A survey of the current physiotherapy management of people with multiple sclerosis

Background: It is estimated that there are over 7,000 people with MS living in Ireland (MS Society 2008). Guidelines and evidence highlight the many benefits to be gained from physiotherapy interventions. However with limited resources (Coote et al 2010) and services for people with MS (PwMS), it is imperative physiotherapy management is effective, appropriate and evidence based. Objectives: To determine what criteria physiotherapists frequently include in subjective and objective assessment for PwMS. To examine the frequency of use of treatments and the use of evidence based practice in treatment choice. Methods: A self-report e-survey was developed and distributed via email to all group members of Physiotherapists with an Interest in MS, Chartered Physiotherapists in Neurology and Gerontology, and Chartered Physiotherapists in Community Care. A survey link was placed in Firsthand and on primary investigators web-page. Data was analysed using descriptive statistics and likert scales. Results: Only 65% of therapists were aware of clinical guidelines for MS. Current MS problems, medical history and active and passive range of movement; were the most frequently assessed domains. The top three treatments used were; patient education, balance and strengthening exercises. Respondents relied heavily on original training (19%) for choosing treatment techniques. Reading research (6%) or reviews (4%) were the least influential. Conclusion: A comprehensive assessment is important in MS management and physiotherapists frequently assess an extensive range of factors. Physiotherapists use a wide variety of treatment techniques when treating PwMS and the importance of exercise and education is evident. Despite reference to clinical guidelines, a lack of evidence based practice was prevalent within this population sample.