Sofia I Hernandez Torres, Austin Ruiz, Lawrence Holland, Ryan Ortiz, Eric J Snider
Evaluation of Deep Learning Model Architectures for Point-of-Care Ultrasound Diagnostics
Bioengineering (Basel, Switzerland)
functional motor disorderthe motor variant functional neurological disorderis disabling condition commonly associated poor health outcomes pathophysiological models inspired new treatment approaches specialist physiotherapy although evidence large randomised controlled trials absent aimed assess clinical effectiveness specialist physiotherapy intervention functional motor disorder compared treatment usual pragmatic multicentre phase 3 randomised controlled trial 11 hospitals england scotland adults clinically definite diagnosis functional motor disorder diagnosed neurologist included participants randomly assigned 11 stratified site using remote webbased application either specialist physiotherapy protocolised intervention nine sessions plus followup treatment usual referral local community neurological physiotherapy individuals working data collection analysis masked treatment allocation primary outcome physical functioning domain 36item short form health questionnaire sf36 12 months randomisation primary analysis followed modified intentiontotreat principle using complete case approach participants unable receive randomised treatment due suspension healthcare services covid19 pandemic excluded primary analysis trial registered international standard randomised controlled trial registry isrctn56136713 completed recruitment occurred oct 19 2018 march 11 2020 pausing covid19 lockdown resuming aug 3 2021 jan 31 2022 355 participants enrolled 179 randomly assigned specialist physiotherapy 176 treatment usual 89 participants excluded primary analysis due covid19 interruption treatment 27 assigned specialist physiotherapy 62 treatment usual accounting withdrawals n11 loss followup n14 primary analysis included data 241 participants 138 91 assigned specialist physiotherapy 103 90 assigned treatment usual physical functioning assessed sf36 differ significantly groups adjusted mean difference 35 95 ci 23 93 p023 serious adverse events related trial interventions 35 serious adverse events recorded specialist physiotherapy group 24 participants 170 24 serious adverse events recorded treatment usual group 18 participants 170 one death occurred specialist physiotherapy group cause death recorded suicide considered unrelated specialist physiotherapy although participants assigned specialist physiotherapy selfrated motor symptoms improved better scores subjective measures mental health intervention result better selfreported physical functioning 12 months specialist community neurological physiotherapy appeared safe valued treatment selected patients functional motor disorder future research continue refine interventions people functional motor disorder develop evidencebased methods guide treatment triage decisions national institute health care research health technology assessment programme