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Jonsdottir J, Santoyo-Medina C, Kahraman T, Kalron A, Rasova K, Moumdjian L, Coote S, Tacchino A, Grange E, Smedal T, Arntzen EC, Learmonth Y, Pedulla L, Quinn G, Kos D. Changes in physiotherapy services and use of technology for people with multiple sclerosis during the COVID-19 pandemic. Mult Scler Relat Disord 2023; 71:104520. [PMID: 36724646 DOI: 10.1016/j.msard.2023.104520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/04/2023] [Accepted: 01/13/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND The COVID-19 pandemic has led to reorganization or reduction of neurorehabilitation services for people with multiple sclerosis (PwMS). The aim of this study was to explore the changes in the organizational framework and technology usage in physiotherapy services for PwMS during the COVID-19 pandemic. METHODS This international cross-sectional survey study was designed, developed, and disseminated by RIMS European Network for Best Practice and Research in Multiple Sclerosis Rehabilitation. Physiotherapists from nine countries (Australia, Belgium, Czech Republic, Ireland, Israel, Italy, Norway, Spain, Turkey) who provided physiotherapy services to PwMS, were invited to complete an online survey to compare physiotherapy delivery to PwMS prior to and during the pandemic period. RESULTS The survey was completed by 215 physiotherapists. Accessibility, the average number, length and perceived effectiveness of physiotherapy sessions provided to PwMS were significantly reduced during the COVID-19 pandemic (p=0.001). Physiotherapists increased the advice of mobile apps, recorded videos for rehabilitation and exercise websites during the pandemic (p<0.001) while the use of telerehabilitation and virtual reality technology did not change. CONCLUSION There was of a reduction in the number, duration and perceived effectiveness of rehabilitation sessions for people with multiple sclerosis during the COVID-19 pandemic while use of remote technologies for physiotherapy did not change. To ensure the continuity of physiotherapy for PwMS with complex healthcare needs also during pandemics, the provision of guidelines and training in telehealth technologies in professional education becomes crucial.
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Affiliation(s)
| | - Carme Santoyo-Medina
- Neurology-Neuroimmunology Department & Neurorehabilitation Unit, Multiple Sclerosis Centre of Catalonia (Cemcat), Barcelona, Spain; Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, C/ Josep Trueta sn, 08195 Sant Cugat del Vallès, Barcelona, Spain.
| | - Turhan Kahraman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey.
| | - Alon Kalron
- Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, and Sagol School of Neuroscience, Tel-Aviv University, Israel; Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Israel
| | - Kamila Rasova
- Department of Rehabilitation, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lousin Moumdjian
- UMSC Hasselt, Pelt, Belgium; REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium; IPEM Institute of Psychoacoustics and Electronic Music, Faculty of Arts and Philosophy, Ghent University, Ghent, Belgium.
| | - Susan Coote
- Centre of Physical Activity for Health, Health Research Institute, University of Limerick, Limerick, Ireland; Multiple Sclerosis Society of Ireland and Physical Activity for Health Research Centre, Ireland.
| | - Andrea Tacchino
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genova, Italy.
| | - Erica Grange
- CRRF "Mons. L. Novarese", Moncrivello (VC), Italy
| | - Tori Smedal
- Department of Physiotherapy, Haukeland University Hospital, Helse Bergen, Bergen, Norway,; Department of Neurology, Multiple Sclerosis Competence Centre, Haukeland University Hospital, Helse Bergen, Bergen, Norway.
| | | | - Yvonne Learmonth
- Discipline of Exercise Science, Murdoch University, Murdoch, Australia; Centre for Molecular Medicine and Innovative Therapeutics, Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, Australia; Perron Institute for Neurological and Translational Science, Nedlands, Australia.
| | - Ludovico Pedulla
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy.
| | - Gillian Quinn
- Physiotherapy Department, St. James's Hospital, Dublin, Ireland
| | - Daphne Kos
- Department of Rehabilitation Sciences, KU Leuven, Leuven 1501-3001, Belgium; National MS Center, Melsbroek, Belgium.
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Fortunato R, van der Maas NA, Biland-Thommen U, Kaufmann M, Sieber C, Kamm CP, Zecca C, Gobbi C, Chan A, Calabrese P, Kesselring J, von Wyl V. Physiotherapy use and access-barriers in persons with multiple sclerosis: A cross-sectional analysis. Mult Scler Relat Disord 2020; 48:102710. [PMID: 33370648 DOI: 10.1016/j.msard.2020.102710] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 12/08/2020] [Accepted: 12/20/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Physiotherapy may alleviate many multiple sclerosis (MS) symptoms, yet very little is known about physiotherapy accessibility and possible barriers in persons with MS (pwMS). We therefore aimed to elucidate physiotherapy use and possible access-barriers using data from 1493 pwMS from the Swiss Multiple Sclerosis Registry (SMSR), a patient-centered, longitudinal, observational MS study. METHODS We used data of the SMSR to investigate the question at hand in a multivariable logistic regression model with regularly receiving physiotherapy (yes/no) as the outcome. Potential explanatory variables were investigated following an AIC-driven model selection approach and consisted of a priori specified socio-demographic variables, health status, and personal or social mobility variables. As a last step, the impact of physiotherapist supply on regular use was assessed in the final model. Missing data were handled by multiple imputation (main analysis), and complete case sensitivity analyses were performed. RESULTS The main analysis included 1493 participants. In the multivariable logistic regression, positive associations were found between the use of physiotherapy and the following variables: having a primary-progressive MS (Odds Ratio (OR) [95% Confidence Intervals] 1.97 [1.18; 3.29]), being more severely impaired (EDSS 4-6.5 OR 1.84 [1.16; 2.91]), higher number of current symptoms (1 OR 3.31 [1.63; 6.74], 2-3 OR 3.43 [1.8; 6.53], 4-5 OR 4.44 [2.28; 8.66], 6-7 OR 4.06 [1.90; 8.70], 8-9 OR 3.87 [1.71; 8.75], being on disability pension (OR 1.75 [1.24; 2.46], or having applied for it OR 2.25 [1.31; 3.85]), having gait problems (OR 1.58 [1.11; 2.23]), having been in a rehabilitation clinic in the past 12 months (OR 4.43 [2.17; 9.03]), and currently being on disease-modifying treatment (OR 1.61 [1.12; 2.31]). Negative associations were found for a higher quality of life (OR 0.92 [0.85; 0.98]), working more than 80% (OR 0.47 [0.30; 0.75]) and being from the French language region (OR 0.66 [0.47; 0.94]). No association between physiotherapist supply and regular physiotherapy use was detected. DISCUSSION In a large, Swiss-based MS population, little evidence for socio-demographic barriers to physical therapy was found. Physiotherapy uptake was higher among pwMS with more impairments, lower health-related quality of life, or who have been discharged recently from inpatient rehabilitation. The uptake differences by language region warrant further investigations.
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Affiliation(s)
- Remo Fortunato
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland; Department of Health Sciences and Technology, ETH Zurich, Zürich, Switzerland
| | | | | | - Marco Kaufmann
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
| | - Chloé Sieber
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
| | - Christian P Kamm
- Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland; Neurocentre, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Chiara Zecca
- Faculty of biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland; Department of Neurology, Multiple Sclerosis Center (MSC), Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Claudio Gobbi
- Faculty of biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland; Department of Neurology, Multiple Sclerosis Center (MSC), Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Andrew Chan
- Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland
| | - Pasquale Calabrese
- Division of Molecular and Cognitive Neuroscience, University of Basel, Basel, Switzerland
| | - Jürg Kesselring
- Department of Neurology and Neurorehabilitation, Rehabilitation Center, Valens, Switzerland
| | - Viktor von Wyl
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland.
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Tacchino A, Brichetto G, Zaratin P, Battaglia MA, Ponzio M. Multiple sclerosis and rehabilitation: an overview of the different rehabilitation settings. Neurol Sci 2017; 38:2131-2138. [DOI: 10.1007/s10072-017-3110-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 09/05/2017] [Indexed: 12/28/2022]
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Rasova K, Freeman J, Martinkova P, Pavlikova M, Cattaneo D, Jonsdottir J, Henze T, Baert I, Van Asch P, Santoyo C, Smedal T, Beiske AG, Stachowiak M, Kovalewski M, Nedeljkovic U, Bakalidou D, Guerreiro JMA, Nilsagård Y, Dimitrova EN, Habek M, Armutlu K, Donzé C, Ross E, Ilie AM, Martić A, Romberg A, Feys P. The organisation of physiotherapy for people with multiple sclerosis across Europe: a multicentre questionnaire survey. BMC Health Serv Res 2016; 16:552. [PMID: 27716390 PMCID: PMC5053346 DOI: 10.1186/s12913-016-1750-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 09/14/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Understanding the organisational set-up of physiotherapy services across different countries is increasingly important as clinicians around the world use evidence to improve their practice. This also has to be taken into consideration when multi-centre international clinical trials are conducted. This survey aimed to systematically describe organisational aspects of physiotherapy services for people with multiple sclerosis (MS) across Europe. METHODS Representatives from 72 rehabilitation facilities within 23 European countries completed an online web-based questionnaire survey between 2013 and 2014. Countries were categorised according to four European regions (defined by United Nations Statistics). Similarities and differences between regions were examined. RESULTS Most participating centres specialized in rehabilitation (82 %) and neurology (60 %), with only 38 % specialising in MS. Of these, the Western based Specialist MS centres were predominately based on outpatient services (median MS inpatient ratio 0.14), whilst the Eastern based European services were mostly inpatient in nature (median MS inpatient ratio 0.5). In almost all participating countries, medical doctors - specialists in neurology (60 %) and in rehabilitation (64 %) - were responsible for referral to/prescription of physiotherapy. The most frequent reason for referral to/prescription of physiotherapy was the worsening of symptoms (78 % of centres). Physiotherapists were the most common members of the rehabilitation team; comprising 49 % of the team in Eastern countries compared to approximately 30 % in the rest of Europe. Teamwork was commonly adopted; 86 % of centres based in Western countries utilised the interdisciplinary model, whilst the multidisciplinary model was utilised in Eastern based countries (p = 0.046). CONCLUSION This survey is the first to provide data about organisational aspects of physiotherapy for people with MS across Europe. Overall, care in key organisational aspects of service provision is broadly similar across regions, although some variations, for example the models of teamwork utilised, are apparent. Organisational framework specifics should be considered anytime a multi-centre study is conducted and results from such studies are applied.
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Affiliation(s)
- Kamila Rasova
- Department of rehabilitation, Third Faculty of Medicine, Charles University in Prague, Ruska 87, Prague 10, 100 00, Czech Republic. .,Third Faculty of Medicine, Charles University in Prague, Ruska 87, Prague 10, 100 00, Czech Republic.
| | - Jenny Freeman
- Faculty of Health and Human Science, Plymouth University, Playmouth, PL6 8BH, England
| | - Patricia Martinkova
- Institute of Computer Science, Academy of Sciences of the Czech Republic, Pod Vodarenskou vezi 2, Prague 8, 182 07, Czech Republic
| | - Marketa Pavlikova
- Third Faculty of Medicine, Charles University in Prague, Ruska 87, Prague 10, 100 00, Czech Republic
| | - Davide Cattaneo
- Don Gnocchi Foundation, Larice Lab, Santa Maria Nascente, Via Capecelatro 66, 20148, Milan, Italy
| | - Johanna Jonsdottir
- Neurorehabilitation at the Don Gnocchi Foundation, Larice Lab, Santa Maria Nascente, Via Capecelatro 66, 20148, Milan, Italy
| | - Thomas Henze
- PASSAUER WOLF Reha-Zentrum Nittenau, Rehabilitations klinik für Neurologie-Geriatrie-Urologie, Eichendorffstr. 21, D-93149, Nittenau, Germany
| | - Ilse Baert
- Hasselt University, Campus Diepenbeek, REVAL Rehabilitation Research Institute (BIOMED), Agoralaan building A, B-3590, Diepenbeek, Belgium
| | - Paul Van Asch
- Fit Up, Fitness- and Physiotherapy Center, Mechelsesteen weg 192a, 2550, Kontich, Belgium
| | - Carme Santoyo
- Cemcat, Neurorehabilitation Unit, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Tori Smedal
- Department of Neurology, Norwegian Multiple Sclerosis Competence Centre, Haukeland University Hospital, P.O. Box 1400, 5021, Bergen, Norway.,Department of Physiotherapy, Haukeland University Hospital, P.O. Box 1400, 5021, Bergen, Norway
| | | | | | | | - Una Nedeljkovic
- Clinic for physical medicine and rehabilitation, Clinical Center of Serbia, Pasterova 2, 11000, Belgrade, Serbia
| | - Daphne Bakalidou
- Technological Educational Institute of Athens, 24, Mitrodorou street, Ak. Pratonos, 10441, Athens, Greece
| | - José Manuel Alves Guerreiro
- School of Health Sciences, Health Research Unit, Polytechnic Institute of Leiria, Campus 2 - Morro do Lena - Alto do Vieiro, 2411-901, Leiria, Portugal
| | - Ylva Nilsagård
- Faculty of Medicine and Health, Örebro University Region, SE- 701 82, Örebro, Sweden
| | - Erieta Nikolikj Dimitrova
- Institute of Physical Medicine and Rehabilitation, Faculty of Medicine, "Ss Cyril and Methodius" University, Elisie Popovski 28, 1000, Skopje, Macedonia, Republic of The former Yugoslav
| | - Mario Habek
- Referral Center for Demyelinating Diseases of the Central Nervous System University Department of Neurology Zagreb School of Medicine and University Hospital Center, Kispaticeva 12, HR-10000, Zagreb, Croatia
| | - Kadriye Armutlu
- Physical Therapy and Rehabilitation departmant of Health Science Faculty, Hacettepe University, Ankara, Turkey
| | - Cécile Donzé
- Groupe Hospitalier de l'institut Catholique de Lille, Department of physical Medicine and Rehabilitation hospital Saint Philibert, Faculté Libre de Médecine, Univ Nord de France, F-59000, Lille, France
| | - Elaine Ross
- St. James's Hospital, St. James's street, Dublin 8, Ireland
| | - Ana Maria Ilie
- "Elias" University Emergency Hospital, 17 Marasti Bulevard, Bucharest, 01146, Romania
| | - Andrej Martić
- Divison of Neurology, Neurorehabilitation unit, University Medical Centre Ljubljana, Zaloška 2, 1000, Ljubljana, Slovenia
| | - Anders Romberg
- Masku Neurological Rehabilitation Centre, Physiotherapy, Vaihemäentie 10, PO Box 15, 21251, Masku, Finland
| | - Peter Feys
- Hasselt University, Campus Diepenbeek, REVAL Rehabilitation Research Institute (BIOMED), Agoralaan building A, B-3590, Diepenbeek, Belgium
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Řasová K, Martinkova P, Cattaneo D, Jonsdottir J, Henze T, Baert I, Van Asch P, Santoyo C, Smedal T, Małgorzata S, Freeman J, Romberg A, Feys P. Physical therapy in multiple sclerosis differs across Europe: information regarding an ongoing study. J Int Med Res 2014; 42:1185-7. [PMID: 25116941 DOI: 10.1177/0300060514540249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
| | - Patricia Martinkova
- Institute of Computer Science, Academy of Sciences of the Czech Republic, Pod Vodarenskou vezi 2, Prague 8, 182 07, Czech Republic
| | - Davide Cattaneo
- Don Gnocchi Foundation, Larice Lab, Santa Maria Nascente, Via Capecelatro 66, 20148 Milan, Italy
| | - Johanna Jonsdottir
- Neurorehabilitation at the Don Gnocchi Foundation, Larice Lab, Santa Maria Nascente, Via Capecelatro 66, 20148 Milan, Italy
| | - Thomas Henze
- PASSAUER WOLF Reha-Zentrum Nittenau, Rehabilitationsklinik für Neurologie-Geriatrie-Urologie, Eichendorffstr. 21 D-93149 Nittenau, Germany
| | - Ilse Baert
- Hasselt University, Campus Diepenbeek, REVAL Research Institute (BIOMED), Agoralaan building A, B-3590 Diepenbeek, Belgium
| | - Paul Van Asch
- Fit Up, Fitness- and Physiotherapy Center, Mechelsesteenweg 192a, 2550 Kontich, Belgium
| | - Carme Santoyo
- CEMCat. Neurorehabilitation Unit. Passeig de la Vall d'Hebron, 119, 08035 Barcelona, Spain
| | - Tori Smedal
- Norwegian Multiple Sclerosis Competence Centre, Department of Neurology/Department of Physiotherapy, Haukeland University Hospital, Jonas Liesvei 65, 5021 Bergen, Norway
| | | | - Jenny Freeman
- Reader in Physiotherapy, Plymouth University, Devon PL6 8BH, UK
| | - Anders Romberg
- Masku Neurological Rehabilitation Centre, Physiotherapy, Vaihemäentie 10, PL 15, 21251 Masku, Finland
| | - Peter Feys
- Hasselt University, Campus Diepenbeek, REVAL Research Institute (BIOMED), Agoralaan building A, B-3590 Diepenbeek, Belgium
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