Are you curious about the intricate world of Functional Neurological Disorder (FND)? In this guide, we'll delve into the ambulatory complexities of FND and its impact on your ability to walk and move with ease.
Having lived with this illness for about two years (at the time of writing) I've found that the challenges around walking have been more complex than I would've originally expected. My walk went from a strut to what I describe as my 'Raptor Walk'; often walking on my toes with bent knees and jerky movements. With this came the use of a cane, and occasionally a wheelchair, a replacement of all of my high heel shoes for supportive footwear, and hops down stairs to avoid my slow coordination of steps.
A big component of how I adapted was through the use of humour and learning about what was happening to my body. In the spirit of supporting each other, I've included the main concepts that helped me the most when I was first figuring out these changes.
Understanding Functional Neurological Disorder
Functional Neurological Disorder (FND) is a condition that affects the nervous system, leading to a wide array of symptoms that can disrupt daily life. Unlike structural neurological disorders, FND does not stem from identifiable structural abnormalities in the nervous system. Instead, it arises from disruptions in how the brain functions (Stone et al., 2010). Its symptoms are sometimes referred to as a dynamic disability due to the constant changes in severity and impact on daily functioning.
Impact of FND on Ambulation
FND can significantly impact your ambulation, affecting your ability to walk and move freely. Individuals with FND may experience a range of ambulatory challenges, including gait disturbances, muscle weakness, and coordination difficulties. These symptoms can vary in severity and may fluctuate over time, posing obstacles to independence and mobility (Hallett, 2016).
Changes in Ambulation
FND can manifest in various changes that affect ambulation. One example is cogwheel contractions, characterized by jerky movements that disrupt the smoothness of walking. Additionally, balance and coordination may be compromised, leading to unsteadiness and an increased risk of falls. Muscle response may also be affected, resulting in weakness or involuntary movements that interfere with walking (Espay et al., 2018).
Treatment Options for Ambulatory Issues in FND
When it comes to managing ambulatory issues related to FND, a multidisciplinary approach is often recommended. Physical therapy plays a crucial role in addressing gait disturbances and improving mobility. Therapists may utilize techniques such as gait training, balance exercises, and strength training to help you regain control of your movements (Nielsen et al., 2015).
Medication may also be prescribed to manage symptoms such as muscle spasms or pain that may impact ambulation. Additionally, psychotherapy and cognitive-behavioural therapy (CBT) can help you cope with the psychological aspects of living with FND, reducing anxiety and improving overall well-being (Nielsen et al., 2017).
In more severe cases where ambulation is significantly impaired, assistive devices such as canes, walkers, wheelchairs or orthotic braces may be recommended to provide additional support and stability. These devices can help you navigate your environment safely and maintain your independence despite mobility challenges (Espay et al., 2018).
In conclusion, Functional Neurological Disorder can present significant challenges to ambulation, affecting your ability to walk and move freely. However, with the right approach to treatment and support, there is hope in overcoming these obstacles and reclaiming your mobility. By understanding the complexities of FND and exploring effective treatment options, you can pave the way for a brighter future.
References
Espay AJ, Aybek S, Carson A, et al. (2018). Current concepts in diagnosis and treatment of functional neurological disorders. JAMA Neurol, 75(9), 1132-1141.
Hallett M. (2016). Functional (psychogenic) movement disorders—clinical presentations. Parkinsonism Relat Disord, 22(Suppl 1), S149-S152.
Nielsen G, Stone J, Matthews A, Brown M, Sparkes C, Farmer R. (2015). Physiotherapy for functional motor disorders: a consensus recommendation. J Neurol Neurosurg Psychiatry, 86(10), 1113-1119.
Nielsen G, Buszewicz M, Stevenson F, et al. (2017). Randomised feasibility study of physiotherapy for patients with functional motor symptoms. J Neurol Neurosurg Psychiatry, 88(6), 484-490.
Stone J, Carson A, Duncan R, et al. (2010). Who is referred to neurology clinics?—the diagnoses made in 3781 new patients. Clin Neurol Neurosurg, 112(9), 747-751.
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