keywords: somatization; rehabilitation; gait; exertion (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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