Dance/Movement Therapy for Functional Neurological Disorder

King's College London30 enrolled

Overview

Building on evidence for somatic or physical interventions in functional neurological disorder (FND), the goal of this study is to test the feasibility of a structured dance/movement task in individuals with FND, and explore the potential use of somatic or body-based therapies in this population. The primary study outcomes will be the feasibility and acceptability of a structured dance/movement therapy (DMT) intervention for individuals diagnosed with FND. The study will also explore whether this type of intervention has potential to contribute to elevating trust in the body and general wellbeing, alongside reducing functional neurological and dissociative symptoms. Researchers will compare structured dance/movement therapy to a physical exercise/body coordination condition.

Functional neurological disorder (FND) sits in between neurology and psychiatry, including symptoms like tremors, limb weakness, functional seizures, and sensory issues. Previous research has found elevated dissociative symptoms (i.e., feelings of detachment or disconnection from the self or surroundings) and/or dissociative disorder comorbidities (i.e., dissociative identity disorder, dissociative amnesia) in FND populations relative to the general population. There is also emerging evidence for alterations in aspects of bodily awareness in FND, specifically including a lack of trust in the body and an increased tendency or likelihood to distract from bodily sensations, and atypical autonomic reactivity. These alterations may contribute to, or play a role in the experience of, FND symptoms. Dance/movement therapy (DMT) may be a potentially beneficial intervention for disorders characterized by bodily symptoms or feelings of disconnection from the self, including FND. Generally, DMT is based on the premise that psychological and bodily experiences reciprocally influence one another and has been shown to improve health-related psychological outcomes and wellbeing in a range of populations (e.g., fibromyalgia, brain trauma). Previous research has shown promise for body-based approaches for the treatment of dissociation and trauma-related distress, encouraging individuals to attend to their bodies/bodily sensations. Previous research demonstrates reductions in bodily disconnection post-DMT in individuals with Depersonalization-Derealization disorder, a dissociative disorder that, like FND, involves disconnections from the self and surroundings and alterations to bodily awareness (lack of trusting the body, difficulties with attention regulation). Using structured DMT for FND may help to encourage a conscious connection to the body/surroundings in the here and now, as well as a recognition of bodily states and, in turn, an adaptive regulation of them. The feasibility of dance/movement therapy has not yet been tested in FND and may provide new avenues for treatment.

Interventions

Structured dance/movementOTHER

Fifteen participants will be randomly assigned using a computer-generated allocation sequence to the dance/movement intervention. This will involve a combination of light stretching, warming up using contact with a stress ball, and aerobic dance movements which follow the rhythm of a piece of music. It will be accessible to a range of abilities and will take \~30 minutes. This intervention has been developed with the aim of: * Enhancing adaptive bodily awareness, allowing the participant to feel more safe and at home in their body while promoting accurate and non-judgmental detection of bodily signals * Working with rhythms and coordinated movements leading to the elevation of the salience of bodily signals (heartbeat, sweating) in a structured setting - promoting adaptive noticing of signals in the body, not distracting from what one might be feeling. * Helping participants to engage with their body, notice and sense what they're feeling, and feel more comfortable moving their body.

Physical exercise/body coordinationOTHER

Fifteen participants will be randomly assigned to this task. This will involve simple functional stretches, balances and limb coordination exercises and will use only neutral instructions. It will be accessible to a range of abilities and will take \~30 minutes. This task has been developed as the control condition with the following in mind: * Including functional movement matched for level of aerobic intensity to the dance/movement task. * Matching the length of the task and level of contact with the lead researcher/research team. * No prompts or explicit instructions to focus on bodily sensations, the self or body in the present moment, or to move in an expressive way; purely focused on mobility and physical functioning.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Aged 18 or older * Fluency in English language * Normal or corrected eyesight * Primary diagnosis of FND with seizures, motor symptoms, sensory symptoms, or mixed FND symptoms * Participants will be asked to provide proof of FND diagnosis in the form of an existing medical letter from a qualified healthcare professional (not required to be from an NHS service). This will be checked prior to engaging in the screening interview for the study. Exclusion Criteria: * Physical symptoms or disability that would prohibit the participant's ability to engage with the intervention and/or attend the in-person sessions (e.g., upper/lower limb paralysis, seizure frequency \> 10 per day, severe tremor) * A diagnosis of functional cognitive disorder or functional cognitive symptoms only * Current participation in another body-based therapy or intervention for FND - participants currently engaging in some form of body- based therapy, whether self-guided or therapist-guided, will be asked to abstain from these sessions during the course of this study. If this is not feasible, the participant will be excluded from the current study. * Current comorbid diagnosis of a major neurological (e.g., epilepsy, Parkinson's), psychiatric (e.g., schizophrenia, active psychosis, severe alcohol or substance use disorder), or cardiovascular (e.g., coronary artery disease, heart failure) disorder that may impair the participant's ability to participate in the study and confound the results

Outcomes

Primary Outcomes

Feasibility of the intervention: Recruitment

The number/proportion of eligible participants who consent to participate in the study by 29/05/2026

Time frame: Up to 16 weeks

Feasibility of the intervention: Adherence

The number/proportion of in-person visits and mid-point calls attended and completed. The number of days the task was completed during the at-home periods.

Time frame: Up to 20 weeks

Feasibility of the intervention: Withdrawal

The number/proportion of enrolled (consented) participants who withdraw from the study prior to completion.

Time frame: Up to 20 weeks

Feasibility of the intervention: Adverse events

The number and nature of adverse events reported during study participation.

Time frame: Up to 20 weeks

Feasibility of the intervention: Acceptability

Qualitative measures of perceived benefit of the intervention, barriers and facilitating factors, experiences of study procedures.

Time frame: Up to 20 weeks

Secondary Outcomes

Clinical Global Impression - Improvement Scale

This is a one question measure that assesses self-reported current symptom severity relative to study intake. Patients will rate their current functional neurological disorder symptoms using this 7-point scale (1=very much improved; 2=much improved; 3=minimally improved; 4=no change; 5=minimally worse; 6= much worse; 7=very much worse).