Functional Neurological Disorder (FND) Treatment: A Multidisciplinary Approach to Recovery

There Is a Way Forward

 A diagnosis of Functional Neurological Disorder (FND) can leave people feeling dismissed, misunderstood, and unsupported. You may have real symptoms—but no structural brain damage. You might hear, "It’s all in your head."

 But we know better. At Exercise Matters, we understand that FND is real, and it is treatable. With a team-based, evidence-based treatment plan—including movement retraining, psychology, education, and support—recovery is possible.

What Is Functional Neurological Disorder?

FND is a condition where there is a disruption in how the brain sends and processes signals to the body, even though brain scans often appear normal.

Symptoms include:

• Limb weakness or tremor

• Non-epileptic seizures (dissociative episodes)

• Difficulty walking

• Jerky movements or functional tics

• Speech or swallowing issues

• Sensory disturbances or fatigue

The Key Pillars of FND Treatment

1. Education and Diagnosis

Understanding the diagnosis is often the first and most important step. Research shows that when people understand FND as a brain miscommunication—not a mystery—they’re more likely to improve.

Evidence: Stone et al. (2010) found that patients who understood their diagnosis were more likely to engage in therapy and recover function.

2. Psychological Therapy

Many people with FND benefit from:

• Cognitive Behavioural Therapy (CBT)

• Trauma-informed approaches

• Mindfulness and acceptance-based therapies

Therapy helps address fear, avoidance, anxiety, trauma, and attentional focus—which often worsen symptoms.

3. Physiotherapy and Exercise Physiology

Movement retraining is essential for recovery. This includes:

• Graded strength and walking practice

• Dual-tasking and distraction training

• Gait retraining and postural work

• Cardiovascular reconditioning

At Exercise Matters, we use structured, patient-led Exercise Physiology to help retrain movement and reduce fear-based avoidance.

4. Occupational Therapy

To support daily function, independence, and pacing. OT may also assist with:

• Sensory retraining

• Fine motor control

• Cognitive fatigue management

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5. Speech Therapy (if needed)

For clients experiencing functional voice loss, speech changes, or swallowing difficulty.

6. Medical and Neurological Oversight

FND should always be diagnosed by a neurologist who can:

• Confirm positive signs of FND (e.g. Hoover’s sign)

• Rule out other conditions

• Provide supportive communication about recovery potential

Why Movement-Based Treatment Matters

The brain learns by doing. Exercise Physiology retrains the nervous system by:

• Reinforcing efficient motor patterns

• Reducing threat-based brain signals

• Restoring normal function without reinforcing disability behaviours

  
  

Key Principles We Use:

• External focus (e.g. stepping toward an object vs "thinking about walking")

• Rhythmic, automatic tasks (e.g. marching, dancing, ball catching)

• Graded exposure to feared movements

• Distraction and dual-tasking to bypass abnormal control

Case Study: Hannah, 25, Diagnosed with FND After Seizures and Weakness

Hannah experienced daily dissociative episodes and could not walk unassisted. She began a program at Exercise Matters including:

• Education around the diagnosis

• Exercise Physiology focused on gait retraining and movement distraction

• Psychological support for anxiety and trauma

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After 8 weeks:

• Her episodes decreased from daily to once per fortnight

• She regained the ability to walk without aids

• She reported higher confidence and returned to part-time work

Frequently Asked Questions

1. Can FND be cured?

FND can improve significantly or go into full remission with the right treatment. Recovery is variable but possible at all stages.

2. Will I need to see more than one therapist?

Usually yes. FND recovery works best with a team approach—neurology, psychology, and physical rehab working together.

3. Is it safe to move if I have symptoms?

Yes. Movement is safe and often essential to retraining normal function. We always work within your comfort zone.

4. Do I need a neurologist’s referral?

Yes—for diagnosis. You can then be referred to our clinic via NDIS, Medicare CDM, or private health.

5. How long does treatment take?

Some see results within weeks; others may take months. It depends on your symptoms, triggers, and consistency with therapy.

FND Treatment Can Be Life-Changing

With the right support, FND doesn’t have to define you. Let us help you build confidence, retrain movement, and reclaim your independence.

📞 Call (07) 5448 3532 🌐 www.exercisematters.healthcare

References:

• Stone J et al. (2010). Functional neurological symptoms: assessment and treatment. BMJ.

• Nielsen G et al. (2015). Physical treatment of functional motor disorders. J Neurol Neurosurg Psychiatry.

• Carson A et al. (2020). FND treatment guidelines. Neurology.