The present study aims to evaluate symptom changes in a heterogeneous cohort 798 patients with complex CNS disorders.

Many chronic health conditions either involve or impact the central nervous system (CNS). It is estimated that nearly one in six of the world's population have a neurological condition, including cerebral palsy, dementia, headache, multiple sclerosis, Parkinson's, traumatic brain injury (TBI), and stroke. Many of these CNS disorders have symptoms including headache, balance problems, confusion, irritability, and fatigue.

From November 2015 to March 2020, 798 (459 men; 339 women; mean age [SD]: 36y [21]) patients with neurological disorders were referred to an outpatient, functional neurology, rehabilitation clinic to complete a 5-day intensive multimodal rehabilitation program utilizing orthoptic, gaze stabilization, neuromuscular re-education, cognitive training, whole body rotation therapy, and photobiomodulation. The primary outcome measures were self-reported rating of headache, balance problems, fatigue, confusion, and irritability evaluated on a 7-point Likert scale (0-6) where 1-2, 3-4, and 5-6 are considered mild, moderate, and severe symptomology, respectively. Results are to be reported as the difference of means (SD) with Cohen’s d effect size and %-change.

In this cohort, headache intensity decreased 0.37 (1.48), corresponding to a 33% decrease with a Cohen’s d of 0.25. Balance problems decreased 0.72 (1.89), corresponding to a 41% decrease with a Cohen’s d of 0.38. Fatigue decreased 0.99 (1.90), corresponding to a 42% decrease with a Cohen’s d of 0.52. Confusion decreased 0.67 (1,59), corresponding to 56% decrease with a Cohen’s d of 0.42. Irritability decreased 0.87 (1.78), corresponding to a 52% decrease with a Cohen’s d of 0.38.

Collectively, the chart-review of this cohort identified a pre-post improvement of self-reported symptoms. We conclude that the relative decrease in symptomology after five days of functional neurology treatment is of clinical and patient relevance, which translates to improved quality of life.