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. 2020 Jan 31;17(3):886.
doi: 10.3390/ijerph17030886.

Content and Delivery of Physical Therapy in Multiple Sclerosis across Europe: A Survey

Kamila Řasová  1 , Jenny Freeman  2 , Davide Cattaneo  3 , Johanna Jonsdottir  3 , Ilse Baert  4 , Tori Smedal  5 , Anders Romberg  6 , Peter Feys  7 , Jose Alves-Guerreiro  8 , Mario Habek  9 , Thomas Henze  10 , Carme Santoyo-Medina  11 , Antonie Beiske  12 , Paul Van Asch  13 , Daphne Bakalidou  14 , Yeliz Salcı  15 , Erieta Dimitrova  16 , Markéta Pavlíková  1 , Ivana Štětkářová  17 , Jana Vorlíčková  18 , Patricia Martinková  18
Affiliations

Content and Delivery of Physical Therapy in Multiple Sclerosis across Europe: A Survey

Kamila Řasová et al. Int J Environ Res Public Health. .

Abstract

Background: Guidelines and general recommendations are available for multiple sclerosis rehabilitation, but no specific guidance exists for physical therapists. Describing aspects of physical therapy content and delivery in multiple sclerosis and its determinants and analysing whether general recommendations connected with physical therapy are implemented in practice is important for interpreting clinical and research evidence. Methods: An online cross-sectional survey of physical therapists specialized in multiple sclerosis (212 specialists from 26 European countries) was used. Results: There was distinct diversity in service delivery and content across Europe. Perceived accessibility of physical therapy varied from most accessible in the Western region, and least in the Southern region. Sixty-four physical therapists adjusted their approach according to different disability levels, less so in the Eastern region. Duration, frequency and dose of sessions differed between regions, being highest in Southern and Western regions. "Hands on treatment" was the most commonly used therapeutic approach in all apart from the Northern regions, where "word instruction" (providing advice and information) prevailed. Conclusions: The content and delivery of physical therapy differs across Europe. Recommendations concerning access to treatment and adjustment according to disability do not appear to be widely implemented in clinical practice.

Keywords: Europe; multiple sclerosis; physical therapy; professional guidelines; questionnaire survey.

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Conflict of interest statement

The Authors declares that there is no conflict of interest.

Figures

Figure 1
Figure 1
Knowledge and use of interventions by physiotherapists in Europe and four European regions.
Figure 2
Figure 2
Perceived accessibility of multiple sclerosis (MS) physiotherapy by region A. In hospital/MS center. B. In the community setting. 10: Available to anyone who needs it, 0: Not available to anyone who needs it.
Figure 3
Figure 3
Characteristics of therapy session by regions. (A). Session duration. (B). Number of sessions per week. (C). Number of sessions per program. (D). Therapy dose (hours).
Figure 4
Figure 4
Therapy session composition by regions.
See this image and copyright information in PMC

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