Patrícia Martinková1, Jenny Freeman2, Adéla Drabinová3, Elena Erosheva4, Davide Cattaneo5, Johanna Jonsdottir6, Ilse Baert7, Tori Smedal8, Anders Romberg9, Peter Feys10, Jose Alves-Guerreiro11, Mario Habek12, Thomas Henze13, Carme Santoyo Medina14, Antonie Beiske15, Paul Van Asch16, Daphne Bakalidou17, Yeliz Salcı18, Erieta Nikolikj Dimitrova19, Markéta Pavlíková20, Kamila Řasová21. 1. Department of Statistical Modelling, Institute of Computer Science, Czech Academy of Sciences, Czech Republic. Electronic address: martinkova@cs.cas.cz. 2. Faculty Health and Human Sciences, Plymouth University, Devon PL68BH, United Kingdom. Electronic address: jenny.freeman@plymouth.ac.uk. 3. Department of Statistical Modelling, Institute of Computer Science, Czech Academy of Sciences, and Faculty of Mathematics and Physics, Charles University, Czech Republic. Electronic address: drabinova@cs.cas.cz. 4. Department of Statistics, School of Social Work, and the Center for Statistics and the Social Sciences, University of Washington, Seattle, USA. Electronic address: erosheva@uw.edu. 5. Don Gnocchi Foundation, IRCCS Milan, Larice Lab, Via Capecelatro 66, 20148 Milan, Italy. Electronic address: dcattaneo@dongnocchi.it. 6. Don Gnocchi Foundation, Larice Lab, IRCCS Milan, Via Capecelatro 66, 20148 Milan, Italy. Electronic address: jjonsdottir@dongnocchi.it. 7. Hasselt University, Campus Diepenbeek, REVAL, BIOMED-Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium. Electronic address: ilse.baert@uhasselt.be. 8. Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, and Department of Physiotherapy, Haukeland University Hospital, P.O.Box 1400, 5021 Bergen, Norway. Electronic address: tori.smedal@helse-bergen.no. 9. Masku Neurological Rehabilitation Centre, Physiotherapy, Vaihemäentie 10, PO Box 15, 21251 Masku, Finland. Electronic address: anders.romberg@neuroliitto.fi. 10. Hasselt University, Campus Diepenbeek, REVAL Rehabilitation Research Institute (BIOMED), Agoralaan building A, B-3590 Diepenbeek, Belgium. Electronic address: Peter.Feys@uhasselt.be. 11. School of Health Sciences, Health Research Unit, Polytechnic Institute of Leiria, Campus 2 - Morro do Lena - Alto do Vieiro, 2411-901 Leiria, Portugal. Electronic address: jose.guerreiro@ipleiria.pt. 12. Referral Center for Autonomic Nervous System Disorders, Department of Neurology, University of Zagreb, School of Medicine, University Hospital Center Zagreb, Kispaticeva 12, HR-10000 Zagreb, Croatia. Electronic address: mhabek@mef.hr. 13. PASSAUER WOLF Reha-Zentrum Nittenau, Rehabilitations-klinik für Neurologie-Geriatrie-Urologie, Eichendorffstr. 21 D-93149 Nittenau, Germany. Electronic address: thomas.henze@outlook.com. 14. Neurology-Neuroimmunology Department & Neurorehabilitation Unit. Multiple Sclerosis Centre of Catalonia (Cemcat) Pg. Vall d'Hebron, 119-129. 08035, Barcelona, Spain. Electronic address: csantoyo@cem-cat.org. 15. Nevrologgruppen Oslo. Lillegrensen 7, N-0159 Oslo, Norway. Electronic address: agbeiske@gmail.com. 16. Fit Up, Fitness, and Physiotherapy Center, Mechelsesteen weg 192a, 2550 Kontich, Belgium. Electronic address: paulvanasch@yahoo.com. 17. University of West Attica Athens, 24, Mitrodorou street, 10441 Ak. Pratonos, Athens, Greece. Electronic address: dafbak@otenet.gr. 18. Hacettepe University, Faculty of Health Science, Department of Physical Therapy and Rehabilitation, Ankara, Turkey. Electronic address: fztyeliz@hotmail.com. 19. Institute of Physical Medicine and Rehabilitation, Faculty of Medicine, "Ss Cyril and Methodius" University, Elisie Popovski 28, 1000, Skopje, The former Yugoslav Republic of Macedonia (FYROM). Electronic address: erietand@yahoo.com. 20. Department of Rehabilitation, Third Faculty of Medicine, Charles University, Ruska 87, Prague 10, 100 00, Czech Republic. Electronic address: pavlikova@biostatisticka.cz. 21. Department of Rehabilitation, Third Faculty of Medicine, Charles University, Ruska 87, Prague 10, 100 00, Czech Republic. Electronic address: kamila.rasova@gmail.com.
Abstract
BACKGROUND: A wide variety of interventions exists in physical therapy (PT), but knowledge about their use across different geographical regions is limited. This study investigated the use of PT interventions in people with multiple sclerosis (MS) across Europe. It aimed to determine whether regions differ in applying interventions, and explore whether factors other than regions play a role in their use. METHODS: In an online cross-sectional survey, 212 respondents from 115 European workplaces providing PT services to people with MS representing 26 countries (four European regions) participated. Cluster analysis, Pearson Chi-squared test and a Poisson regression model were used to analyze the data. RESULTS: Thirteen of 45 listed PT interventions were used by more than 75% of centers, while nine interventions were used by less than 25%. For 12 interventions, regions differed markedly in their use. Cluster analysis of centers identified four clusters similar in their intervention use. Cluster assignment did not fully align with regions. While center region was important, center size, number and gender of physical therapists working in the center, and time since qualification also played a role. Cluster analysis exploring the use of the interventions provided the basis for a categorization of PT interventions in line with their primary focus: 1. Physical activity (fitness/endurance/resistance) training; 2. Neuroproprioceptive "facilitation/inhibition"; 3. Motor/skill acquisition (individualized therapy led); 4. Technology based interventions. CONCLUSIONS: To our knowledge this is the first study that has explored this topic in MS. The results broaden our understanding of the different PT interventions used in MS, as well as the context of their use.
BACKGROUND: A wide variety of interventions exists in physical therapy (PT), but knowledge about their use across different geographical regions is limited. This study investigated the use of PT interventions in people with multiple sclerosis (MS) across Europe. It aimed to determine whether regions differ in applying interventions, and explore whether factors other than regions play a role in their use. METHODS: In an online cross-sectional survey, 212 respondents from 115 European workplaces providing PT services to people with MS representing 26 countries (four European regions) participated. Cluster analysis, Pearson Chi-squared test and a Poisson regression model were used to analyze the data. RESULTS: Thirteen of 45 listed PT interventions were used by more than 75% of centers, while nine interventions were used by less than 25%. For 12 interventions, regions differed markedly in their use. Cluster analysis of centers identified four clusters similar in their intervention use. Cluster assignment did not fully align with regions. While center region was important, center size, number and gender of physical therapists working in the center, and time since qualification also played a role. Cluster analysis exploring the use of the interventions provided the basis for a categorization of PT interventions in line with their primary focus: 1. Physical activity (fitness/endurance/resistance) training; 2. Neuroproprioceptive "facilitation/inhibition"; 3. Motor/skill acquisition (individualized therapy led); 4. Technology based interventions. CONCLUSIONS: To our knowledge this is the first study that has explored this topic in MS. The results broaden our understanding of the different PT interventions used in MS, as well as the context of their use.
Authors: Kamila Řasová; Jenny Freeman; Davide Cattaneo; Johanna Jonsdottir; Ilse Baert; Tori Smedal; Anders Romberg; Peter Feys; Jose Alves-Guerreiro; Mario Habek; Thomas Henze; Carme Santoyo-Medina; Antonie Beiske; Paul Van Asch; Daphne Bakalidou; Yeliz Salcı; Erieta Dimitrova; Markéta Pavlíková; Ivana Štětkářová; Jana Vorlíčková; Patricia Martinková Journal: Int J Environ Res Public Health Date: 2020-01-31 Impact factor: 3.390