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Abstract

Functional Neurological Disorder (FND) is associated with significant sensory processing dysfunction that can negatively impact occupational performance and participation in meaningful activities. Although sensory-based strategies are emerging within occupational therapy practice for individuals with FND, there remains limited literature describing how these interventions are systematically integrated into evaluation and treatment planning. The purpose of this case series was to examine the implementation and outcomes of an occupation-based sensory intervention approach within an outpatient neurorehabilitation setting.

A descriptive non-experimental observational design with retrospective analysis of clinical documentation and patient outcomes was utilized. Five individuals with neurologist-confirmed FND who completed occupational therapy plans of care were included. All participants completed the Adolescent/Adult Sensory Profile to guide individualized intervention planning. Outcome measures were selected based on presenting symptoms and included the Canadian Occupational Performance Measure (COPM), QuickDASH, Nine Hole Peg Test, Box and Block Test, Functional Dexterity Test, and Jamar Dynamometer. Interventions incorporated sensory modulation strategies, co-regulation techniques, environmental adaptations, grounding strategies, and integration of sensory supports into meaningful occupations and daily routines.

Four of five participants demonstrated partial or complete cessation of FND symptoms following intervention. Improvements were observed across functional outcome measures, including dexterity, grip strength, upper extremity function, and occupational satisfaction. All participants demonstrated sensory processing differences in one or more quadrants of the Adolescent/Adult Sensory Profile, most commonly low registration, sensory sensitivity, and sensory avoidance. Therapists reported successful integration of the sensory-based protocol into routine occupational therapy practice through collaborative clinical reasoning and individualized treatment planning.

Findings suggest that occupation-based sensory strategies may support symptom regulation, functional engagement, and participation outcomes for individuals with FND. This case series contributes preliminary evidence for the feasibility and clinical utility of sensory-informed occupational therapy interventions and highlights the need for larger studies to develop evidence-based clinical practice guidelines for sensory-based approaches in FND rehabilitation.

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