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Table 3 Schedule of data collection

From: Physio4FMD: protocol for a multicentre randomised controlled trial of specialist physiotherapy for functional motor disorder

Study Procedures Face-to-face assessment Post Treatment telephone call Telephone, mail or online form assessment*
Screening & Baseline Assessment 6 Months 12 Months
Informed consent    
CRF Inclusion/exclusion criteria    
Medical history    
Clinical characteristics    
Assessments Short Form 36  
Functional Mobility Scale  
Revised Illness Perception Questionnaire  
Hospital Anxiety & Depression Scale  
Client Service Receipt Inventory  
EQ-5D-5 L  
Work Productivity & Impairment Questionnaire  
Clinical Global Impression Scale (CGI-I)  
Fatigue State
Confidence in correctness of diagnosis  
Extended Patient Health Questionnaire-15    
Adverse events screen  
Satisfaction with intervention Questionnaire     
Participant description of intervention     
HES data obtained from NHS Digital and eDRIS services covering the previous 18 months    
  1. *6 and 12 month follow up assessments will be completed by the participant's preferred option out of telephone, mail or online form