The organisation of physiotherapy for people with multiple sclerosis across Europe: a multicentre questionnaire survey

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.PubMedWoSScopu

A study of the parameters of the chronic fatique syndrome and the quality of life in multiple sclerosis patients

Ιntroduction: Multiple sclerosis (MS) is a disease that plagues many people, especiallywomen and an effective treatment does not exist. Fatigue is a hallmark of the disease. Duringthe last decade there is an intense research focusing on the origin of fatigue and its relationshipwith other aspects of the disease.Purpose: The purpose of this prospective study was to investigate the influence ofatmospheric parameters (ambient temperature, the discomfort index) to fatigue and quality oflife of patients with MS.Material and Methods: Two scales for fatigue, the FSS and MFIS were used. For theassessment of depression, the Beck Depression Inventory (BDI-II) was used. The assessmentof quality of life was made by the Greek adaptation of the questionnaire SF-36v2. Four fatiguemeasurements were performed at the end of each season: the day of November, February, Mayand August. In each measurement the patients and the controls filled the questionnaires FSS,MFIS, BDI-II and SF-36V2. The study sample composed of patients (N = 99) and healthycontrols (N = 75) who were recruited from the outpatient clinics of Neurological MedicalSchool of the Universities of Ioannina and Athens.Results: The FSS validation study confirmed that this is a one-dimensional scale, while theanalysis MFIS revealed two factors, cognitive and physical. Both scales had excellent internalreliability (Cronbach a>0.90) Healthy controls exhibited statistically significant fluctuations offatigue during the four seasons, while fatigue in patients remains practically constant. Besidesfatigue, depression, physical functioning and social activity parameters also remain stableduring the year. The multiple linear regression models showed that all three factors (socialfunctioning, physical functioning and depression) were independent predictors of fatigue andtheir contribution depends on the scale used and the season. When the MFIS was applied, the three factors independently associated with fatigue regardless of season, the percentagecontribution of each one separately to the fatigue ranging between 30% -66 % , with thehighest rate regarding depression in August . In the case of FSS, only the physical functioningwas predictor of fatigue in all seasons.Conclusion: This study challenges the concept that fatigue in patients with MS fluctuatesbetween seasons and confirms that more than one scale should be used in assessing fatigue.Future studies may be directed to the field of interaction of parameters coexisting with fatigue,as well as to further investigation of the role of ambient temperature, but with a differentresearch concept and design.Εισαγωγή: Η πολλαπλή σκλήρυνση (ΠΣ) είναι μια νόσος που ταλαιπωρεί πολύκόσμο, κυρίως γυναίκες, και χωρίς αποτελεσματική θεραπεία. Ένα από τα κύριαχαρακτηριστικά της νόσου είναι η κόπωση. Την τελευταία δεκαετία υπάρχει ιδιαίτερααυξημένο ερευνητικό ενδιαφέρον σχετικά με την προέλευση της και τη σχέση της με άλλεςπαραμέτρους της νόσου.Σκοπός: Ο σκοπός της προοπτικής αυτής έρευνας ήταν να διερευνήσει την επίδρασητων ατμοσφαιρικών παραμέτρων (ατμοσφαιρική θερμοκρασία, δείκτης δυσφορίας) στηνκόπωση και στην ποιότητα ζωής των ασθενών με ΠΣ.Υλικό και μέθοδος: Χρησιμοποιήθηκαν δύο κλίμακες μέτρησης για την κόπωση, ηFSS και η MFIS. Για την εκτίμηση της κατάθλιψης χρησιμοποιήθηκε η κλίμακα BeckDepression Inventory (BDI-II). Η εκτίμηση της ποιότητας ζωής έγινε με την ελληνικήδιασκευή του ερωτηματολόγιου SF-36v2. Οι μετρήσεις, τέσσερις στον αριθμό, διεξήχθηκανστο τέλος της κάθε εποχής, δηλαδή, την τελευταία ημέρα του Νοεμβρίου, του Φεβρουαρίου,του Μαΐου, του Αυγούστου. Σε κάθε μέτρηση οι ασθενείς και υγιείς συμπλήρωναν ταερωτηματολόγια της FSS, MFIS, BDI-II και SF-36V2. Το δείγμα της μελέτης αποτελείταιαπό τους συμμετέχοντες ασθενείς (N=99) και υγιείς (N=75) που στρατολογήθηκαν από τα εξωτερικά ιατρεία των Νευρολογικών κλινικών της ιατρικής σχολής των ΠανεπιστημίωνΙωαννίνων και Αθηνών.Αποτελέσματα: Η στάθμιση της FSS επιβεβαίωσε ότι πρόκειται για μονοδιάστατηκλίμακα, ενώ η στάθμιση της MFIS αποκάλυψε δύο παράγοντες, γνωστικό και σωματικό. Καιοι δύο κλίμακες παρουσίασαν εξαιρετική εσωτερική αξιοπιστία (Cronbach a>0,90). Οι υγιείςεκδηλώνουν στατιστικά σημαντικές διακυμάνσεις της κόπωσης κατά τη διάρκεια τωντεσσάρων εποχών, ενώ η κόπωση στους ασθενείς παραμένει πρακτικά σταθερή. Εκτός τηςκόπωσης, η κατάθλιψη, η σωματική λειτουργικότητα και κοινωνική δραστηριότηταπαραμένουν επίσης σταθερές παράμετροι κατά τη διάρκεια του έτους. Τα μοντέλα πολλαπλήςγραμμικής παλινδρόμησης έδειξαν ότι και οι τρεις παράγοντες (κοινωνική λειτουργικότητα,σωματική λειτουργικότητα και κατάθλιψη) αποτελούν ανεξάρτητους προγνωστικούςπαράγοντες της κόπωσης και η συνεισφορά τους εξαρτάται από τη χρησιμοποιούμενηκλίμακα και την εποχή. Όταν χρησιμοποιείται η MFIS και οι τρεις παράγοντες σχετίζονταιανεξάρτητα με την κόπωση όλους τους μήνες, με την ποσοστιαία συμβολή του καθενόςξεχωριστά στην κόπωση να κυμαίνεται από 30%-66%, με το υψηλότερο ποσοστό να αφοράτην κατάθλιψη κατά το μήνα Αύγουστο. Στην περίπτωση της FSS, μόνον η σωματικήλειτουργικότητα αποτέλεσε προβλεπτικό παράγοντα της κόπωσης σε όλες τις εποχές.Συμπέρασμα: Η παρούσα μελέτη αμφισβητεί την αντίληψη ότι η κόπωση στουςασθενείς με ΠΣ εμφανίζει διακυμάνσεις μεταξύ των εποχών και επιβεβαιώνει ότι επιβάλλεταιη ταυτόχρονη χρήση περισσοτέρων της μιας κλίμακας εκτίμησης κόπωσης. Οι μελλοντικέςέρευνες θα πρέπει ίσως να προσανατολιστούν στο πεδίο της αλληλεπίδρασης των παραμέτρωνπου συνυπάρχουν με την κόπωση, καθώς και στην περαιτέρω διερεύνηση του ρόλου τηςατμοσφαιρικής θερμοκρασίας, αλλά με διαφορετικό ερευνητικό σχεδιασμό και αντίληψη

Application of Wearable Sensors Technology for Lumbar Spine Kinematic Measurements during Daily Activities following Microdiscectomy Due to Severe Sciatica

Background: The recurrence rate of lumbar spine microdiscectomies (rLSMs) is estimated to be 5–15%. Lumbar spine flexion (LSF) of more than 10° is mentioned as the most harmful load to the intervertebral disc that could lead to recurrence during the first six postoperative weeks. The purpose of this study is to quantify LSFs, following LSM, at the period of six weeks postoperatively. Methods: LSFs were recorded during the daily activities of 69 subjects for 24 h twice per week, using Inertial Measurement Units (IMU). Results: The mean number of more than 10 degrees of LSFs per hour were: 41.3/h during the 1st postoperative week (P.W.) (29.9% healthy subjects-H.S.), 2nd P.W. 60.1/h (43.5% H.S.), 3rd P.W. 74.2/h (53.7% H.S.), 4th P.W. 82.9/h (60% H.S.), 5th P.W. 97.3/h (70.4% H.S.) and 6th P.W. 105.5/h (76.4% H.S.). Conclusions: LSFs constitute important risk factors for rLDH. Our study records the lumbar spine kinematic pattern of such patients for the first time during their daily activities. Patients’ data report less sagittal plane movements than healthy subjects. In vitro studies should be carried out, replicating our results to identify if such a kinematic pattern could cause rLDH. Furthermore, IMU biofeedback capabilities could protect patients from such harmful movements

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

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 practic

Data_Sheet_1_Quality of life and quality of education among physiotherapy students in Europe.docx

BackgroundThe study of physiotherapy is challenging and can affect the students’ well-being and quality of life. The aim of this study was to describe and compare factors that could affect well-being among students across Europe.MethodsIn this descriptive cross-sectional study using an online questionnaire survey, students of bachelor’s physiotherapy programs from 23 European faculties, from 8 countries, were interviewed on mental health and stress burden, sleep quality, dietary habits, and physical activity.ResultsAlthough 75% of students rated their quality of life positively and 47% were satisfied with their mental health, 65% showed higher levels of stress and 51% described impaired sleep quality. The minimum physical activity of 150 min weekly was described by 79% of students, within which 67% engaged in strengthening twice a week. Students with a higher stress load/worse psychological health also showed worse sleep quality and lower amount of physical activity, women were significantly worse off. In terms of physical activity and sleep quality, students from Finland and Kosovo achieved the best results, while students from Italy, Greece, and Portugal achieved the worst. Students from Italy indicated the greatest dissatisfaction with the organisation of the study system and communication with teachers, while in Kosovo students rated the communication and study organisation the highest. All students had a problem with adhering to nutritional habits. Students from Italy and Spain, with the lowest body mass indexes and weight averages, were closest to the nutrition recommendations.ConclusionWe demonstrated that physiotherapy students are burdened with stress, suffer from sleep disorders, and do not follow the recommendations regarding nutrition nor physical activity. There are significant differences between universities and countries in some aspects.</p

Abstracts of the 9th International Organisation of Physical Therapy in Mental Health Conference

This book contains the abstracts of the papers presented at the 9th International Organisation of Physical Therapy in Mental Health Conference, Organized by the International Organisation of Physical Therapy in Mental Health and Greek Scientific Section “Physiotherapy in Mental Health” of PanHellenic Physiotherapists’ Association, held on 4–6 May 2022. It is the biannual conference of the International Organization of Physical Therapy in Mental Health (IOPTMH), and we answered with success the question: Physiotherapy in mental health; what’s next? The highly qualified scientific program, the reputable presenters, and the venue altogether form a powerful motivation for both physiotherapists and other mental health professionals to attend this conference. Conference Title: 9th International Organisation of Physical Therapy in Mental Health ConferenceConference Theme: Physiotherapy in mental health; what’s next?Conference Date: 4–6 May 2022Conference Location: Crowne Plaza Athens - City Centre Hotel, 50, Michalakopoulou Str. GR 11528 AthensConference Organizer: International Organisation of Physical Therapy in Mental Health and Greek Scientific Section “Physiotherapy in Mental Health” of PanHellenic Physiotherapists’ AssociationConference Secretariat - Public Relations: Alpha Public Relations and Integrated Marketing S.A., 55, Pytheou Str. GR 11743 Athen