21 research outputs found
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 (82Â %) and neurology (60Â %), with only 38Â % 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 (60Â %) and in rehabilitation (64Â %) - were responsible for referral to/prescription of physiotherapy. The most frequent reason for referral to/prescription of physiotherapy was the worsening of symptoms (78Â % of centres). Physiotherapists were the most common members of the rehabilitation team; comprising 49Â % of the team in Eastern countries compared to approximately 30Â % in the rest of Europe. Teamwork was commonly adopted; 86Â % of centres based in Western countries utilised the interdisciplinary model, whilst the multidisciplinary model was utilised in Eastern based countries (pâ=â0.046). 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
The impact of the COVID-19 pandemic on physical therapy practice for people with multiple sclerosis: A multicenter survey study of the RIMS network
Background
The impact of the COVID-19 pandemic on physical therapy services for people with multiple sclerosis (pwMS) is unknown. Therefore, the Special Interest Group for Mobility (SIG Mobility) of the European Network for Best Practice and Research in Multiple Sclerosis Rehabilitation (RIMS) has undertaken the initiative to examine the impact of the COVID-19 outbreak on physical therapy services and physical activity participation in pwMS across Europe, Israel and Australia.
Objective
To describe the impact of the COVID-19 outbreak on physical therapy practice from the perspective of the therapist.
Methods
An online survey was developed and conducted from December 2020 to July 2021. The survey (50 questions), included multiple-choice questions and open-ended responses.
Results
In total, 215 physical therapists (PT's) from 9 countries (Australia, Belgium, the Czech Republic, Ireland, Israel, Italy, Norway, Spain, and Turkey) participated in the study. The therapy most affected during the pandemic was aerobic training/conditioning exercises; 33.5% reported that these activities were either reduced or unavailable. In contrast, 15% of the PTs reported increased use of relaxation/mind body techniques and/or fatigue management programs during the pandemic. PTs reported a mixture of positive and negative feelings about the therapeutic sessions offered during the pandemic. Most reported positive feelings included âpositiveâ (26.5%), and âoptimisticâ (24.7%). Negative feelings most frequently reported included âworriedâ (30.7%), and âhesitantâ (20.9%). The PTs reported a 10% decrease in the use of hands-on techniques and a 10% increase in the use of oral instructions when treating moderately and severely pwMS during as compared to before the pandemic.
Conclusion
The COVID-19 pandemic has affected physical therapy services in pwMS internationally in terms of content, frequency of use and format
The use of botulinum toxin A in children with cerebral palsy, with a focus on the lower limb
Purpose The purpose of this review is to clarify the role
of botulinum toxin serotype A (BTX-A) in the treatment of
children with cerebral palsy (CP), with a special focus on
the lower limb.
Background The treatment of spasticity is central in the
clinical management of children with CP. BTX-A blocks
the release of acetylcholine at the motor end plate, causing
a temporary muscular denervation and, in an indirect way,
a reduced spasticity. Children with increased tone develop
secondary problems over time, such as muscle contractures
and bony deformities, which impair their function and
which need orthopaedic surgery. However in these younger
children, delaying surgery is crucial because the results of
early surgical interventions are less predictable and have a
higher risk of failure and relapse. As BTX-A treatment
reduces tone in a selective way, it allows a better motor
control and muscle balance across joints, resulting in an
improved range of motion and potential to strengthen
antagonist muscles, when started at a young age. The
effects are even more obvious when the correct BTX-A
application is combined with other conservative therapies,
such as physiotherapy, orthotic management and casts.
There is now clear evidence that the consequences of
persistent increased muscle tone can be limited by applying
an integrated multi-level BTX-A treatment approach.
Nevertheless, important challenges such as patient selection, defining appropriate individual goals, timing, dosing and dilution, accuracy of injection technique and how to measure outcomes will be questioned. Therefore, ââreflection is more important than injectionââ remains an actual statement.status: publishe